Understanding the Difference Between Clinic-Based and School-Based Physical Therapy

by Howard Gerber on May 26, 2016

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school physical therapistIf you are transitioning from a clinic or hospital-based physical therapist job to a school-based PT job, you may have an idea about how they are different. After all, you know you will be working with children and teens in an educational environment as opposed to a clinical setting. Although the foundations of your responsibilities as a physical therapist are similar, there are also many differences to be aware of. Consider some of the following questions and answers regarding the differences between clinically-based and school-based PT work.

Who qualifies for services?

When you work in a clinical setting, such as a nursing home or hospital, physical therapy is usually recommended by the doctor based on the patient’s diagnosis. When it comes to qualifying for services in a school setting, physical therapy is considered a related service for children who benefit from special education. Children who receive special education services are entitled under law also to receive services, which support a student’s individualized educational program (IEP).

Who pays?

If you receive physical therapy in a clinical setting, you are required to pay for services. In many cases, the patient pays for services through their medical insurance. Payment works differently for school-based physical therapy. Parents are not responsible for payment.

If PT is deemed necessary for a child’s ability to participate in special education, costs are covered by a combination of the state’s Medicaid program and the school district the child is attended.

Are physical therapy techniques different in a school setting?

The principles of physical therapy – such as improving motor function, strength, and balance – remain the same regardless of the setting. Therapists in all settings assess their patients and implement therapeutic interventions. But physical therapy in a school setting primarily addresses physical challenges that interfere with the child’s education. For example, a physical therapist may work with a student to explore seating adaptations or teach children how to use adaptive equipment that helps the student move around the school.

It’s common for therapists to focus on increasing mobility and safety so children can participate in school activities. In some instances, physical therapists instruct teachers on how to assist the child with physical tasks or help the student use adaptive equipment.

How is therapy provided?

There are certain regulations physical therapists must follow when they provide therapy in a school setting. Individual guidelines may vary. Usually, children are treated individually or in a small group setting. A certain amount of time is set aside during school hours for the child to participate in PT. The therapist must also set aside time to discuss the child’s progress with parents and teachers and update goals and interventions performed.

When is therapy discontinued?

If you work as a therapist in a hospital or rehab center, physical therapy is completed when the doctor discontinues the services or the patient is discharged from the facility. In a school setting, physical therapy may continue for as long as the educational team and parents feel therapy is still required for the child to progress towards the goals listed on his individualized educational program.


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