There are primarily four ways a child can receive occupational and/or physical therapy once a need has been identified.
- a hospital or an outpatient clinic; served by the medical model
- outpatient clinic; served by the medical model
- home-based services; served by the medical model
- school-based services; served by the educational model only when occupational and/ or physical therapy is required to meet educational needs
The factors determining the need for intervention may be very different in these two models.
This can sometimes be very confusing.
In the medical model:
- Referral is initiated by the physician based on a particular diagnosis or observed delay in one or more areas of development.
- The parent is then referred to a hospital or clinic for an evaluation and/or treatment by the appropriate professional.
- Need for service is primarily based on testing and clinical observations. The assessment would take all settings into consideration.
- Children with mild, moderate and severe deficits may qualify for services.
- Therapy can address movement quality as well as function.
- The parent is responsible for obtaining the needed services as well as payment for those services.
- Health insurance may frequently assist with payment, but not always.
In the educational model:
- Occupational/Physical therapy is provided by schools as service only when it is related to educational needs.
- Related services are possible only when they are “required to assist a student with a developmental delay or disability to benefit from special education”.
- Need for service is primarily based on testing, classroom observations and input from the student’s IEP team. However, the child is only assessed for needs associated with his or her educational program.
- The school district must establish whether the service is needed for the child to benefit from his or her education.
- In general, students with significant needs qualify for as these services in order to benefit from their special education.
- Related services, like occupational/physical therapy, are only provided when the student's educational program would become less than appropriate without the service.
- A child who does not perform to what may be his/her full potential but does function adequately, would not qualify for school based services.
- Related services are provided only when they support an educational need. They are not provided when there is a transportation problem or other obstacle in getting outpatient or home based occupational/ physical therapy.