Pediatric Therapy vs. School Services
How private pediatric therapy and school-based services compare — and why most families end up using both.
Most parents don't realize their child's school district has therapists on staff — or that those therapists have specific limitations. Understanding what school services cover (and don't) is essential for making decisions about private therapy.
School-based therapy: what it is
Under federal special education law (IDEA), school districts must provide therapy services for children whose disabilities affect their educational performance. This includes occupational therapy, speech-language therapy, and physical therapy when appropriate.
Services are free, delivered during the school day, and tied to the child's Individualized Education Program (IEP) goals. They're typically delivered in 20–30 minute sessions, often in groups, focused on academic-related skills.
Private therapy: what it is
Private therapy is delivered in a clinical setting (or sometimes telehealth), 1:1, and isn't bound by educational impact criteria. Sessions are typically 45–60 minutes, weekly or twice-weekly, and address a much broader scope.
Where they differ
The key differences:
- Eligibility: school requires educational impact, private only requires concern
- Cost: school is free, private is insurance-billed or self-pay
- Frequency: school 1–2x/week in groups, private 1–2x/week 1:1
- Scope: school addresses educational impact, private addresses comprehensive functioning
- Family involvement: school limited, private central
- Caseload: school SLPs/OTs often have 50+ children, private practitioners much smaller caseloads
When to use which (or both)
For children whose challenges primarily affect school performance and are mild to moderate, school services may be sufficient. For more comprehensive challenges, complex profiles, or when you want family-centered work, private therapy adds significant value.
Many of our families use both. School covers the academic component; we cover the broader work that school services can't.
How they coordinate
When you have both school and private therapy, coordination matters. With your permission, we communicate with school therapists and IEP teams, share evaluation reports, and align goals. Coordinated care produces better outcomes than fragmented care.
Frequently Asked Questions
Will my child qualify for school services?
If my child gets school services, is private therapy redundant?
Will school services and insurance compete?
Can private therapists attend IEP meetings?
Related Free Resources
School services and private therapy aren't in competition — they cover different parts of the picture. The best plan often uses both, coordinated together.