The Difference Between Your Child’s Physical Therapy in School versus Clinical Settings

You may be curious as to why your child requires both school-based and clinical physical therapy, or, perhaps, you’re confused as to why your child qualifies for clinic-based physical therapy but not for in-school services. Keep reading below to learn more about the similarities and differences of physical therapy in different settings.

Similarities Between School- and Clinic-Based Physical Therapy

Regardless of the setting where a child receives PT, both clinics and schools require the therapists to have proper licensure, practice ethically, and adhere to state laws. The goal of PT is to make sure the child has the best quality of life and to gain the most functionality possible. Physical therapists in both settings can work with other disciplines to provide a full scope of service if necessary. For example, the treatment plan can consist of your child getting both physical and occupational therapy. In this case, the physical therapist would work with an occupational therapist to either co-treat or provide services that work towards the same goal of helping your child be as independent as possible. Finally, expect both school and clinic PTs to work with you in regards to goals, advice, and concerns that you have.

School Physical Therapy

Physical therapy received in a school setting has the goal of promoting as much functionality in the school environment in regards to participating in school activities. Children will qualify for PT in schools if they meet the criteria under the IDEA (The Individual with Disabilities Education Act) or state requirements. A referral for school-based PT can be given by the parent, teacher, or therapist.

 If a referral is made, the decision to go forward with school-based PT is up to the IEP (Individualized Education Program) team based on an evaluation done by a PT in the school environment. The IEP team then creates or adds goals to an existing IEP plan that are centered on PT.

 The therapy then occurs in the school environment and is integrated into the daily school activities. Usually, the PT will work with the child’s teachers and consult with parents as well. Your child’s progress is documented in their IEP plan, and you as a parent will receive a copy with updates. School-based physical therapy services are completely covered and not billed to the family. They are paid for by the school or reimbursed through federal programs.

Clinic Physical Therapy

Clinical physical therapy is centered on promoting the most mobility and functionality in daily life. Private PT is for those children with a medical diagnosis. For example, pediatric PT can be recommended for those children with cerebral palsy, torticollis in infants, or a toe-walking gait. In Ohio, a referral is required for PT in private clinic settings. Once a referral is given, an evaluation will be done by a physical therapist that uses a series of tests to determine if the child qualifies for services and to create a plan of care that targets the diagnosis.

 If the physical therapist determines that the child would benefit from physical therapy services, services will be provided either by a PT or a PTA (Physical Therapy Assistant) in a clinic, home, hospital, or other private settings. If therapy is conducted by a PTA, the progress will be monitored by a PT. Since private PT is usually covered by insurance or private pay, the documentation is part of the child’s medical records and documented using diagnostic and billing codes. A plan of care will still be shared with the family, and goals will be updated and monitored regularly. The PT will also work with the family to counsel and advise on steps that can be taken at home to help the child daily.

  • This article is a summary of the information provided by the Academy of Pediatric Physical Therapy Fact Sheet:

    APTA Pediatrics, “Physical Therapy for Education Benefit,” 2015, accessed March 9, 2022, https://pediatricapta.org/includes/fact-sheets/pdfs/15%20PT%20for%20Educational%20Benefit.pdf.

Vicky Moroz

Vicky works closely with a group of EJ’s therapists to curate helpful content geared towards parent education and research-based writing.

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Providing Pediatric Physical Therapy in School Versus Clinical Settings

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