School-Based vs. Clinic-Based Therapy
A child can receive therapy in a clinic or at school. In both settings, a licensed therapist delivers the therapy. School-based therapy focuses on improving the child's ability to succeed in school. (1,2)
Who is eligible for therapy?
School-based
- The Individuals with Disabilities Act (IDEA) highlights 13 categories of disabilities or if a child meets the requirements of having a developmental delay (Sec 300.8[a])
- The student must need therapy in order to participate in school
- OT and PT services are sometimes provided under Section 504 of the Rehabilitation Act of 1973 – in this case, the therapist may provide assistance with modifications to allow for improved access for a child to their school
Clinic-based
- The need for therapy is often identified by a physician or parent
Who provides the treatments?
School-based
- The therapist or therapy assistant can provide treatments, but the therapist may also choose to educate other members of the educational team to carry out activities that will assist with motor, communication, or educational skills
Clinic-based
- Generally, a therapist or therapy assistant will provide treatment in the clinic setting
Who pays for therapy?
School-based
- Therapy in the schools under IDEA is provided by school districts if needed for the student to receive a free and appropriate public education (FAPE)
Clinic-based
- Private funds or insurance reimbursement whether public or private insurance
Is all therapy one-on-one?
School-based
- The therapist may work with the child in the classroom setting, in groups, or one-on-one
Clinic-based
- Most often treatment is one-on-one in a clinic setting
What are the goals of therapy?
School-based
- Goals are focused on education
- Created by all members of the IEP team
- Related to skills that will assist the child to function in the school, access the school, and perform in school-related activities
Clinic-based
- Goals are focused on rehabilitation
- Created by the therapist and may have family input
- Made into a Plan of Care and signed by the physician
- Designed to assist the patient in all settings
How are therapy services ended?
School-based
- The IEP team or 504 team meets to evaluate the student
- Services are discontinued if the therapist is no longer involved in goals, accommodating student needs, or training staff
- Services are discontinued if therapy is no longer necessary for the student to participate in educational activities
Clinic-based
- The patient can be discharged if he is no longer making progress, the goals of therapy have been met, or insurance or private funds are no longer available
References:
- Department of Education, State of Georgia.
http://archives.gadoe.org/_documents/ci_exceptional/Characteristic_of_Ed_Relevant_&_Clinical_Therapy_2011.pdf. Accessed on March 2, 2014. - Department of Education, State of Indiana. http://www.indianatransition.org/13-A%20Transition%20from%20First%20Steps/Educational%20vs%20Medical%20Model%20-Family%20Final%2010-07.pdf . Accessed on March 2, 2014.
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