About The Author: Beth Tenace MOT, OTR/L has over 8 years of therapy experience having practiced in both school and clinical settings. Currently, Beth is the Clinical Director for the Pediatric Occupational Therapy department at Bothell Pediatric & Hand Therapy. She and her husband moved to Washington state in 2013 and they currently reside in the greater Seattle area.
School Based Therapy and Clinic Based Therapy: Is There a Difference?
Have you ever wondered about the differences between school based and clinic based therapy? Children who come to a pediatric occupational therapy clinic are often having trouble in school. Some of them are already receiving therapy services in school, so the question becomes “why should a child receive private services from a clinic if they are already getting services in school?” On the surface it might seem school-based therapy is the same thing, but the real answer might surprise you.
School based occupational therapy is very specific; it is, just like the title says, “school” based. A school therapist evaluates the child looking for deficits that significantly affect their ability to successfully participate in their school day. These can be poor handwriting, difficulty attending to school work, problems shifting gaze from the board to the desktop, etc. The therapist will then develop a treatment plan and goals that are education based. So, while school based OT can be very helpful for children, it is also very specific and somewhat limited. If a skill deficit is not deemed severe enough to significantly affect education, a school based therapist will not be able to provide treatment. If the problems a child is having is sensory based, the therapist may provide some strategies and tools for the classroom, but may have difficulty justifying teaching a child self-regulation skills. If a student is having difficulty with handwriting, they may not be able to address underlying core or hand strength deficits. What they are able to do is work directly with teachers and the child to adapt the classroom and help a child learn and function successfully in school. They see and assist children with specific skill deficits that are making school hard for them.
Clinic based occupational therapists are more general. Their evaluation is based on concerns mentioned by the family and may be longer and more thorough than a school based therapist’s. If handwriting is a concern, the therapist may look at core and hand strength, since a child who is slumped over on a desk or has tired hands can’t write well. They may test hand skills, vision skills, and then both together, because without eye-hand coordination a child cannot form letters correctly or keep them on the same line. The therapist may check sensory processing skills because writing for long periods of time is difficult if a child is easily distracted or frustrated. Clinic based occupational therapists are more likely to create goals that focus on underlying needs that affect a child across multiple settings. They may also be able to help with “minor” problems before they become major problems.
School and clinic based occupational therapists can work well as a team. We can help treat the whole child across settings. If your child is receiving occupational services at school, and you feel that they could use a little extra help (or if you think your child just needs a little help that they don’t qualify for at school) bring them to the pediatric clinic at BP&HT. We can give them a comprehensive evaluation and see if occupational therapy is right for them.
