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  School-based Therapy Clinical-based Therapy



(also referred to as medical based or community based)

Governed by

Governed by federal and state laws.  Therapy is a related service to special education and is provided only if the child needs therapy to function in the educational setting.

Governed by state and national practice guidelines that focus on a child’s medical/functional needs in home and community settings.

Determination for Therapy

In the school, the need for therapy is determined by the IEP Team. Parents are a part of this team. The team determines the amount, frequency and duration of therapy— not the physician alone.

In clinical-based therapy, the physician, family and therapist make the decision regarding amount, frequency and duration of therapy recommended. The amount of therapy actually received may be affected by whether or an insurance company, Medicaid Program or other funding sources reimburse for the recommended services.

Methodology of Therapy

Therapy may be provided individually or in small groups by a therapist or therapist assistant. Intervention may or may not be provided directly with the child. Collaborating with educational staff to modify the child’s environment and daily school activities is always a part of school therapy.

A therapist typically provides individual treatment. Individualized home programs and ongoing caregiver training are necessary parts of the service to encourage carryover outside of treatment.

Location of Therapy

Therapy takes place where the child receives education. Appropriate intervention may be provided in classrooms, hallways, gyms, playgrounds, lunchrooms, bathrooms, or in a separate therapy room.

Community-based therapy is provided in clinics, hospitals, homes and community settings.

Therapy Services

Therapy services can be provided via direct intervention, consultation with staff, provision of adaptive equipment, individual exercise programs, safety training (including transfer training, lifting and back care), recommendations for classroom/school equipment, as well as fine and gross motor training.

Families have the opportunity to seek out services from a therapist with specialty training in areas such as soft tissue mobilization, post surgical intervention, sensory integration, aquatic therapy or neurodevelopmental treatment.


Treatment techniques, such utilizing physical modalities such as heat/cold, electrical stimulation and biofeedback training are typically not provided.

Treatment techniques utilizing physical modalities, such as hot/cold, electrical stimulation and biofeedback training may be utilized.

Dismissal of Services

The decision to discontinue therapy is made by the IEP Team. This may occur when the student no longer is eligible for special education, when other members of the IEP Team can provide necessary interventions, or when the child can perform school tasks without therapeutic intervention. There may still be a need for community-based services.

Intervention is discontinued when any of the following occurs: functional skills are achieved, a plateau in progress is reached, participation in service is limited because of various circumstances, child is stable with therapy maintenance program, discharge is requested. At discharge, indicators for potential follow up are identified. There may still be a need for school-based therapy