Continuing school occupational therapy services is a team decision.

II is with great interest that I read "Direct Occupational Therapy in the School System: When Should We Terminate?" by Susan G. Nesbit (AJOT, September 1993, pp 845-847) and "Will I See You in September? A Question of Educational Relevance" by Anita C. Bundy (AJOT, September 1993, pp. 848-850). I have worked in public schools for 11 years. I have experienced the stress and challenges of school practice. Some of my colleagues have Jeft practice because of the dissonance between our clinically hased training and the educational culture in which we work. School practice is significantly different from other areas of occupational therapy practice. II is subject to houndaries and interpretations set by law, namely the Individuals With Disahilities Education Act (IDEA) (Puhlic Law 101-476). Occupational therapy as related service does not stand on its own. Decisions concerning the student's educational program, goals, and services are team decisions with parents haVing the right to appeal any decision. (Interestingly, due process is not addressed hy either author). This is why I disagree with exit criteria. Exit criteria do not adequately address educational relevance, teaming, or future plans for the student (transition planning). Schoolbased occupational therapy should not :md cannot operate isolated from the educational selling and with separate goals. It must have some connection to Sl udents' school needs. Whether a Student needs occupational therapy services to henefit from his or her educational program must be a team decision. The henefits of the team decisions are an integrated relevant program that appropriately addresses the st udent's needs. The question of whether the Student has had enough direCt occupational therapy should be answered through the individualized education program (JEP) process. I realize that this does not alwavs occur due to fauors beyond our control (e.g., flarents reluctant [0 let g<> of a free service their children are "entitlecl" to or overworked teachers \vho see us as an extra pair of hands). Dr-. Bundy points out that educational relevance is complex. I agree. [ aLso helieve that school-based occupational theraflists must take a proactive stance striving for educational relevance through best flractices that hegin at referral and continue through assessment, goal identification, and intervention planning levels. For example, the instructional goals we sUPflOrt must reflect an integrated, unified team approach and our intervention rlans must address the student's educational goals in the least restrictive manner. We must have the student's future in mind. Planing and training for the students' transition from school to work must start at the elementary-school level to assure self-esteem and empowerment and preparation for adult life. Using a forward-thinking framework that considers the needs of students acros' the life span can assist us with teaming with teachers and parents. The specialty of school-based rractice within occupational therapy is coming into its own. The establishment of the School System Special Interest Section gives us a forum in which to exchange ideas and information and continue to develop educationallv relevant practice. I look forward to it and hope more school-based occupational therapists will write articles such as those hv Ms. Neshit and Dr. Bundy. Miriam Struck MA, OTRIL Silver Spring, Maryland