We have put together some helpful information on therapy under the educational and medical models.


A common concern for families is whether their child should obtain therapy services at school, at home, or in an outpatient medical facility. Additionally, if an evaluation is done in one setting, can it be transferred to another? Here is some information about the differences between therapy done under the educational and medical model.

Educational Model:

Therapy services provided in the school setting fall under the Educational model of practice. This model focuses on skills that may be impacting a child’s access to education and their academic performance. The goal is to ensure all children have equal access to their school environment.

Eligibility for Special Education services in the school setting is based on assessment/testing usually completed by the onsite Diagnostician and must adhere to criteria in the Individuals with Disabilities Education Act (IDEA). This will allow the student to have an evaluation for Speech, Occupational, and/or Physical therapy services through the district, provided at no cost to the family. The assessment of the child’s performance must describe an educational need for services and be approved by the ARD committee. The committee is a multidisciplinary team including the Teacher, Special Education Teacher, Therapists, and parents who work together to implement the Individualized Education Plan and target the goals agreed upon.

Therapy is often conducted in a group setting and sessions with the therapist may be scheduled over the course of each 6-week period. Therapists in this setting can implement modifications and acquire accommodations to assist the child’s functional performance in the classroom. For example, an OT may provide sensory or fine motor tools to help attention and handwriting while a SLP can create communication tools to ensure the child understands what’s asked of them and can have their needs met.

Medical Model:

Any therapy services provided outside of the school setting will fall under the Medical model of practice. This can be in a hospital, outpatient clinic, or even via a home health agency. The focus is to maximize skills contributing to functionality and independence in all areas of life – home, school, and in the community. Eligibility for Speech, Occupational, and/or Physical therapy is determined from a therapist’s clinical observations and the results from standardized testing completed in the evaluation. A prescription or referral for therapy must come from the Pediatrician. Services may be billed to medical insurance, or the family may pay out of pocket on a private pay basis. Each year, patients undergo a reevaluation consisting of additional standardized testing to assess the child’s progress in therapy and adjust their therapeutic goals as needed.

Recommendations on the frequency of therapy sessions are based on the results of the evaluation and are typically conducted on a weekly basis. Therapists will work directly with the patient in a 1:1 setting each session with opportunities for interactions among other patients depending on the facility. At Cutting Edge, Physical and Occupational therapy sessions last one hour while Speech and Feeding therapy lasts 30 minutes. Goals are based on skills required for functioning at the highest possible level or age-appropriateness in the child’s environments.

Next Steps:

In the end, both models offer opportunities for your child to make progress towards their goals. If you feel your child may require additional services to aid their educational plan, please reach out to inquire about scheduling an evaluation. We would be happy to help your family!


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