Cassandra Sines

This is a great visual and explanation of the difference between community-based therapy vs. school-based therapy. Many parents believe they are the same, but they are not. So many skills may not be addressed in the school system that may help the child because they are not educationally related.

OT is OT, so why not just do it at school and make life easier, right? But here’s the scoop:

School-based OT is educationally driven.

It’s only provided if the child’s disability is impacting their ability to access or participate in their education. The OT’s job in this setting is to support function within the school environment, like:
• Holding a pencil to write
• Sensory supports
• Using scissors during class projects
• Organizing materials or managing transitions

It’s not about treating all developmental concerns—just the ones that interfere with educational access.

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Outpatient OT is medically based.

This focuses on overall development and function, not just how the child does at school. It covers:
• Sensory processing challenges at home and in the community
• Fine motor delays that may not affect schoolwork (yet)
• Feeding concerns, dressing, toileting, self-regulation, etc.

Even if a child doesn’t qualify for school OT (because their delays don’t impact school performance enough), they might still have real functional delays that need outpatient support.

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So why can’t school OT be used just for convenience?

Because it’s legally tied to educational necessity. It’s not meant to replace medical services, and schools aren’t allowed to provide therapy “just in case” or “to make life easier”—even if we wish they could!