Starfish Therapies

March 31, 2016

Educational vs Medical Based Physical Therapy

Filed under: Developmental Milestones — Starfish Therapies @ 5:00 pm
Tags: , , ,


If my child is receiving medically based physical therapy, why don’t they get physical therapy at school?

This is a question we are asked all the time. While some children may have both an educational and a medical need for physical therapy the answer comes down to the purpose of services.

When a physical therapist recommends services medically this is based on the child’s health and rehabilitating a prior level of function or a need for therapy in order to achieve something that will improve their health and decrease their need to access other medical services.

For a physical therapist to recommend services at school, the therapist has to document that the child needs to do something at school to be safe or access their school curriculum that require the services of a skilled therapist to achieve. When a child is on an individual education plan (IEP) this is driven by needing the services of a skilled therapist to meet the goals identified for them to indicate adequate educational progress. When a child is on a 504 plan, this means that in order to progress with their current group of peers, they require the support of a skilled therapist to meet educational standards.

This means that once a child is safely able to move around their classroom, the campus, and use the playground on site safely and as independently as they will able to given other factors like age, cognition, or behavior they frequently are found to not need educationally related physical therapy as they are successful in that environment. While this does not mean they’ve met their maximum motor abilities or that in a different model of service delivery, like the medical model, they would not have a need for the services of a physical therapist, it does mean that there mobility skills are no longer limiting their education.

We frequently try to explain it in the simplest ways, physical therapy in the educational environment is to support the student safely accessing their education.  In school, gross motor development generally falls under physical education.

This is just to help with a basic understanding of the difference in the models.  It would be easy to go further in depth but we wanted to help answer a question we get a lot of times.



  1. Great information! Thanks for explaining the difference between the two, this is always such a common question.

    Comment by Jennifer — April 2, 2016 @ 12:31 am | Reply

  2. Thank you for trying to explain this, but I think there are other factors which continue to baffle me. I have been a teacher who works with quadriplegic children for 40 years. As school districts look for ways to cut finances, the medical vs. educational model debates are used as rationale to limit important prescribed services. A hungry child cannot focus on educational objectives, and the school offers breakfast and lunch in recognition of the “physical” need…why is it not just as important that a physically impaired child in pain from tight inactive muscles,factors into educational performance. I am baffled that more and more therapists succumb to limiting important services in the school setting under the shaky medical vs. educational theory. Parents struggling to load up a 100 + lb. child or young adult to transport them to a hospital setting for PT once or twice weekly just isn’t going to happen very often or will result in the parents needing physical therapy from the strain. These students need the service provided in the setting they are naturally in…school. The service needs to be provided by certified professionals not teachers and their assistants, and I cannot understand therapists not advocating for these children simply to appease directors looking for ways to cut expenses by passing responsibilities to other agencies or allowing unrealistic caseloads.

    Comment by Denise Fitzpatrick — April 2, 2016 @ 8:39 am | Reply

  3. The APTA has a very good document that addresses educational and medical models of physical therapy service.

    Comment by Andy — April 5, 2016 @ 6:58 pm | Reply

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