[Editor's note: This issue, ADVANCE columnist Iris Kimberg answers reader questions.]

Q: There are students within my district that struggle with fine motor skill development. For some of them, it is the only area of impairment and, unfortunately, the district is very strict about meeting requirements for a 504 plan. Can I legally provide intervention for this type of child?

A: For starters, let's review the difference between an IEP and entitlements under 504. Terri Mauro, author of 50 Ways to Support Your Child's Special Education, offers a good differentiation. A 504 plan falls under civil rights laws. "504" refers to Section 504 of the Rehabilitation Act and the American with Disabilities Act, which specifies that no one with a disability can be excluded from participating in federally funded programs or activities, including elementary, secondary or postsecondary schooling.

Section 504 is designed to attempt to remove barriers and allow students with disabilities to participate freely in education. A 504 plan spells out the modifications and accommodations that will be needed for these students to have an opportunity perform at the same level as their peers.

An Individualized Education Plan falls under the Individuals with Disabilities Education Act. Students eligible for an IEP represent a small subset of all students with disabilities. They generally require significant remediation and assistance. Only certain classifications of disabilities are eligible for an IEP, and students who do not meet those classifications but still require some assistance to be able to participate fully in school may be candidates for a 504 plan.

It is entirely possible that students with grasp, fine-motor and handwriting issues may not be eligible for federally funded OT services through 504 or IDEA, but as we all know, it does not mean that services are not indicated. Some school districts opt to hire therapists directly through a "miscellaneous" budget line, a grant, money raised by the PTA, etc. Unless your contract forbids this, an OT can certainly pursue this type of opportunity. It should still be regarded as providing occupational therapy services, and in states that require it, an OT should still get a doctor's prescription and have malpractice insurance in place prior to beginning services.

Q: As an OT trying to build a private practice, I want to encourage potential patients to contact me to ask questions. I am considering an "Ask the Therapist" link on my Web site. Is this okay to do?

A: I always encourage therapists to make their Web sites interactive. Having an "Ask the Therapist" link is one way to get the ball rolling. However, how you answer any question posed to you via email is very important.

From a risk-management viewpoint, vulnerability for malpractice exists with every interaction a therapist has with a patient, and an email exchange is considered a legitimate interaction. So the answer you offer a potential patient has to be carefully tailored to the question, and should remain reasonably general in nature. You can certainly offer information about treatment you might suggest, what you have offered similar patients, etc., but you certainly would not want to give specific treatment recommendations or exercises for a patient to try on their own.

The following list of additional risks were compiled by MD Anderson Hospital, and are worth mentioning:

• Emails can be copied, circulated, forwarded and stored in paper and electronic files.

• Emails can be accidentally or intentionally immediately broadcast worldwide and received by many unintended recipients.

• Emails are easier to falsify than handwritten or signed documents.

• Backup copies of email may exist even after the originator or recipient has deleted his or her own copy.

• Employers and online services have a right to archive and inspect e-mails transmitted through their systems.

• Emails are discoverable and can be used as evidence in court.

• Emails can be misinterpreted.

Iris Kimberg, MS PT, OTR, is the founder of New York Therapy Guide (http://www.nytherapyguide.com/), a site dedicated to the growth, viability and success of therapists in the private sector. She can be reached at infonytherapy@aol.com.