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School Based OT vs. Outpatient OT

As we start another school year there are so many questions parents have in regards to therapy in the school system.

Occupational therapy addresses so many areas it can often be overwhelming to know if all your child’s needs are being met. Looking at your child’s goals from each provider and making sure they align with your family goals is very important. We want each child to be as independent as possible but this can only be achieved if your provider understands your goals for home. Every household looks unique and is special in its own way. We want to foster a child to love their environment and have productive skills and strategies in each setting.

When looking at outpatient vs. school models keep your goals in mind and make sure you set up your child for success in both settings. They both have specific goals and objectives.

Every district is a little different but there are some general ideas to help navigate services from schools and in an outpatient clinic.

Outpatient Clinic (Medical)

Addresses the whole child: We are passionate about looking at fine motor, gross motor, bilateral coordination, handwriting, motor planning, sensory modulation, eye hand coordination, visual perceptual skills, ocular motor skills, and ADL’s.

Multi-disciplinary approach: We work closely with other professionals such as SLP’s, PT’s, ABA therapist, play therapist, and learning specialist to provide well rounded and holistic care.

Across Settings: We try to work closely with families and the family unit to see how strengths and weaknesses are affecting home, school, family outings, travel, functionality of day to day life, and community. It is important to make sure children can generalize their skills to other settings. For example, if they can tie their shoes at the clinic they can tie them at home and school.

One-on-one: In the medical setting occupational therapy must exclusively be one on one for insurance to reimburse. This allows for the most individualized plan and treatment sessions over time. Each child’s goals are being met in a one on one setting.

School Based Occupational Therapy

Academic Based: Occupational therapy in the school setting is based solely around academic need and goals. Children’s goals are educational based therefore, many times OT in the schools is handwriting, ADL’s within a school setting, transitioning, fine motor skills, and visual perceptual skills.

Collaborative Approach: Occupational therapists in the school setting work through more of a consultation model than direct therapy. Depending on the child’s need they try to help give teachers the tools and equipment needed to carry over strategies for growth in the classroom. They work with a variety of team members to educate on sensory strategies if needed and strategies to build independence without doing as much direct therapy.

IEP (Individualized Educational Plan): OT in schools is considered “related services” which means in order to qualify for OT in the schools you need to have an IEP. In the outpatient setting it is not necessary to have a referral or diagnosis to receive OT services. OT does not have stand-alone goals within the IEP, the goals typically support the teacher’s goals. The therapist often collaborates with the teacher to ensure success and that the child’s OT needs are being met in the classroom.

Treatment Frequency: In a school setting, a child will receive OT services for 30 minutes or less a week, at times, this is done within a natural classroom environment or group therapy to increase success with transfer of learning. Whereas, in an outpatient setting, a child is typically seen 1-2 hours a week in the one-on-one environment.

Both settings can be extremely beneficial for your child. Having realistic expectation of each setting and your family's goals at the forefront will help everyone feel understood and valued.

Every child deserves boundless opportunities. You are their greatest advocate; knowing more facts helps us advocate in the best way we can for our children.

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