Outpatient vs School-Based Therapy Pediatric Settings
All therapists, no matter the discipline, have a common goal in mind and that is to help individuals achieve independence and improve daily functioning at any age of life. Despite the setting, therapists strive to construct an individualized treatment plan that addresses the goals and needs of both the client and families. Understanding the nuances of both outpatient and school-based services is important for proper advocation of a child's needs; however, can also be confusing at times. This blog's purpose is to help educate others on both types of pediatric therapy settings.
Therapies are considered a "related" service
Services will only be provided if they are "educationally necessary"
Educationally necessary means the concerns are impacting their ability to learn and access their educational environment
All skills addressed must directly help the child access their school and education, not necessarily their community or home environment
Governed by federal and state laws
The need for services is declared by the IEP (Individualized Education Plan) team
An IEP is developed to layout the special education, supports and services the child needs to progress in school
The IEP team is comprised of any discipline who works with the child such as teachers, therapists, psychologists social workers etc.
Parents are apart of the IEP team and are participate in the decision making process
The entire team helps develop the frequency, duration, and amount of therapy a child may need (if needed)
Parents, teachers or staff at the school can refer a child for therapy services
Services can only be stopped with approval from the IEP team
Therapy can take place individually, in small groups, or in a "push in" style
Some children may only require consultations, which means that related service team members may provide staff training, classroom modifications and provide strategies for stakeholders to implement directly with the child
Some children may require a 504 plan instead of an IEP plan
A 504 plan helps to modify and provide changes to a child's regular educational program in a regular classroom environment
A child with a 504 plan will not receive services or support in a special education classroom
Participation from parents to create a 504 plan is not necessary unlike an IEP plan
A medical model
The primary focus of this setting is to enhance functional independence in the community and at home, which can also mean educationally
Child is typically referred to this setting by a physician; however, referral can also come from a teacher or parent
Therapist can address any skills that are impacting the child's ability to participate and function independently in any environment, not just educational based skills
There is a chance a child would qualify for services in the clinic but, not at school because their type of needs may not be impacting their participation in an educational environment
Evaluation can take place in a clinic, hospital, or community based setting
Evaluation results are discussed with the family
Caregivers play an active role in goal creation alongside the therapist
Some or all of therapy services may be covered by insurance or individual would be responsible for the out-of-pocket expense
Coverage for therapy is dependent on medical necessity and that the child presents with clear skill deficits that need to be addressed
SIMILARITIES OF BOTH SETTINGS
Collaboration between disciplines is very common in both settings
Discharge when goals are met
In both settings, a child will be discharged from services once goals are met or there is a plateau in skill development
Children may resume therapy at any point in time if they begin have difficulty with tasks or certain skills
We all want your child to flourish
No matter the setting, all therapists want to help your child, succeed, grow, and become independent individuals!
Region 10 Education Service Center. (n.d.). School based vs. clinical based therapy. Region 10 Website. Retrieved February 21, 2022, from https://www.region10.org/programs/occupational-and-physical-therapy-services/school-based-vs-clinical-based-therapy/
Mangano, J. (2017, August 1). Outpatient therapy vs. school based therapy. Arizona Orthopedic Physical Therapy. Retrieved February 21, 2022, from https://azopt.net/outpatient-therapy/
Palladino , B. (2019, July 24). Outpatient vs. school-based occupational therapy. Outpatient vs. School-Based Occupational Therapy. Retrieved February 21, 2022, from https://brainspotential.com/outpatient-vs-school-based-occupational-therapy/
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