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Educational Therapy Model versus Medical Therapy Model

Educational Model

The Educational Model focuses on the skills impacting educational performance in all subject areas. Deficits are addressed through an Individual Education Plan (IEP) that is agreed upon by the school-age child’s educational team. A child’s IEP in this model will focus solely on the outcome that enables a child to benefit from his/her educational program. Therefore, the school therapist(s) (Physical Therapist (PT) or Occupational Therapist (OT) or Speech Therapist (ST) (or a combination thereof) will direct therapy so the child will gain skills to maximize his/her opportunities within the school environment. Therapy services are provided in school and most often within a group setting.

 

Eligibility: Eligibility for related services must be based on assessment, must include an educational need for service, and have approval of the Admission, Review Dismissal (ARD) committee.

 

Medical Model

The Medical Model generally focuses on the impairment regardless of severity level to ensure that the child can successfully perform the basic activities of daily living (i.e., putting on their clothes, feeding themselves, speaking clearly their wants and needs, walking). Services are performed on a one-on-one basis in an outpatient clinic.

 

Eligibility: The physician or other certified practitioner along with a child’s parents/ guardian and licensed therapist determine the severity and impact on developmental areas or self-care skills and develop a Plan of Care (POC) for the therapist to follow.

                                

Educational - Medical - Developmental Therapy Models

The following chart describes the differences between the:

  1. Educational model - school-based occupational and physical therapy provided under an individualized education program (IEP)
  2. Clinical or Medical model for providing occupational and physical therapy.

 

Educational School-Based Therapy

Medically-Based or Clinical Therapy

Legal Requirements

Occupational therapy and physical therapy are considered related services in the Individuals with Disabilities Education Act of 2004 (IDEA 04). Related services are provided to the children in special education, and are primarily to ensure that the child is able to participate in the learning tasks (e.g., fine motor difficulties that interfere with performing academic tasks, safety issues related to access all or part of the school settings).

State and federal licensure requirements and public and private funding requirements.

What is the focus of the therapy

The therapy addresses adaptation and performance in the educational setting. If the child does not need special education then the child is not eligible to receive the therapy as a related service.

Treatment is to alleviate or cure specific underlying medical problems. It refers to treatment that a child needs for medical reasons. It takes a global approach considering whole-life, restorative, developmental issues and the ability to functional in aspect of daily life.

Who determines the need and amount of therapy?

The ARD committee, which includes the parents and school staff, utilize evaluation data from the therapists’ evaluations and therapists’ recommendations.

The child’s physician, with the therapist’s input. The child’s insurance company may also be a deciding factor.

Where is the therapy performed?

The location is determined by ARD committee and is written in the student’s EP. It can occur in the classroom, or elsewhere (e.g., the gym, special education classroom).

Clinic, hospital, rehabilitation facility, and/or home.

Who provides the therapy?

Therapies included as related services may be provided as direct services by qualified personnel or as consult services by teachers or paraprofessionals acting in accordance to instructions of qualified personnel. Schools may employ therapists or contract with licensed therapists for related services.

A licensed therapist of a clinic, hospital, rehabilitation facility, or self-employed.

What are the ages of the recipients?

3-21 years

Any age

Who pays for the therapy?

Therapies that are included as related services under IDEA are provided by public schools at no cost to the parent.

Paid by parent/patient, insurance, governmental assistance, etc.

What is the documentation for the therapy?

1. Individualized Education Program (IEP) — emphasis is on educationally relevant therapy (educational terminology).

 

2. Under State Physical and Occupational Therapists Practice Rules, a written order from a physician is required in order for the physical therapist to provide physical therapy and occupational therapy to a child with disability.

Documentation required by provider and payer of service using medical terminology.