Special Services: Occupational & Physical Therapy

There are primarily four ways a child can receive occupational and/or physical therapy once a need has been identified.

The factors determining need for intervention may be very different in these two models. This can sometimes be very confusing.

In the medical model:

In the educational model:

Some children will receive services through both models. For some children the frequency or intensity of occupational/physical therapy they receive at school through the educational model will not meet all of the child's needs for occupational/physical therapy. There may be goals that are not addressed by school based therapy and would require home or community based services from the medical model. In each setting, the child should be assessed individually to determine the best way to meet his or her needs.

EDUCATIONAL MODEL MEDICAL MODEL
WHO DECIDES? Educational team, including parents, student (if appropriate), educators, administrators and school based therapists determine the student’s educational needs and what support is required by related services. Medical team determines focus, frequency and duration of therapy. Insurance coverage may be determining factor.
WHAT? Therapy focuses on adaptation and intervention to allow the student to participate, access their special education and school environment. Therapy addresses medical conditions; works to get full potential realized.
WHERE? On school grounds, bus, halls, playground, classroom, lunchroom, etc. In the clinic, hospital or home.
HOW? The student’s educational needs are met individually. Services may include direct one on one treatments, staff training, program development, collaboration with staff, integrated therapy, inclusive therapy (with peers) or by consultation for the student’s daily program. Direct one on one treatment to accomplish set goals.
ELIGIBILITY Educational need as determined by the IEP team based on testing eligibility. Medical need as determined by medical professionals.
COST No cost to student or family. Fee for service payment by family, insurance or governmental assistance.
DOCUMENTATION Related to IEP with accessible, readable language guided by the setting and best practice. Dictated by insurance requirements and guidelines of the setting. Emphasis on medical terminology
These May Include EDUCATIONAL MODEL MEDICAL MODEL
THERAPY EXAMPLES: Provided by therapist reinforced by trained staff Provided by therapist or assistant. Must be doctor prescribed.
Gait Traing To improve efficiency, speed to safely move between classes on campus and to interact safely with peers. To improve heel strike or attain normal gait pattern, not required for daily function.
Range of Motion Positioning program to address range of motion daily during class activities. Goal to attain what range is needed for daily living. Program to gain full physiological joint range, beyond what is required for daily living.
Changes in Physical Status Adapting equipment, schedule or environment to provide access to special education/meet IEP goals. Rehabilitate for strength, range of motion to attain full potential post surgery.
Difficult Writing Strengthening, positioning, repetitive motions due to fine motor, visual motor or other impairments. Rehabilitate and Cognitive Tasks in home and community.
ADLS*: Feeding, dressing, toileting, grooming Lunch Room Assessment, equipment training/issued transfers, safety. In home therapy swallowing difficulties, swallowing studies, equipment issued.

*Assisted Daily Living Skills