Certification of occupational therapists in the public schools

Certification Of Occupational Therapists in the Public Schools: The Wisconsin Experience (schools, OT education) Alice Punwar Eugene Wendt Alice Punwar, M.S., OTR, FAOTA, is a Professor in the Occupational Therapy Program, University of Wisconsin, Madison. he dramatic increase in the numbers of handicapped children served by the public schools because of federal and state legislation has made enormous programatic changes necessary and has led to the hiring of more occupational and physical therapists in public school systems. The number of occupational therapists employed in the schools was tracked by Mitchell and Lindsey (I). In their article, they referred to two surveys conducted by the AOTA. The 1973 survey found 674 occupational therapists were employed in the schools and the 1977 survey located approximately 2,000 (I). The most significant ca use for this large increase was the enactment of Public Law94-142 (2). This law mandated a free public education for all handicapped children and ensured that the necessary support services such as occupational therapy were provided so that the children could reap maximum benefits from their individually designed educational programs. One immediate problem was the manpower to fill these positions and the related issue of qualifications for employment in school programs. Some states began to require that public school therapists meet T Eugene Wendt, M.S., OTR, is an occupatIonal therapist employed by the Madison Metropolitan School District, Madison, WisconsIn. Both authors were members of the committee that developed certification standards for public school occupational therapists in Wisconsin. The history of public school certification for occupational and physical therapists is reviewed. The process used to develop the current standards for certification of public school occupational therapists in Wisconsin and the standards that resulted are described. The implicatIons of school certification requirements are discussed in terms of basic professional education In occupational therapy, and recommendations are made regarding the establishment of certification standards for school-based therapists. The American Journal of Occupational Therapy Downloaded From: http://ajot.aota.org/ on 07/23/2018 Terms of Use: http://AOTA.org/terms 727 minimum standards of competency to ensure quality practice in school settings. In an earl y article on certification of public school occupational therapists, Reed described the method used in the State of Washington to develop certification standards that would measure the competence of the practitioner (3). This effort, initiated in 1967, was probably the first attempt by occupational therapists working with a state department of education to establish certification standards unique to occupational therapy. Few states followed Washington's lead, however, and many continued to certify therapists in the same way they certified teachers, if certification was required at all. The issue of qualifications for school-based therapists continued to arise as other states passed mandatory special education laws. Local and state educational agencies began to look more closely at the issue of special certification req uiremen ts for pu blic school personnel. Development of Wisconsin School Certification Some of the first occupational therapists hired in Wisconsin schools were requested to meet the teacher certification requirements (18 credits of undergraduate course work in education). Passing the AOTA certification examination and becoming a registered occupational therapist was considered a sufficient qualification until the early 1970s. Chapter liS of the Wisconsin Statutes was passed by the State Legislature in 1973 and mandated the public school education of all handicapped children between the ages of 3 and 21 years. Although the law did not define certification standards, it clearly stated that occupational and physical therapists would be certified by the state Department 728 ties to prepare their graduates for employment in public school programs. With the passage of Chapter 115, the Wisconsin Occupational Therapy Association (WOTA) formed an ad hoc committee to consider the implementation of this act and its effect on occupational therapists employed in public schools. When mandatory certification became an issue, the charge of this committee was expanded to include assisting the Department of Public Instruction with the development of certification standards for public school occupational therapists and reporting the progress of this effort back to the state association. Establishment of Certification Standards of Public Instruction and that such certification would be mandatory (4). This made certification an urgent issue if local educational agencies were to receive the 70 percent salary reimbursement specified under Sl15.88 (4). Since certification had become mandatory, it seemed logical to write standards that would help prepare therapists to work in a public school setting. The idea that state licensure or national certification assured competency was challenged. These "certifications" reconfirmed that the individual was indeed an occupational or physical therapist, but in no way assured that he or she was qualified to practice in a public school. It was believed that an additional credential was needed to give such assurance, and to oblige colleges and universi- November 1980, Volume 34, No. 11 Downloaded From: http://ajot.aota.org/ on 07/23/2018 Terms of Use: http://AOTA.org/terms During the summer of 1976, a representative of the Wisconsin Department of Public Instruction (DPI) formed a committee to revise the certification standards for public school occupational and physical therapists. Initial meetings of the committee focused on the identification of competencies needed by occupational and physical therapists in public school programs and later discussed relevant curriculum content within colleges and universities that could be expected to provide some of the needed competencies. The DPI members of the committee as well as the special education administrators felt strongly that initial certification requirements should give some assurance that the candidate showed a basic understanding of exceptional children as seen in the public school population and a working knowledge of how therapy programs relate to the overall educational objectives for the child. Public hearings on the proposed certification standards revealed that strong differences of opinion existed among state occupational and physical therapists. The proposed 15credit requirement was believed to bean unrealistic demand. The physical therapists, who were already licensed by the sta te for the practice of physical therapy, challenged a separa te licensi ng proced ure for practice in public schools, feeling that their general state licensure was adequate for this purpose. The testimony received at the public hearings was considered by the committee, which voted to accept a reduction in the number of semester credits required for certification. A total of nine semester credits, in content areas from special education, was approved. The final version of the certifica tion requirements included the following statement: Effective July I, 1978, School Occupational Therapists not certifiable under (a) must meet the following criteria: I. Licensure as an occupational therapist by the appropriate professional licensing authority. 2. Completion of a minimum of nine semester credits in professional special education such as: Psychology or nature of exceptional children; Ed uca tional assess men tl diagnosis of the handicapped; Language development for the exceptional child; Language disorders; Behavior modification for the exceptional child; Introductory course to a specific area of exceptionality; Adaptive physical education; Guidance of exceptional children; Early childhood handicapped education; Elective(s) in special education (5). A similar proposal was drafted for physical therapy certification. At this point, the physical therapists, led by the officers of the Wisconsin chapter of the American Physical Therapy Association, withdrew from the joint efforts of occupational therapists and physical therapists for school-based certification. A new committee was formed to develop physical therapy certification standards based on performance competencies. The revised certification standards for occu pa tional thera pis ts went into effect on July I, 1978. Although there continued to be mixed feelings about the appropriateness of the standards, most school therapists appeared to meet them with little difficulty. Therapists employed by a school district between 1974 and 1977 who had at least two semesters of experience were grandfathered into the new requirements. Those with less than two semesters' experience were issued one-year licenses with the expectation that two semesters of experience would be completed by 1978. They then became eligible for the three-year license. Therapists employed after July 1,1978 were subject to the new nine-credit rule. Through their ad hoc liaison committee, the WOTA was kept informed of progress in establishing certification standards. When the final draft of the proposed standards was prepared, WOTA was asked to take an official position on the nine-credit requirement. The WOTA Board voted to approve the requirement, but recommended periodic re-evaluation of the standards and consideration of the inclusion of relevant occupational therapy courses and continuing education programs. Impact of Certification Standards on Educational Programs As the revised certification stan· dards went into effect; Wisconsin occupational therapy educators became aware of the need to identify courses available in state colleges and universities that could be used to fulfill certification requirements. Greater numbers of students were becoming interested in public school employment, and increasing numbers of positions were becoming available in state schools. With the certification requiremen t decreasing to nine semester credits, it seemed feasible to state occupa tiona I therapy educators to offer students the option of completing certification requirements while earning the undergraduate degree in occupational therapy. Each of the three basic professional curricula in Wisconsin was expected to identify courses on its campus that were believed to fulfill the content areas specified in the certification rule and to su bmi t lis ts of these courses to DPI for approval. Such courses could be taken as electives within the undergraduate degree. Many options are available for persons wishing to fulfill certification requirements. In addition to courses being a vaila ble on these campuses, many other state campuses offer a major in special education and have courses that are applicable to the school certification requirement. The state television network frequently offers special education courses for credit, providing another route by which therapists may work toward certification. The State University'S Extension Division also offers some special education courses through independent study (home study) that are appropriate for certification. The Wisconsin school certification requirement is being publicized among students enrolled in occupational therapy curricula so that it may be completed as part of the undergraduate degree; increasing numbers of students are following this option. Occupational ther- The American Journal of Occupational Therapy Downloaded From: http://ajot.aota.org/ on 07/23/2018 Terms of Use: http://AOTA.org/terms 729 apy curricula in other states may wish to consider whether there is. a need to review school certification requirements in their state and whether such req uirements could be met as part of the basic educational preparation in occupational therapy. Considerable variation appears in school certification requirements from state to state. A 1976 report published by the AOTA found that 10 states required OTR certification only, 15 states reported additional requirements besides professional certification, and 14 states feported that there was no mechanism for certification of school occupational therapists in their state (6). The 1978 survey to delineate school occupational therapy roles and functions by Gilfoyle and Hays (7) did not specifically address the iss ue of certifica tion, bu tfound tha t all states required occupational therapy certification or state licensure as minimum requirements. They identified a trend to require additional credits for maintaining school certification by such means as continuing education units, certification as a teacher, or special certification as a school-based occupational therapist. They also noted that administrators of occupational therapy programs expressed a need for additional training related to occupational therapy practice as applied to education to acquire and maintain school certification. Conclusion and Recommendations Many models exist for establishing certification standards. The Wisconsin experience in developing certification standards for public school occupational therapists has demonstrated one way of aiding state departments of education to 730 establish reasonable standards for the hiring of occupational therapists in school settings. The Wisconsin certification requirements represent a compromise agreement among the therapists, school administrators, and the Department of Public Instruction. The process established a positive working relationship with the Department of PublicInstruction on which future developments may be built. We believe this type of relationship is critical to the continued development and use of occupational therapy in school programs. Presently 92 occupational therapists are employed in Wisconsin schools and this number is expected to increase. In Wisconsin, the establishment of certification standards for school therapists had a significant impact on occupational therapy educational programs. Improved educational preparation for school-based therapists appears to be needed to meet the special demands of this unique practice setting. We believe that special certification standards need to be developed by states to ensure quality occupational therapy services in public schools. The following recommendations are made relevant to school certification: I. Therapists should investigate the certification requirements of their state for employment and practice in public schools. 2. A national listing of certification requirements by state, periodicalIy updated, would be helpful to those seeking employment in public schools. 3. Certification standards, once established, should be periodically re-eval ua ted beca use occupa tiona I therapy practice and special education programs change over time. 4. Since occupational therapy is increasingly recognized as a certi- November 1980, Volume 34, No. 11 Downloaded From: http://ajot.aota.org/ on 07/23/2018 Terms of Use: http://AOTA.org/terms fied public school profession, it is desirable that state departments of education employ an occupational therapy consultant to offer consultative and support services to schoolbased therapists. 5. School-based therapists need to become familiar and stay current with the state regulations and administrative rules governing their services. 6. Occupational therapy educators should consider whether the certification requirements of their state for school therapists could be met as part of the undergraduate degree program. 7. States without certification standards for school occupational therapists should consider establishing minimum standards to ensure the employment of well-qualified practitioners in public school programs. The authors believe that state licensure alone is not sufficient. 8. State associations are advised to maintain a liaison with their state department of education to provide input on the certification and practice of occupational therapy in public schools. REFERENCES 1. Mitchell MM, Lindsey D: A model for establishing OT and PT services in the public school. Am J Occup Ther 33: 361­364,1979 2 Public Law 94­142, The Education for All Handicapped Children Act, enacted 1975 3. Reed KL: Certification of occupational therapists in the public schools. Am J Occup Ther 26: 406­409, 1972 4. Chapter 115, Wisconsin Statutes, S115.88(1 ) 5. PI 3.20(13), Wisconsin Administrative Code, Adopting rules 6. 1976 Report Occupational Therapy in the Public School Systems, Professional Development (Practice) Division, AOTA, Rockville, Md. 7. Gilfoyle EM. Hays C: Occupational therapy roles and functions in the education of the school­based handicapped student. Am J Occup Ther33: 565576,1979