Educational vs Medical Model

The appropriateness and extent of therapy provided by a school division should be related to the educational needs rather than the medical needs of a student with disabilities. It is therefore important to understand the difference between educational and medical models and strategies for service delivery.




Educational team includes parents, educators, and therapist(s). Using therapist(s) evaluations, the team collaborates to determine focus on service as well as frequency and duration based on the student’s educationally-related therapy needs.


Medical team recommends focus, frequency, and duration of therapy. Third party (insurance) may be ultimate decision maker.

Therapy focuses on intervention to improve the student’s ability to learn and function in the school environment.


Therapy focuses on treatment to alleviate or cure specific underlying medical pathologies.

Services are provided primarily on school grounds and through school-sponsored community integration and vocational programs.

Treatment settings usually include clinic, hospital and home.

Services are usually provided in a variety of settings in the student’s educational environment (e.g., cafeteria, classrooms, bus, etc.)


Treatment usually is one-on-one in a clinical setting.


Student’s ages range from 0-21.

Clients/patients span all age ranges


Services are provided at no cost to parents.

Payment is on fee-for-service basis, covered by private insurance, governmental assistance or family

Documentation of intervention is related to IEP. Emphasis is placed on educational terminology.

Therapy documentation is dictated guidelines of the setting and insurance requirements. Emphasis is placed on medical terminology.


Educational Relevance

“Education takes place through the process of communication. The ability to participate in active and interactive communication with peers and adults in the educational setting is essential for a student to access education (Michigan Speech-Language-Hearing Association, 1995). In order for a communication disorder to be considered a disability within a school-based setting, it must exert an adverse effect on educational performance. The speech-language pathologist and team determine what effect the disorder has on the student's ability to participate in the educational process. The educational process includes pre-academic/academic, social-emotional, and vocational performance.” (American Speech-Language Hearing Association:  Guidelines for the Roles and Responsibilities of the School-Based Speech-Language Pathologist)