Pediatric Therapeutic Services

Here’s Help Translating School-Based Therapy “Alphabet Soup”

Imagine: It’s your first day in your brand-new school-based therapy job. The school psychologist pokes her head into your office. “Hi!” she says. “The MDT is meeting to discuss Amy Jones’ MDE since the IEP meeting is in two weeks. I put you on the PTE, so you can get started!”

New female school-based therapist sits in circle with five elementary school boys and girls during group session.Blinking, you stare at her in silence. As soon as she leaves, you quickly Google what she said. Chances are the search terms will lead you to this very blog!

If you’re leaving a hospital or rehabilitation setting to start working in schools, you may feel like you’ve arrived in a different country where everyone speaks a different language. It may sound more like alphabet soup than clinical terminology!

At Pediatric Therapeutic Services (PTS), we know our field’s “lingo” can confuse clinicians just entering school-based therapy. That’s why we’ve put together a brief introduction to help you understand what everyone’s talking about.

How Qualification Differs in Medical vs. School-Based Therapy 

Students receiving related services in school must qualify based on their need for supports, Some children who would qualify for medically based therapy services won’t qualify for school-based therapy services.

In the medical model, the physician initiates a referral based on a particular diagnosis or an observed delay in one or more developmental areas. But in an education-based model, schools provide therapy only when it’s related to educational needs.

The medical environment bases services on testing and clinical observations of both quality and function. But in schools, related services are possible only when “required to assist a child with a disability to benefit from special education” (Individuals with Disabilities Education Act (IDEA) § 300.34). Testing, classroom observations, and input from the student’s team determine the need for services, but the child is assessed only for needs associated with their educational program.  

Once you enter school-based therapy, you must ask, “Does this student need my support to be able to learn or do X so they can participate in their educational program?” before saying the student qualifies for therapy.

In addition, the decision to qualify a student for related services is a team decision. Everyone on the child’s Multi-Disciplinary Team (MDT) can provide input: teachers, parents, administrators, and (when they are older) students.  

Assessment Process Procedures and Possible Outcomes

When you’re testing students to determine if they qualify, your evaluation becomes part of a comprehensive Multi-Disciplinary Evaluation (MDE)—a global look at a child’s strengths and needs. The specific disciplines an MDE includes vary depending on what functional issues a student exhibits.

Female school-based occupational therapist sits with boy with Down syndrome facial characteristics as he practices writing.

Testing can’t begin until the child’s parent or guardian formally signs a Permission to Evaluate (PTE).  This document outlines who is doing the testing and what kind of testing can be done. Never begin standardized testing without parental permission. Doing so is one of school-based therapy’s big “No-Nos”!

Once the evaluation is complete, you, the student’s parents, and other team members will meet.

If the child qualifies for special education, the team creates an Individualized Education Plan (IEP).

If the child qualifies for supports in the regular education setting due to a medical condition (for example, Attention Deficit Disorder or Muscular Dystrophy) that impacts a major life function, the team creates a 504 Plan.

Another term you’ll want to know is the Notice of Recommended Placement (NOREP) (in some states, also called a Prior Written Notice). The NOREP is one of the most misunderstood documents in special education. The school district must provide one whenever it proposes or refuses to change any child’s special education identification, placement, or provision of a Free Appropriate Public Education (FAPE).

Many timelines govern these documents’ signing and the beginning of services. They vary by state, so make sure you learn when things are due and what pieces are yours to handle (responsibilities depend on your therapy specialty).

Setting, Reaching, and Reporting on School Therapy Goals

You will be asked to write measurable, observable goals for the child’s IEP, which should be goals driven by your evaluation’s findings. It’s important to know and document where the child is now (their present level of function) to compare to your goal(s) for measurable progress.

You’ll also be asked to write Specially Designed Instructions (SDIs). SDIs are strategies and supports related to your discipline that adapt content, methods, and/or instructional delivery to address a student’s unique needs and enable them to achieve the highest outcomes.

As in the rehabilitation setting, students receiving related services in school need their progress monitored and assessed to support ongoing delivery of services. You’ll need to report on students’ progress toward their measurable, observable goals with the same frequency that students in regular education get report cards. 

Let PTS Help You Enter School-Based Therapy the Right Way

We hope this discussion of some core school-based therapy concepts and the acronyms we use to talk about them gets you off to a good start. Give yourself a little time and you too will be speaking school-based therapy “alphabet soup!”

Learning the language isn’t the only issue to consider. For example, will you work as a school employee or an independent contractor?

Click here to download our free guide to figuring out whether practicing as an independent contractor is right for you!

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