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Clinical-Based and School-Based Occupational Therapy: What’s the Difference?

Oftentimes the question is asked, “What is the difference between occupational therapy (OT) in schools in comparison to an outpatient clinic?”  There are many similarities and the differences may be subtle and challenging to identify. First, with the medical model (outpatient clinic), OT services can address any deficit area for a client, as long as funding sources allow.   In the school-based model, OT services address deficit areas that are related to and impact the student’s education so they must have an IEP (Individualized Education Program).  The purpose of school-based OT is to help a student benefit to their fullest potential from their educational program. 

Outpatient clinic OT services may directly work with areas of deficits such as:

  • Fine Motor /Visual Motor Skills
  • Cognition
  • Executive Functioning
  • Mental Health
  • Sensory Processing
  • Self-Regulation
  • Ocular-Motor Skills
  • Oral Motor
  • Life Skills
  • Strength
  • Range of Motion
  • Balance Coordination
  • Gross Motor

School-based OT services also address the above; however, the deficit must directly impact the student’s ability to access their educational program. For example:

  • Fine motor/visual motor skills to complete school-based tasks
  • Life skills that affect areas such as changing for gym class, independence in the lunchroom, donning/doffing coat for recess time
  • Executive function skills (organization, time management, attention to task, appropriate play)
  • Sensory processing challenges that affects the student’s ability to participate in their school day
  • Strength, which affects the student’s ability to maintain appropriate posture to complete school related tasks

Another important difference in a school-based setting is that not all students will qualify to receive OT.  School-based OT is a related service per IDEA (Individuals with Disabilities Education Act) and a student needs to have an IEP (Individualized Education Program) to qualify for related services.  A very basic example is the child who is receiving outpatient OT to help them become more independent with hygiene, brushing their teeth, washing their hair, and grooming. In a school setting, those tasks are not necessarily performed in school and may not affect the student’s ability to access their education, therefore, he or she may not receive that specific OT service. Another example is the 1st grade student who cannot donn or doff their coat independently and requires assistance from a teacher or staff member each time they prepare for recess or pack up to go home. If the student has related services at school on their IEP, then this area could be addressed by an OT in the school setting. 

It is a confusing difference to understand, but the best advice is to consult with your child’s physician, their clinic therapist and/or educational staff to determine which services are appropriate and necessary. 

Respectfully submitted by: JJ Schweikert, MOT, OTR/L


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Patient Reviews

LLA Therapy

Patient Reviews

Crystal Scheibe

Great place, glad we found them. Been going to Medina over 2 months now and he loves Lauryn and Kyler. Wish they had more ABA therapy places available... live in Wooster and long drive everyday.

Karrie Swan LaRock

My 11 year old son has dyslexia and has made noticeable gains in working At LLA THERAPY. Katie is strong in her approach toward him and also keeps him comfortable enough to perform well. We will continue visiting both the Fairlawn and Hudson offices and recommend them highly.

Ron Monroe

My 9 year old just completed about 9 months of weekly speech sessions (due to his stuttering) with Matt Hagge at LLA and we are thrilled with the experience and results. What I thought might be a negative (what kid really wants to go to speech class?) was made very positive by Matt, and my son never hesitated or complained when we talked about class. He really enjoyed it and really took what Matt taught him to heart. His speech has been greatly improved and we definitely recommend LLA. Thank you so much!

Heather Dougherty-Pantoja

My son’s Occupational Therapist, Jess, is an amazing OT! She gives practical tips on working with my son at home and school!

Terri Apgar

I cannot say enough good things about LLA Therapy. My daughter was a client of Teal Simmons’ for approximately 2 years and was just released from speech therapy! She was diagnosed with Apraxia in 2015 and worked with Teal twice a week. Through Teal’s application of PROMPT therapy, my daughter had age-appropriate speech after one year. All of the staff we interacted with at LLA were absolutely wonderful. They really care about what they do and making sure your child achieves their goals.

Kelli Geisler Davisson

LLA Therapy has been an excellent experience for my son as well as my family! My son always asks, "When can I go see Ms. Jeannine again, is it Monday??" He has also made huge gains in only 5 months! I would highly recommend LLA and have already shared my experience with friends looking for services!

Victoria Hansford-Price

We are so grateful for our Speech Therapist Ms.Teal. We have seen a great improvement with our sons confidence and communication abilities since we have started "Prompt" therapy. What we love the most about LLA and Ms. Teal is that Kohl feels comfortable and relaxed which has played a critical role in his progress. Thank you Ms. Teal for all you have done.

Laura Lee Hogsett

They have helped in numerous ways. Speech, OT and behavioral. I've had numerous compliments on my son's progress thanks in very large part to LLA. I would recommend LLA before I recommend our local children's hospitals, though they are good, they don't have the staff that LLA does.

Amy Furukawa

We had a great experience with Matt Hagge at LLA! Our Middle School age son was becoming very conscious of his voice, which is nasal due to a cleft palate. Matt helped him to better form his sounds and project his voice in a way that makes the unavoidable nasality less noticeable.Our son is more confident and outgoing & even took on a speaking role in the church play. Matt has the perfect personality to relate with our son, and we would recommend him to anyone needing speech therapy services!

Jessica Havalotti

LLA Therapy has been an excellent experience for our daughter. I would highly recommend LLA. Miss Grace was so amazing and I can't believe how quickly our daughter showed improvement. Thank you!
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