Click here for photo creditAs many of our little kiddos prepare to head back to school, it would be a great time to discuss the difference between therapy in school and medical based therapy.
Sometimes, the issue of therapy services for your child can be difficult to navigate and, at times, just plain overwhelming!
Why doesn’t my child get therapy in school?
Can my child get therapy in school and outside of school?
Do I need to do therapy outside of school if they are already getting therapy in school?
How come they can get therapy outside of school but don't qualify for therapy in school?
There’s a lot to unpack! Let’s start by talking about the difference between therapy in a school setting and therapy in a clinical setting.
In the educational model, physical therapy and occupational therapy are considered related services. This means that in order to receive PT and OT in school your child must be eligible for special education services and have an IEP. In some rare instances a child may receive support from PT and OT under a 504 accommodation plan.
School based PT and OTs focus on functional abilities needed to access educational materials or to move safely about the school. This includes activities of a school day, like: moving throughout school grounds, sitting, standing in line or at the board, moving in class or through the building. Interventions may include adaptations to school environments, working with a student on motor skills, assistance with identifying and getting special equipment, and collaboration with school staff and other professionals. Related services, such as school based PT and OT, are possible only when they are “required to assist a child with a disability to benefit from special education.” School-based therapy services are intended to help students participate in and benefit from their educational program, (IDEA 2004) and focus on the academic impact. It is not meant to be rehabilitative in nature. Unlike speech therapy, PT and OT can not stand alone on the IEP. Speech therapy can stand alone on an IEP however, the speech therapy goals must also support the student’s ability to be successful in their educational setting.
In a school setting, your child may receive services through a direct model where they are seen on an individual basis or in a small group setting. Or they may receive services through a consultative model where the therapist consults with the educational team regarding adaptations or modifications your student might need in order to be successful. The service delivery model is typically determined at the Planning and Placement team meeting and should be outlined on your student’s individual educational plan (IEP).
There are many factors that are considered by the IEP team when determining the appropriate service delivery model in a school. One of those factors is the least restrictive environment. This means that a child with a disability must be educated in a classroom with non disabled peers to the fullest extent possible. LRE plays a crucial role in the development of a child’s IEP and influences where a child spends their time in school and what service delivery model is utilized. The question for an IEP team to consider is: If a child spends time outside of their LRE or general education, how much time? And is that the most appropriate setting for them? Direct therapy may not always be in the best interest of the student if it pulls them from their LRE and decreases the amount of time they spend with neuro-typical children. Oftentimes, therapists will recommend a consultative model versus direct therapy service.
Medical based therapy is typically delivered in a clinical setting or sometimes directly in the child’s home. Through this model, the therapists will typically receive a referral from a child’s pediatrician that will indicate a need for therapy. Based on the evaluation assessment and caregiver concerns, a plan of care including short term and long term goals are established. In this setting the therapist addresses all areas of need and is not limited to areas that have an educational impact. Goals can range from self-help skills to sensory integration therapy to gross motor acquisition. The sessions are typically on an individual basis and specifically individualized to your child’s needs.
Although there are differences between medical based therapy and school-based therapy, those differences are there to help your child be the most successful in their natural environment. It is important to note that students who qualify for medical based (or clinical) therapy, may not qualify for school-based services. If you have questions about receiving medical based therapies, give us a call and request a free phone consultation to discuss your concerns.
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