50 School Occupational Therapy Accommodations for IEPs

As a school-based Occupational Therapist, understanding and recommending appropriate accommodations is a large part of ensuring a student’s access to their education. Accommodations are changes to how a student learns or demonstrates knowledge, without changing what they are expected to learn. They are required for the just right challenge and allowing students to participate fully in their academic setting.

–Bestie Tip: Start with a few accommodations the student may need. These accommodations should be tracked throughout the school year to see if they are working and if the student needs them. If they are not working or the student doesn’t need them then they should be taken off the IEP. I have seen too many times throughout the years where IEPs have 50 plus accommodations because professionals have been adding and adding without reassessing the needs. Remember accommodations have to be implemented by law according to the IEP. If they aren’t being implemented there could be trouble.

This list provides 50 common and effective occupational therapy accommodations that I personally use and can be considered for inclusion in a student’s Individualized Education Program (IEP). Remember, accommodations should always be individualized to the student’s specific needs and directly address the educational impact of their disability. Not every child should have the same accommodations.

Handwriting & Written Output Accommodations

1. Use of adaptive paper: (e.g., raised line, bold line, wider ruled, colored lines, graph paper).
2. Use of pencil grip: (e.g., ergonomic, weighted, foam).
3. Use of slant board or vertical surface: For improved wrist extension and visual access.
4. Reduced amount of written work: (e.g., fewer problems, shorter essays, fill-in-the-blank).
5. Allowing alternative methods for written responses: (e.g., typing, verbal responses, dictation, scribe).
6. Use of word processor/computer for written assignments.
7. Use of speech-to-text software.
8. Use of pre-written sentence starters or templates.
9. Extended time for written tasks/assignments.
10. Use of weighted pencil/pen: For increased proprioceptive feedback.
11. Use of non-slip mat under paper: To stabilize paper during writing.
12. Teacher/peer provided notes or outlines.
13. Reduced copying demands from board/textbook.
14. Use of a highlighter or ruler to track lines.
15. Access to a word bank for spelling/vocabulary.

II. Seating & Positioning Accommodations

16. Access to an adaptive chair/seating: (e.g., rocking chair, wobble cushion, T-stool, scoop chair).
17. Foot support: (e.g., footrest, stack of books, therapy band around chair legs).
18. Preferred seating location in classroom: (e.g., near teacher, away from distractions, near a wall).
19. Access to alternative seating options: (e.g., standing desk, floor cushion, beanbag chair).
20. Use of a non-slip mat on chair seat: To prevent sliding.
21. Back support: (e.g., lumbar roll, cushion for upright posture).

III. Sensory Regulation Accommodations

22. Access to sensory breaks: (e.g., movement breaks, quiet space, sensory tools).
23. Use of fidget tool: (e.g., stress ball, tangle, discreet fidget).
24. Access to a quiet work area/space: (e.g., carrel, study cubby, designated corner).
25. Use of noise-canceling headphones/ear defenders.
26. Access to weighted lap pad: For calming proprioceptive input.
27. Allowing movement during tasks: (e.g., standing, rocking, chewing gum).
28. Modifications to lighting: (e.g., natural light, dimmer, desk lamp).
29. Reduced visual clutter in workspace.
30. Access to calming sensory tools: (e.g., glitter jar, visual timer).
31. Opportunities for heavy work activities: (e.g., moving chairs, carrying books, wall pushes).

IV. Fine Motor & Manipulation Accommodations

32. Use of adaptive scissors: (e.g., loop scissors, spring-loaded, tabletop scissors).
33. Pre-cut materials for craft/art activities.
34. Use of adaptive tools for fasteners: (e.g., button hook, zipper pull).
35. Larger manipulatives/materials for tasks: (e.g., jumbo crayons, larger puzzle pieces).
36. Velcro closures on clothing/backpacks.
37. Adapted grips for tools: (e.g., paintbrushes, eating utensils).

V. Organization & Executive Functioning Accommodations

38. Use of visual schedules/checklists: For daily routines or multi-step tasks.
39. Color-coding system for materials/folders.
40. Reduced number of items on desk/in cubby.
41. Use of a planner/agenda with teacher check-ins.
42. Designated and organized storage space for materials.
43. Verbal prompts/reminders for organization.
44. Breaking down multi-step tasks into smaller steps.
45. Use of a visual timer for transitions/tasks.

VI. Self-Care & Daily Living Accommodations

46. Visual sequence for self-care routines: (e.g., handwashing, toileting).
47. Adapted clothing: (e.g., elastic waistbands, larger buttons).
48. Extended time for self-care tasks: (e.g., dressing for gym, eating lunch).
49. Assistance with food/container opening during lunch.
50. Designated quiet space for self-care breaks if needed.