Miscellaneous

Occupational therapy (OT) and physical therapy (PT) practitioners often need to help parents and other team members understand how school-based therapy differs from therapy provided in medical or clinical settings. 

A helpful starting point is to help the parent understand that the question is not simply whether their child could benefit from OT or PT at school, but whether OT or PT is required for the student to access, participate in, and benefit from their educational program. 

Explain the Difference Between Medical Need and Educational Need   

A student may have a disability, developmental delay, diagnosis, or medical need and still not require OT or PT as part of the IEP. Likewise, a medical provider may appropriately recommend therapy while the school team determines that school-based OT or PT is not required. 

The difference is in what each setting is trying to determine. A medical provider may be asking, “Would therapy help address this condition, impairment, or functional difficulty?” The school team is asking, “What does this student need to participate in and make progress in their educational program, and is OT or PT needed to provide that support?” Both questions are important, but they serve different purposes. Recommendations from outside providers can provide valuable information about the student and should be considered by the school team, while decisions about school-based services are based on the student’s individual educational needs. 

A useful way to explain this to parents is: 

 “We want to understand what your child needs to participate, learn, and make progress at school, and then work together to determine whether OT or PT would be helpful and, if so, what support would best meet your child’s needs at school.” 

Focus on Participation and Educational Impact 

Help keep the discussion centered on what the student is actually able to do within school routines and activities. 

Participation-based evaluation helps parents understand how a student’s strengths and challenges affect their ability to participate in everyday school activities. Rather than focusing primarily on whether an impairment or developmental delay exists, school-based evaluation looks at how the student is functioning within the educational environment and what may be affecting their access, participation, and progress. Observing the student in actual school routines can make the connection between difficulty with a particular skill and its impact on the student’s educational experience much clearer. 

This approach can also help parents understand why school-based assessment may look different from an evaluation conducted in a medical or clinical setting. The goal is to understand how the student’s needs affect participation, access, and progress in the educational program and what supports may be needed in that setting. 

To gather this information, therapists may observe students in authentic school environments, conduct routines-based interviews, analyze tasks, and gather input from the student, teachers, and parents. Classroom observations, work samples, progress-monitoring information, and other functional data can help show what the student is doing during everyday school activities, what supports are already helping, and where barriers remain. Standardized tools with a participation or functional focus may also be helpful, such as the School Function Assessment (SFA) or Participation and Environment Measure for Children and Youth (PEM-CY). 

Sharing this information with parents helps make the team’s reasoning more transparent and demonstrates how recommendations are connected to the student’s actual educational performance and individual needs.  

Explain That School-Based Therapy May Look Different from Outpatient Therapy 

Parents may expect school-based therapy to look like clinic-based treatment, including regularly scheduled one-to-one sessions. 

School-based OT and PT may look different from therapy provided in an outpatient or medical setting. Services are designed around the student’s participation in the educational environment and may occur in classrooms, on the playground, in the cafeteria, gym, or other school routines and settings. Depending on the student’s individual needs, a therapist may work directly with the student, collaborate with teachers and other team members, adapt tasks or environments, modify equipment, model strategies, or help identify the supports that enable the student to participate more successfully in school activities. 

The focus is not simply on how much time a student spends with the therapist, but on what support the student needs to participate, access, and make progress in the educational program. 

Use Clear, Strengths-Based Language 

Strengths-based language can help parents understand the student’s needs without making every area of weakness sound like a need for therapy. 

Describe what the student can do, what supports are working, where participation remains difficult, and how those difficulties affect school performance. 

At the same time, avoid language that may sound dismissive, such as: 

• “That’s medical, not educational.” 

• “We don’t work on that at school.” 

• “Your child isn’t eligible for OT.” 

Instead, acknowledge the concern and explain how the team will consider it in the educational setting: 

“I can see why you’re concerned about this. Let’s look at how this difficulty is affecting your child at school, what supports are already helping, and whether additional support is needed for your child to participate and make progress.” 

Have a Clear, Consistent Way to Describe Your Role 

Having a simple explanation ready can prevent misunderstandings and keep conversations focused on educational need. 

For example: 

“As a school-based therapist, my role is to understand what may be getting in the way of a student’s participation and success at school and to determine whether OT or PT can help. When therapy is needed, I work with the student, teachers, and other team members to find practical strategies and supports that help the student participate and make progress.” 

Using clear, consistent language across the school team can help families better understand the role of school-based OT and PT and how services support their child’s educational needs. 

Conclusion 

Helping parents understand the educational model begins with clearly explaining how school-based OT and PT support is connected to the student’s participation, educational performance, and individual needs. Participation-focused evaluation and meaningful school-based data help illustrate that connection, while clear communication about the therapist’s role and how services support the student within everyday school routines can help families understand what school-based OT and PT look like in practice.