School-Based and Clinic-Based Therapy: whats the difference?

by Jenn's Admin Account on March 13, 2013

When doctors recommend occupational or speech therapy for school-aged patients, some parents may respond that their children already receive therapy through the public school system. However, a doctors medical goals or the familys functional goals and the goals of the schools therapist often differ. Understanding the difference between school-based therapy and clinic-based therapy will help families avoid the false impression that services are being duplicated. More importantly, understanding the difference will help families avoid the pitfall of refusing helpful, clinic-based therapy because of the false impression.

For the most part, public schools deliver speech or occupational therapy under the orders of the Individuals with Disabilities ActPart B. To qualify for services, children must meet the Acts definition of being disabled. The Act states that school-based therapy must focus only on goals that are related to a childs ability to benefit from special education. Therefore, school-based therapy puts emphasis on education-based skills. Challenges that affect a childs ability to function normally at home or in the broader community may be excluded from therapy.

On the other hand, clinic-based therapy takes a more global outlook on the well-being of the child and the family. In the clinic setting, therapists will often coordinate with teachers, school-therapists, and physicians. Treatment focuses first on defining the underlying foundations of each childs challenges. Subsequent therapy focuses on those foundations with goals that encompass success at home, school, public, and later in life. From: http://www.therapycenterofbuda.com

Specific Differences between Clinic-Based Therapy and School-Based Therapy Characteristics of Therapy Start of Therapy Clinic-Based Therapy Can begin before grade school to give a child the best possible head start on his or her individual school career. A child can be treated in an individual or small group session with the therapist. Time is set aside periodically to discuss progress with parents or caregivers and make recommendations for home activities to build upon the gains made in therapy to support the childs development School-Based Therapy Children must be at least 3 years of age

Delivery of Therapy

Goals of Therapy

Traditionally, therapy is provided in a group setting. Sometimes, the therapist may see the child as the child participates in the routine activities of the school day. Examples are working on writing in the classroom when the rest of class is working on writing, working on motor skills in P.E., or working on mobility when the children are moving from one location to another. The therapists role is primarily consultative. This may include teaching classroom staff about sensory strategies, transfers, body mechanics, positioning, or use of adaptive equipment to maximize students success. Treatment is able to address issues of Therapy must limit itself to goals that relate articulation, picky-eating, coordination, directly to the exact skills necessary to do sensory processing, self-care, etc. The well in school. Much like how a school Occupational Therapist or Speech-Language nurse only addresses a students medical Pathologist identifies the etiology or needs at school, school-based therapy only underlying deficits of a problem and works on skills necessary for a student to addresses those directly through frequent function at school. School therapists assess rehabilitative activities. The therapist the students functional skills and identify

areas of difficulties. Therapists support academic and non-academic outcomes including social skills, math, reading, writing, recess, participation in sports, selfhelp skills, pre-vocational/vocational participation, and more, for students with disabilities, 3 to 21 years of age. Rather than rehabilitate a deficit, the school therapists facilitate access to curricular and extra-curricular activities through supports and design planning. The therapist may adapt and modify the environment or offer the teacher strategies to implement on a daily basis to afford success. Therapy continues as long as the family and Discharge from Therapy Therapy ends when a child has reached maximum potential or when the family can educational team agree there is a need for continue the therapy maintenance therapist expertise to help the student independently. After a therapy break of participate in his or her education and several months, a child may be reassessed and progress toward the goals of his or her IEP. participate in another round of therapy if the When a child reaches a functional level therapist sees potential for progress. This comparable to his or her peers or the cycle may be repeated multiple times over classroom staff are able to implement several years, for some children. general strategies to meet the childs needs, skilled therapist intervention is no longer indicated. From: http://www.therapycenterofbuda.com

identifies the building blocks and attempts to minimize deficits for improved function. A clinical therapist may see a child one-on-one several times a week to strengthen and rehabilitate deficits. This area of practice is much broader and can impact the child as a whole.