PediatricDigest: Understanding the Differences Between the Medical Model and School Model for Pediatric Therapy

Our Occupational Therapy team explains the differences between medical and school models for pediatric therapy.

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Understanding the Differences Between the Medical Model and School Model for Pediatric Therapy

When parents learn that their child may benefit from pediatric therapy, whether it's Occupational Therapy (OT), Physical Therapy (PT), or Speech Therapy (ST), one of the first questions that often comes up is, "What kind of therapy setting is right for my child?" Pediatric therapy can be provided in two different models: the medical model (like through outpatient therapy clinics) and the school model (therapy provided in educational settings). While both aim to support your child's development and ability to engage in daily activities, the approach, goals, and setting for each are quite different. This post will explore the differences between these two models and help you understand which might be the best fit for your child.

1. Purpose of Therapy

The primary difference between the medical and school models lies in the purpose of the therapy provided.

Medical Model: Therapy in the medical model focuses on addressing your child's specific medical conditions, impairments, or developmental delays. The goal is to improve your child's overall health, daily functioning, and quality of life across various settings, including home, school, and community.

School Model: In the school model, the focus of therapy is to ensure your child can access and participate in their academic program. The goal is to help your child succeed in the classroom, ensuring they can effectively engage in school-related tasks.

2. Who Qualifies for Services

The qualifications for therapy differ between the two models.

Medical Model: Any child with a physician's referral or medical diagnosis that requires therapy can typically qualify for services. This might include conditions such as developmental delays, sensory processing disorders, motor deficits, or speech and language challenges. Therapy in this setting is typically individualized to meet the child's specific needs to support their life.

School Model: For your child to receive therapy in school, their needs must impact their ability to participate in or benefit from their educational experience. Services are provided as part of an Individualized Education Program (IEP) under the Individuals with Disabilities Education Act (IDEA), or in some cases, through a 504 plan.

3. Focus of Treatment

The focus of treatment in each model is quite different, depending on the child's needs in various settings.

Medical Model: Therapy in the medical model focuses broadly on your child's overall development and daily functioning. Whether your child needs help with fine motor skills, gross motor skills, communication, sensory processing, or mobility, outpatient therapy addresses the skills your child needs to navigate daily life, at home, in the community, and beyond.

School Model: In the school setting, therapy is more narrowly focused on skills directly related to your child's ability to succeed in school. These may include handwriting, following classroom directions, physical movement within the school environment, speech clarity, and social communication. Therapy is provided with the specific goal of supporting the child's access to education.

4. Setting of Therapy

The location of services differs between the two models.

Medical Model: Therapy takes place in outpatient therapy clinics, hospitals, or in-home settings. It is typically one-on-one and focuses on individualized goals that address a broad range of skills. Clinics often have specialized equipment and materials to target specific areas of need.

School Model: Therapy is provided within the school environment. This could be in the classroom, resource room, or a designated therapy space. Therapists often work closely with teachers and school staff to ensure that therapy goals align with the child's academic needs.

5. Duration and Frequency of Therapy

The amount of therapy your child receives can vary greatly between these two models.

Medical Model: The frequency and duration of therapy are usually determined by the therapist and based on the child's specific needs. Services are often more frequent, with a greater focus on intensity to address the underlying issues.

School Model: The frequency of therapy in schools is typically determined by the IEP team and is based on the child's needs in the educational setting. Services are usually less frequent and may be delivered in small group settings, depending on the child's goals.

6. Family Involvement

The role of the family in therapy is another important difference between the two models.

Medical Model: Parents and caregivers are typically very involved in therapy in the medical model. They often attend sessions, collaborate with therapists on goals, and are provided with strategies to continue working with the child at home.

School Model: In the school model, parents are involved in IEP meetings and goal-setting but are generally less involved in day-to-day therapy. Therapists communicate with parents through progress reports and updates, but the therapy is primarily school-based.

7. Payment for Services

How services are funded is another significant difference.

Medical Model: Therapy is often covered by private insurance, Medicaid, or out-of-pocket payments. Services are typically driven by medical necessity, and the child's needs determine the duration of therapy.

School Model: School-based therapy services are provided at no cost to families as part of the child's IEP under IDEA. Therapy is funded by the school district and is limited to interventions that support educational goals.

Coordinating Care Between Medical and School Models

If your child receives therapy in the school setting but also has challenges at home or in the community, outpatient therapy through the medical model may offer additional support. Deficits that impact academic performance often affect other areas of daily life, such as self-care skills, social interactions, or independence at home.

For children who receive therapy services in school and in an outpatient clinic, it is important to coordinate care between the school-based therapist and outpatient therapist. Doing so ensures that both teams are working toward common goals and that your child is getting the comprehensive support they need across all environments. Communication between your child's therapists can also help avoid confusion and ensure consistency in the strategies used at school and home.

Is My Child Eligible for Outpatient Services?

If your child is already receiving services through their school, we offer free screenings to determine whether an outpatient therapy evaluation could further benefit your child. These screenings can help you understand if your child may need additional therapy to support their daily activities beyond the classroom.

At Cutting Edge Pediatric & Adult Therapy, we are committed to helping your child thrive in every aspect of their life. Whether at school, home, or in the community, we provide comprehensive therapy services to promote independence and success in all environments.