Occupational/Physical Therapy - School-Based
Role of School-Based Occupational/Physical Therapy
Occupational and Physical Therapy in Texas public schools are a related service and may be different from therapy provided in private therapy centers, hospitals, clinics or home settings. It is important for parents to understand that the service recommendations for school-based therapy typically do not match those provided in a medical/clinical model. While clinical and school therapists work on similar skills, the school therapist’s overall goal is to collaborate with instructional staff to promote educational progress and/or functional performance within the academic setting. School-based therapies focus on supportive services that a student needs in order to learn. Medical-based therapies address issues directly related to the child’s disability. School-based therapies will not provide typical medical intervention such as stretching, range-of-motion exercises, massage, etc. However, school-based therapy will address concerns through classroom functional positioning and participation in PE.
In school, the Occupational and/or Physical therapist will collaborate with the student’s teacher(s) in order to promote the highest level of functional skills possible for the student to achieve his/her individual goals. La Porte I.S.D. implements a team approach to providing OT/PT services to our students. Decisions about a student’s need for therapy services, along with service recommendations, are made by the ARD committee. These decisions are based on formal and informal evaluations, teacher and therapist observations, and the Occupational and Physical Therapists’ recommendations. When receiving services in the school district, a prescription/referral from a physician is necessary in order for physical therapy to be provided and also for the school district to bill Medicaid if applicable.
Therapy services may be provided through a variety of methods including: direct instruction, observation of a student in the school environment, consultation, monitoring, staff training, and/or adaptive equipment provision or equipment modifications. The therapy services may be delivered in a variety of settings (i.e. therapy room, classroom, cafeteria, hallway, gymnasium, playground, etc.). As with other related services, the provision of Occupational and/or Physical Therapy services is based on the individual student’s needs and monitored on a regular basis.
Educational vs Medical model
Related services are a support that all students with disabilities have a Free and Appropriate Public Education (FAPE) with education services designed to meet specific individual educational needs. To qualify for related services, the student must show an educational related difficulty which impairs his/her ability to function in the school environment. The goal of educationally-based intervention is to assist a student to function well within the school setting. This differs significantly from clinic-based therapy service. The goal of clinic-based intervention focuses on treatment to alleviate specific underlying medical pathologies. Results from private clinic-based evaluations can be considered, but do not have to be implemented in the educational setting.
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Educational Model
Educational eligibility = Impairment + Educational need |
Medical Model
Medical Eligibility = Impairment + Performance in Activities of Daily Living |
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Student’s age ranges from 3-21 |
Client’s age range from 0-18 |
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Services are provided as part of FAPE and are at no cost to the parent |
Fee-for-service payment basis, covered by private pray, insurance, Medicaid, Chips |
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Educational team: parent, assessment, teacher, related service. Team collaborates to determine IEP based on educational needs. |
Medical team: physician prescribes therapy, therapist determines frequency and duration, Funding source determines treatment |
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Initial evaluation is completed as part of integrated full and individual evaluation report presented to the IEP team |
Initial evaluation is completed discipline specific, sent to the physician for signature, sent to funding source for authorization |
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Therapy focuses on strategies to improve students’ ability to access school setting, function in school or learn |
Therapy focuses on treatment/intervention to remediate specific medical pathologies |
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Services are provided in the classroom, hall, restroom, cafeteria, bus, playground |
Treatment usually occurs in clinic or hospital setting, daycare or home |
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Services are provided in the classroom |
Treatment is one-to-one in clinic or home setting |
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Goals/objectives reviewed annual basis with progress noted at grading periods |
Goals/objectives reviewed or updated every 2-6 months according to agency policy |
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Goals/objectives are implemented in collaboration with team |
Goals/objectives are therapy specific during scheduled session |
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Services are provided during the school year |
Services focus on continuity of care and are provided year round as funded |
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Review of re-evaluations are conducted at least every 3 years |
Re-evaluations are completed every 2 – 6 months depending on agency policy and funding source |
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Ability driven intervention |
Disability driven treatment |