Outpatient vs. School-Based Occupational Therapy

crayons closeup with blurry background

Occupational therapists help individuals across the lifespan develop and strengthen skills for the job of living! The occupation of a child depends on their age and can include dressing, toileting, feeding, school, social interactions, and a variety of other occupations. Most importantly, the child’s job is to PLAY! Occupational therapists (OTs) have a variety of training in the areas of human development, psychology, sociology, anatomy, physiology, and kinesiology. OTs work with clients and their families to develop a treatment plan to addresses physical, emotional, social, and psychological needs to improve daily functioning.

Outpatient Occupational Therapy (Medical Model)

The primary role of an outpatient occupational therapist is treatment that enhances functional participation of the child at home and in community activities, which may also include school. This process generally starts with a diagnosis and a referral from a doctor but doesn’t have to. Treatment is focused on the child’s current health status and level of development and may take an interdisciplinary approach. These services emphasize a family-centered approach to care and treatment can be provided with just the client or with caregivers present. Evaluations are shared with the family and they play a very active role in goal setting. Outpatient services are reimbursed by third-party payers (insurance) or self-pay. Outpatient therapy is able to address a wide variety of skills, environments, diagnoses, and conditions. Additionally, therapy is primarily provided in a one-on-one approach but is flexible to include social settings. Not all insurance providers will provide coverage for occupational therapy and the amount may depend on whether the child is developing a skill they have never had before or rehabilitating a skill they lost due to injury or illness. 

School-Based Occupational Therapy (Educational Model)

The primary role of a school-based occupational therapist is supporting the student through academic challenges. This process generally starts with a teacher, parent, or other involved person identifying a student who is struggling academically. The services provided by school-based OTs must be relevant to the education of the student, which includes assisting with development or improvement of academic performance and school functionality. These services may be provided directly with the child, in a small group setting, in the classroom, or as a consultation service. In order to receive direct occupational therapy services, a child must have an Individualized Education Plan (IEP), which establishes relevant services and programs needed for a child’s access to an appropriate education. Consultation services can be provided as part of an IEP or a 504 plan; a 504 plan is established by personnel apart from the therapy team and is implemented to provide needed supports without direct services. Deficits that are not significantly impacting participation in school or extracurricular activities are not addressed in a school-based program. School services are reimbursed by federal, state, and district funds and are of no cost to the family. These services are provided during school and do not require a medical diagnosis. However, the student must qualify under educational diagnoses.

Both school and outpatient OTs may use a variety of intervention strategies including but not limited to: play, sensory integration, strengthening, handwriting, coordination, visual perceptual skills, and socialization. Additional interventions may include: toileting, feeding, and dressing.

The bottom line is, occupational therapy is client-specific and focuses on the client’s strengths and areas of need regardless of the location.

Schedule a free consultation with a BRAINS Occupational Therapist today to see if it’s right for you or your child by calling 616-365-8920

About the Author: Bailey Palladino, MS, OTRL is a licensed occupational therapist specializing in autism spectrum disorders, ADHD, and developmental delay. She is a member of the clinical team at BRAINS in Grand Rapids, Michigan. Read more about Bailey click here.