This will provide an understanding of the differences between educational and medical therapy models as they pertain to a child’s therapy needs and how each is beneficial. An example to help differentiate . . .A school-age child who is unable to pronounce the “R” sound but is not carrying the deficit over into spelling or writing assignments, and is still intelligible to a listener would not qualify for therapy services under the educational model because while there is an impairment present, there is not an educational need. However, this child’s articulation deficits and mispronunciations of the “R” sound affect their social interactions and appropriate communication exchanges during activities of daily living, hence this child would qualify for therapy services under the medical 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.
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.
Is one better than the other?
Both models of Education and Medical Therapy services can coexist to meet all of the needs of a client. It typically works best for the child’s parent/guardian to share any assessment given by the Educational Team with the child’s physician and vice versa. This approach helps to ensure that both your child’s school professionals and physicians/specialists are fully aware of the impact a child’s impairment or disability has upon the whole child in all environments. At The Therapy Spot, we strive to treat the whole child in order to provide them with the necessary tools to cope with all aspects of daily living and to support their overall educational performance.
DIFFERENCES IN SERVICE DELIVERY MODELS
|EDUCATIONAL MODEL||MEDICAL MODEL|
|Team of Caregivers|
|Educational team includes parents, educators, and therapist(s). Using therapist(s) evaluations, the team collaborates to determine focus on service as well as frequency and duration based on the student’s educationally-related therapy needs.|
Medical team recommends focus, frequency, and duration of therapy. Third party (insurance) may be ultimate decision maker
|Duration of Services||Services are provided during the school year.||Services are provided year-round|
|Goals of Therapy||Therapy focuses on intervention to improve the student’s ability to learn and function in the school environment.||Therapy focuses on treatment to alleviate or cure specific underlying medical pathologies.|
|Goals Reviewed||Goals are reviewed or updated every 12 months.||Goals are reviewed or updated as needed or minimally through monthly progress notes.|
|Re-evaluations||Every 3 years.||Every 3 months (or as appropriate as determined by the specific insurance carrier to update levels of performance and target individual needs of the client.)|
|Documentation||Documentation of intervention is related to IEP. Emphasis is placed on educational terminology.||Therapy documentation is dictated guidelines of the setting and insurance requirements. Emphasis is placed on medical terminology.|
|Costs||Services are provided at no cost to parents.||Payment is on fee-for-service basis, covered by private insurance, governmental assistance or family|
|Ages||Student’s ages range from 0-21.||Clients/patients span all age ranges|
|Setting of Therapy||Services are provided primarily on school grounds and through school-sponsored community integration and vocational programs. Services are usually provided in a variety of settings in the student’s educational environment (e.g., cafeteria, classrooms, bus, etc.||Treatment settings usually include clinic, hospital and home. Treatment usually is one-on-one in a clinical setting.|