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Related services in special education are the transportation and other developmental, corrective and supportive services a student with a disability needs in order to benefit from special education, such as speech-language services, counseling services, school health services or OT and PT services. Under IDEA, the IEP team decides which ones a student needs and writes them into the IEP with their frequency, location and duration. This guide covers the federal list with examples, supplementary aids and services, the difference from specially designed instruction, IEP wording, providers, medical versus school health services, and funding, including school-based Medicaid.
Table of contents
Executive Summary
Speech or language impairment was the disability category of 18% of the 8.2 million students ages 3 to 21 served under IDEA in 2024-25, and students in every other category can also receive related services. The providers are stretched: the ASHA 2026 Schools Survey reports a median caseload of 50 students for full-time school-based speech-language pathologists (SLPs) who are clinical service providers, against 40 that they judge manageable.
The federal rules are short. The district work is not: deciding each service from evaluation data, writing an amount a parent can understand, delivering and logging it, and recovering what Medicaid allows.
Key Takeaways
- Related services help a student benefit from special education (34 CFR 300.34); the federal list is not exhaustive.
- Supplementary aids and services are different: they help a student learn alongside nondisabled peers (34 CFR 300.42).
- Each service needs a start date, frequency, location and duration in the IEP.
- Speech can be special education or a related service, depending on state standards.
- Health services a nurse or trained person can provide are related services; physician services are excluded except for diagnosis and evaluation.
- Medicaid can pay for some services with written parental consent and at no cost to the family.
What Are Related Services in Special Education?
Related services are the supportive services, listed in the IEP, that a student with a disability needs to benefit from specially designed instruction.
IDEA defines them as “transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education” (34 CFR 300.34(a)). The Department of Education’s 2006 analysis calls the list “not exhaustive,” since it would be “impractical to list every service that could be a related service” (71 Fed. Reg. 46569).
Two limits follow. No related service is required unless the IEP team finds it necessary for the student to benefit from special education and writes it into the IEP. And a student who needs only a related service, not special education, is not a child with a disability under IDEA, unless state standards treat that service as special education (34 CFR 300.8(a)(2)).
List of Related Services Under IDEA
The table follows the definitions in 34 CFR 300.34(c). The school examples are original; the IEP team decides each service from the evaluation.
| Related service | What IDEA includes | School example |
|---|---|---|
| Audiology | Identifying hearing loss, auditory habilitation, amplification | Checking a classroom amplification system each term |
| Counseling services | By qualified social workers, psychologists, guidance counselors or other qualified staff | Weekly small-group counseling on coping strategies |
| Early identification and assessment | A formal plan to identify disabilities early | Preschool screening |
| Interpreting services | Sign language, oral or cued language transliteration, CART and other transcription; services for deaf-blind students | An interpreter in science class and at assemblies |
| Medical services | By a licensed physician, for diagnosis or evaluation only | A physician’s evaluation needed for eligibility |
| OT services | By a qualified OT: improving, developing or restoring functions and independent task performance | Handwriting tools and a self-care routine |
| Orientation and mobility | Safe movement for blind or visually impaired students at school, home and in the community | Cane travel between campus buildings |
| Parent counseling and training | Helping parents understand needs and support the IEP | Coaching a family on a communication device |
| PT services | Services provided by a qualified PT | Practice with stairs and hallway movement |
| Psychological services | Testing and interpretation, consultation, psychological counseling, positive behavioral intervention strategies | Helping the team design a behavior plan |
| Recreation | Leisure assessment, recreation programs, leisure education | Learning the routines of an after-school club |
| Rehabilitation counseling | Career development, employment preparation, independence | Job application sessions for a 17-year-old |
| School health and school nurse services | Health services that enable FAPE, by a school nurse or another qualified person | Blood glucose checks during the day |
| Social work services in schools | Social history, counseling with child and family, linking community resources | Coordinating with a family and a community agency |
| Speech-language pathology services | Identification, diagnosis, services for communicative impairments, guidance for parents and teachers | Small-group language sessions with an SLP |
| Transportation | Travel to, from, between and within schools; adapted buses, lifts and ramps | A lift-equipped bus |
Related services exclude a surgically implanted device such as a cochlear implant and its mapping, though the school must check that the external part works (34 CFR 300.34(b)). Assistive technology is a separate obligation (34 CFR 300.105).
Supplementary Aids and Services
IDEA defines supplementary aids and services as “aids, services, and other supports that are provided in regular education classes, other education-related settings, and in extracurricular and nonacademic settings, to enable children with disabilities to be educated with nondisabled children to the maximum extent appropriate” (34 CFR 300.42). They are the test for removal: a student leaves the regular class only if education there “with the use of supplementary aids and services cannot be achieved satisfactorily” (34 CFR 300.114(a)(2)(ii)). They also apply at meals, recess and other nonacademic activities (34 CFR 300.117).
Supplementary Aids and Services Examples
The Center for Parent Information and Resources, citing New Mexico’s guidance, groups examples by need: environment, staff support, planning time, equipment, pacing, presentation, materials, assignments, self-management, testing, social interaction and staff training. The examples below are original.
| Setting | Example | Need |
|---|---|---|
| General education class | Text-to-speech for content texts; notes before the lesson | Presentation |
| General education class | A paraprofessional during lab work | Staff support |
| Lunch and recess | A trained peer and an adult prompt for the first 10 minutes | Social interaction |
| Clubs and athletics | An interpreter at meetings; adapted equipment | Equipment, communication |
The full categorized list is in IEP accommodations.
Program Modifications and Supports for School Personnel
The IEP must also state “the program modifications or supports for school personnel” that will be provided (34 CFR 300.320(a)(4)). Wisconsin’s Department of Public Instruction (DPI) classifies services provided “on behalf of the student,” such as a provider’s consultation with teachers or staff training on equipment, in this category, and requires their amount, frequency, location and duration (Information Update Bulletin 24.02, September 2024).
Related Services vs Specially Designed Instruction
The IEP lists four kinds of services (34 CFR 300.320(a)(4)). Wisconsin’s bulletin asks teams to consider all four for each need, notes that at least one IEP service must include specially designed instruction, and says related service decisions are “not based on disability category criteria or other checklists.”
| Type | What it does | Example |
|---|---|---|
| Special education (specially designed instruction) | Adapts content, methodology or delivery of instruction (34 CFR 300.39) | Explicit decoding instruction in a small group |
| Related services | Supportive services needed to benefit from special education | Weekly counseling services |
| Supplementary aids and services | Supports for learning with nondisabled peers | An interpreter in general classes |
| Supports for school personnel | Help for the adults who carry out the IEP | SLP consultation with a teacher |
Instruction is covered in specially designed instruction examples.
When Speech Is Special Education and When It Is a Related Service
Speech-language pathology services are on the related services list, but special education also includes them “if the service is considered special education rather than a related service under State standards” (34 CFR 300.39(a)(2)(i)). In Wisconsin, SLP services can be any of the four service types, and Wisconsin requires a reevaluation before OT or PT services are added to an IEP. Goal examples and the speech-only IEP are covered in speech IEP goals.
How Related Services Are Written in the IEP
Each related service appears in the statement of services (34 CFR 300.320(a)(4)) with “the projected date for the beginning of the services” and “the anticipated frequency, location, and duration” (300.320(a)(7)). The 2006 analysis says the amount must be stated so the district’s “commitment of resources will be clear to parents and other IEP Team members,” and that the Act does not require naming each provider (71 Fed. Reg. 46667).
Example service statements (original, to adapt):
- “Speech-language services: 30 minutes, 2 times per week, small group in the speech room, from [start date] to [end date].”
- “Counseling services: 20 minutes weekly, individual, counselor’s office, from [start date] to [end date].”
- “Transportation: lift-equipped bus, daily, to and from school, for the duration of the IEP.”
The IEP must be accessible to each related services provider responsible for it, and each must be told their specific responsibilities (34 CFR 300.323(d)). Related services staff may join the team at the parent’s or district’s discretion (34 CFR 300.321(a)(6)). The evaluation must identify all special education and related services needs, “whether or not commonly linked to the disability category” (34 CFR 300.304(c)(6)). A full sample with a services table is in our IEP example.
Who Provides Related Services
States set qualifications. Related services personnel must meet the state’s certification or licensing rules for their discipline, without emergency, temporary or provisional waivers; trained and supervised paraprofessionals and assistants may assist (34 CFR 300.156(b)). The definitions in 300.34(c) name some providers: counseling services by qualified social workers, psychologists or guidance counselors; school nurse services by a qualified school nurse; school health services by a nurse or another qualified person; medical services by a licensed physician.
Medical Services, School Health Services and the Supreme Court
- Irving Independent School District v. Tatro (1984): clean intermittent catheterization during the school day, which a layperson can learn in under an hour, was a related service, because without it the child could not attend school. The Court upheld regulations that exclude physician services and include school health services by “a qualified school nurse or other qualified person.”
- Cedar Rapids Community School District v. Garret F. (1999): a student who uses a ventilator was entitled to the continuous nursing services he needed during school hours. The Court rejected a cost-based test: physician services, other than for diagnosis and evaluation, are excluded; services a nurse or qualified layperson can provide are not.
Tatro also limits the duty to services needed during the school day, so a medication that can be given at home is not owed at school. In 2006, the Department added that districts are responsible for health and safety services such as suctioning a tracheotomy when a trained person can provide them (71 Fed. Reg. 46571). These are legal questions: check state rules and involve district counsel before refusing a health-related service.
Related Services Under a Section 504 Plan
Section 504 regulations define an appropriate education as regular or special education and “related aids and services” (34 CFR 104.33(b)). Wisconsin’s bulletin notes that a student who does not need specially designed instruction may receive related services under a 504 plan, following Section 504 procedures.
Funding and Staffing
Related services in the IEP are part of FAPE, provided “at public expense, under public supervision and direction, and without charge” (34 CFR 300.17). IDEA Part B funds may pay only the excess costs of special education and related services (34 CFR 300.202). For the wider picture, see our guide to special education funding.
School-Based Medicaid
- Medicaid may pay for IDEA services as the program allows, and the Medicaid agency’s financial responsibility comes before the district’s (34 CFR 300.154(a)(1), (d)(1)).
- Families pay nothing: no required enrollment, deductible, co-pay or loss of coverage.
- Consent and notice: written parental consent before first access, naming the information, purpose and agency, and written notice before first access and every year. A refusal does not reduce the district’s duty to serve.
- No school exclusion: a Medicaid agency may not disqualify an eligible service because it is delivered at school (300.154(b)(1)(ii)).
The Centers for Medicare & Medicaid Services (CMS) issued its comprehensive guide to Medicaid services in school-based settings on May 18, 2023; its bulletin is still listed on the HHS guidance portal. Programs differ by state: Washington’s Health Care Authority notes that schools have been eligible for Medicaid reimbursement of IEP services since the late 1980s and that a 2014 CMS change to “free care” guidance opened billing for some non-IEP services (HCA, 2023), and Wisconsin told districts that CMS compliance changes would take effect July 1, 2026 (DPI, 2025). Check with your state Medicaid agency.
Staffing
The ASHA 2026 Schools Survey reports that school clinical service providers average 21 hours a week of direct intervention and that full-time providers have a median caseload of 50 against 40 judged manageable, and 45 states reported special education teacher shortages in 2024-25 (Learning Policy Institute, 2026).
Common Mistakes District Leaders Make
- Deciding services by disability label instead of evaluation data.
- Writing “as needed” or “consult” with no frequency, location or duration.
- Treating consultation as nothing. It is a support for school personnel and needs an amount.
- Not logging delivered sessions. Missed sessions are missed services.
- Refusing a health service as “medical” when a nurse or trained person can provide it.
- Billing Medicaid without valid consent or charging families any cost.
- Planning supports only for the classroom, forgetting lunch, recess, clubs and transportation.
Recommended Actions
- Audit service statements in a sample of IEPs for start date, frequency, location and duration.
- Compare scheduled with delivered minutes for each provider every month.
- Adopt a written decision guide that asks the four service-type questions for each need.
- Review health services procedures with the school nurse lead and district counsel.
- Check Medicaid consent and annual notices against 34 CFR 300.154 and your state program.
- Measure workload, not only caseload, including consultation and paperwork time.
Questions District Leaders Should Ask
- What share of scheduled related services minutes were delivered last semester, by provider type?
- How many IEPs list a related service without a clear amount?
- Which services do we bill to Medicaid, and how many eligible students lack a valid consent?
- Do our IEPs include supports for lunch, recess, clubs and transportation where needed?
Frequently Asked Questions
What are the different types of special education programs?
IDEA requires a continuum of placements: instruction in regular classes, special classes, special schools, home instruction, and instruction in hospitals and institutions, plus supplementary services such as resource room or itinerant instruction alongside regular class placement (34 CFR 300.115). In fall 2024, 68% of school-age students served under IDEA spent 80% or more of the day in regular classes.
Is speech an IEP service or a related service?
It can be either. Speech-language pathology services are on IDEA’s related services list, but a state may treat them as special education, in which case a student can have an IEP with speech as the only service (34 CFR 300.39(a)(2)(i) and 300.8(a)(2)). Either way, the service is written in the IEP with its frequency, location and duration.
What is a supplemental aid?
IDEA’s term is supplementary aids and services: aids, services and other supports provided in regular classes, other education-related settings, and extracurricular and nonacademic settings so a student with a disability can learn with nondisabled peers to the maximum extent appropriate (34 CFR 300.42). Examples include text-to-speech, a paraprofessional during lab work, an interpreter at club meetings or a trained peer at recess.
What are some examples of educational support services?
In IDEA terms, support services include related services, such as speech-language services, counseling services, school health services, OT and PT services, interpreting and transportation, and supplementary aids and services, such as notes before a lesson or a paraprofessional in class. Consultation and training for teachers count as supports for school personnel. Each must be written into the IEP.
How are related services determined?
The IEP team, including the parents, decides from the evaluation, which must identify all of the student’s special education and related services needs whether or not they are commonly linked to the disability category (34 CFR 300.304(c)(6)). The question is whether the service is required for the student to benefit from special education, not which label the student has.
Can AI help related service providers with their workload?
AI tools can help a provider draft a parent-friendly explanation of a service, a blank session log or practice materials, which the provider then checks. They should not receive student names, health information or other identifying details unless the district has approved the tool for that data, and they cannot decide what a student needs. See the ChatGPT for teachers guide.
Related Resources
- Specially Designed Instruction Examples
- Speech IEP Goals
- IEP Accommodations
- IEP Example: A Complete Sample IEP
- IEP Meeting Guide
- Special Education Funding
Conclusion
Related services in special education are where an IEP meets the staffing chart. For each one, the law asks whether the student needs it to benefit from special education and expects a clear answer: how much, how often, where and from when. Districts that decide services from evaluation data, log what they deliver, respect the Tatro line and bill Medicaid with proper consent protect both students and budgets.
Sources: 34 CFR 300.34, Related services; U.S. Department of Education, IDEA Part B final regulations and analysis of comments, 71 Fed. Reg. 46540 (Aug. 14, 2006); Irving Independent School District v. Tatro, 468 U.S. 883 (1984); Cedar Rapids Community School District v. Garret F., 526 U.S. 66 (1999); Wisconsin DPI, Information Update Bulletin 24.02 (September 2024); Center for Parent Information and Resources, Supplementary Aids and Services; CMS, Delivering Service in School-Based Settings: A Comprehensive Guide to Medicaid Services and Administrative Claiming (May 18, 2023); Washington Health Care Authority, New CMS Guidance on Medicaid Claiming for School-Based Services (June 15, 2023); U.S. Department of Education, OSEP, 2024-25 Static Tables (Part B Child Count & Educational Environments); ASHA, 2026 Schools Survey: SLP Caseload and Workload Characteristics Report. Other sections of 34 CFR Parts 104 and 300 are linked where they are cited.
Join the 2027 Special Education Pilot
A student who sees the SLP for an hour a week still needs many practice turns between sessions, and with caseloads above what providers judge manageable, that practice rarely has an adult beside it. Telo AI is being adapted for students with IEPs: patient, 1-on-1 practice aligned to each student’s IEP goals and pace, including speaking practice. It is a practice tool and does not diagnose or treat any condition. We are inviting districts to shape it with us in a 2027 pilot.
Apply to pilot Telo AI in your Special Education program
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