School-based Therapy | Clinical-based Therapy | |
---|---|---|
|
|
(also referred to as medical based) |
Governed by |
Governed by federal and state laws. Therapy is a related service to special education and is provided only if the child needs therapy to function in the educational setting. |
Governed by state and national practice guidelines that focus on a child’s medical/functional needs in home and community settings. |
Determination for Therapy |
In the school, the need for therapy is determined by the IEP team. Parents are a part of this team. The team determines the amount, frequency and duration of therapy— not the physician alone. |
In clinical-based therapy, the physician, family and therapist make the decision regarding the amount, frequency and duration of therapy recommended. The amount of therapy actually received may be affected by whether an insurance company, Medicaid Program or other funding sources reimburse for the recommended services. |
Methodology of Therapy |
Therapy may be provided individually or in small groups by a therapist or therapist assistant. Intervention may or may not be provided directly to the child. Collaborating with educational staff to modify the child’s environment and daily school activities is always a part of school therapy. |
A therapist typically provides individual treatment. Individualized home programs and ongoing caregiver training are necessary parts of the service to encourage carryover outside of treatment. |
Location of Therapy |
Therapy takes place where the child receives education. Appropriate intervention may be provided in classrooms, hallways, gyms, playgrounds, lunchrooms, bathrooms, or in a separate therapy room. |
Community-based therapy is provided in clinics, hospitals, homes and community settings. |
Therapy Services |
Therapy services can be provided via direct intervention, consultation with staff, provision of adaptive equipment, individual exercise programs, safety training (including transfer training, lifting and back care), recommendations for classroom/school equipment, as well as fine and gross motor training. |
Families have the opportunity to seek out services from a therapist with specialty training in areas such as soft tissue mobilization, post-surgical intervention, sensory integration, aquatic therapy or neurodevelopmental treatment. |
Modalities |
Treatment techniques, such as utilizing physical modalities such as heat/cold, electrical stimulation and biofeedback training are typically not provided. |
Treatment techniques utilizing physical modalities, such as hot/cold, electrical stimulation and biofeedback training may be utilized. |
Dismissal of Services |
The decision to discontinue therapy is made by the IEP team. This may occur when the student is no longer eligible for special education, when other members of the IEP Team can provide necessary interventions, or when the child can perform school tasks without therapeutic intervention. There may still be a need for community-based services. |
Intervention is discontinued when any of the following occurs: functional skills are achieved, a plateau in progress is reached, participation in service is limited because of various circumstances, the child is stable with a therapy maintenance program, discharge is requested. At discharge, indicators for potential follow up are identified. There may still be a need for school-based therapy. |
Occupational & Physical Therapy
- OT and PT as related services
- School based vs Clinical Based
- TEA Resources
- State Resources
- Other Resources
OT and PT as related services
Occupational and Physical Therapy as Related Services
Under the Individuals with Disabilities Act (IDEA), occupational therapy and physical therapy are considered as related services.
Related services are those that are deemed necessary for a child to make progress towards goals/objectives. Intervention in the education setting is not provided to remedy dysfunction under IDEA, but instead to help the student achieve his/her learning and participation goals.
Schools are responsible only for those services necessary for the student to make progress in his/her special education program.
Discontinuation of related services may occur when skills needed have been incorporated into school routines, when needed support is in place without the addition of services or when the student no longer needs related service support to progress on goals/objectives.
Legal Framework defines related services as "a wide array of developmental, corrective, and other supportive services that are required to assist the child to benefit from special education. Related services do not include a medical device that is surgically implanted, the optimization of that device’s functioning (mapping), maintenance of that device, or the replacement of that device. Special education and related services are based on peer-reviewed research to the extent practicable. This means there is reliable evidence to demonstrate that the program or services are effective in meeting the needs of the child. Peer-reviewed research ensures that the quality of the research meets the established standard of the field. Peer-reviewed research may apply to academic, as well as nonacademic areas, such as behavioral interventions. Related services include, but are not limited to assistive technology, audiology services, counseling services, interpreting services, medical services, music therapy, occupational therapy, orientation and mobility services, parent counseling and training, physical therapy, psychological services, recreation, rehabilitation counseling services, school health services, social work services in school, speech-language therapy, and transportation." (Legal Framework Glossary)