School-based therapy is one of many settings in which children with disabilities may receive therapeutic intervention. As one piece in the child’s rehabilitation puzzle, you may be asking yourself where do I fit in the overall picture and how does each piece connect to the next?


Two pieces occur prior to school-based intervention and serve as a foundation for future intervention.

  1. NICU is an intensive care unit for infants born prematurely and/or with medical complications. Therapeutic intervention focuses on positioning, tone/contracture management, feeding, and sensory input regulation.  The service team consists of the family, doctors, nurses, and therapist.  The entire team coordinates care until discharge.  Children are usually referred to outpatient or early intervention services for follow up.
  2. Early intervention is therapy and medical services in the natural environment for children ages 0-3. Goals and intervention are based on family concerns and outlined in the IFSP (individual family service plan).  A service coordinator helps acquire and schedule evaluations and services.  Family training is desired over frequent direct intervention and/or multiple specialties.  Early intervention provides a transitional meeting for children to assess their need for service continuation via the school system at age three.


The next three pieces can be used together or separately at any point in time.  Realizing that you may not be the only therapist involved in a child’s care is essential to finding your fit. 

  1. School system intervention is provided to children ages 3-21 with disabilities that affect their ability to participate in and benefit from the educational system. The service team, consisting of the child, family, therapists, teachers and others, is involved in making the IEP.  Goals, frequency, and duration are specific to needs within the education setting.
  2. Outpatient therapy services are clinic based. The service team can consist of multiple therapy disciplines, and a physician order is usually required.  Frequency and duration are determined by the evaluating therapist to attain the patient or family goals.  Some families may attend outpatient therapy services in conjunction with school-based intervention to address goals outside of education needs.
  3. Inpatient rehabilitation/PICU are hospital based therapy interventions that can occur at any age following an illness, surgery, or injury. Therapy interventions are focused on the child being able to function upon return home following discharge.  Children can be discharged with the need for continuing services and equipment.  A working knowledge of therapy services can assist upon the child’s return to school, such as a change in equipment and physician issued restrictions.


Completing a puzzle can take time and effort, such as understanding how one setting transitions to another, or discussing equipment needs with all of the child’s therapists, or focusing on tasks that are not being addressed by other settings.  By better understanding how other therapists are shaped by their specific role, you can discover how to become the child’s perfect fit.


Author: Jill G. Bugner, PT, DPT

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