(a) Specialized rehabilitative services are rehabilitative services that promote age-appropriate development by correcting deficits and teaching compensatory skills for deficits that directly result from medical, developmental, or other health-related conditions. Specialized rehabilitative services include physical therapy, speech language pathology services, occupational therapy, and specialized skills training.
  (1) Physical therapy.
    (A) Physical therapy services are defined in 34 CFR §303.13(b)(9).
    (B) Physical therapy services must meet the requirements of subsection (b) of this section.
    (C) Physical therapy services must be provided by a licensed physical therapist who meets the requirements of 42 CFR §440.110(a) and all other applicable state and federal laws or a licensed physical therapy assistant (LPTA) when the assistant is acting under the direction of a licensed physical therapist in accordance with 42 CFR §440.110 and all other applicable state and federal laws.
  (2) Speech language pathology services.
    (A) Speech language pathology services are defined in 34 CFR 303.13(b)(15).
    (B) Speech therapy services must meet the requirements of subsection (b) of this section.
    (C) Speech therapy services must be provided by:
      (i) a licensed speech language pathologist (SLP) who meets the requirements of 42 CFR §440.110(c) and all other applicable state and federal laws;
      (ii) a licensed assistant in SLP when the assistant is acting under the direction of a licensed SLP in accordance with 42 CFR §440.110 and all other applicable state and federal laws; or
      (iii) a licensed intern when the intern is acting under the direction of a qualified SLP in accordance with 42 CFR §440.110 and all other applicable state and federal laws.
  (3) Occupational therapy.
    (A) Occupational therapy services are defined in 34 CFR §303.13(b)(8).
    (B) Occupational therapy services must meet the requirements of subsection (b) of this section.
    (C) Occupational therapy services must be provided by a licensed occupational therapist who meets the requirements of 42 CFR §440.110(b) and all other applicable state and federal laws or a certified occupational therapy assistant (COTA) when the assistant is acting under the direction of a licensed occupational therapist in accordance with 42 CFR §440.110 and all other applicable state and federal laws.
  (4) Specialized skills training.
    (A) Specialized skills training seeks to reduce the child's functional limitations across developmental domains including, strengthening the child's cognitive skills, positive behaviors, and social interactions.
    (B) Specialized skills training includes skills training and anticipatory guidance for family members or other routine caregivers to ensure effective treatment and to enhance the child's development.
    (C) Specialized skills training services must meet the requirements of subsection (b) of this section.
    (D) Specialized skills training must be provided by an Early Intervention Specialist.
(b) Specialized rehabilitative services must:
  (1) be designed to create learning environments and activities that promote the child's acquisition of skills in one or more of the following developmental areas: physical/motor, communication, adaptive, cognitive, and social/emotional;
  (2) be provided in the child's natural environment, as defined in 34 CFR §303.26, unless the criteria listed at 34 CFR §303.126 are met and documented in the case record and may be provided via telehealth with the prior written consent of the parent, and if the parent does not consent to telehealth services, will be provided in person;
  (3) meet the requirements of §350.1104 of this chapter (relating to Early Childhood Intervention Services Delivery); and
  (4) be provided on an individual or group basis.
(c) In addition to the criteria in subsection (b) of this section, group services must meet the requirements as described in §350.1107 of this chapter (relating to Group Services for Children).
(d) Service Authorization.
  (1) Specialized rehabilitative services must be recommended by an interdisciplinary team that includes a licensed practitioner of the healing arts and be documented in an Individualized Family Service Plan (IFSP) in accordance with Subchapter J of this chapter (relating to Individualized Family Service Plan (IFSP)).
  (2) Services must be monitored by the interdisciplinary team as described in §350.1104 of this chapter.
(e) Documentation. Documentation of each specialized rehabilitative services contact must meet the requirements in §350.1111 of this chapter (relating to Service Delivery Documentation Requirements).

Source Note: The provisions of this §350.501 adopted to be effective September 1, 2011, 36 TexReg 5403; amended to be effective June 30, 2019, 44 TexReg 3280; transferred effective March 1, 2021, as published in the Texas Register February 5, 2021, 46 TexReg 941; amended to be effective March 17, 2022, 47 TexReg 1277