Becoming a School-Based Clinician 101

Are you interested in becoming a school-based clinician? Or perhaps you’ve recently accepted a school-based job? Do you just want to know more about your options?

In this article, we’ll provide a foundation in school-based clinical practice as well as ideas, tips, and tricks for starting your school-based journey. We will touch on a few key aspects of being a school-based clinician—which can vary significantly from other settings—and hopefully serve as a guide to help you get started or make a decision about whether school-based work is right for you.

Let’s jump in.

Understanding the School Environment

The school environment can differ greatly depending on the district, county, and state you are working in. As a school-based OT, PT, or SLP, you will need to know:

• District policies
• The school calendar, including both the daily and yearly schedule
• The school culture
• How to navigate school grounds, including knowing the location of emergency exits and bathrooms
• How the Individuals with Disabilities Education Act (IDEA) shapes clinical practice in schools

Also, take the time to introduce yourself to key members of the staff whom you may rely on in the future—everyone from administration to teaching staff to custodial.

Expert tip: If you have the option to work in the summer, consider these questions:

• Are you required to work summer school/extended school year (ESY)? If so, what are the days and times?
• Is your summer contract different from your school-year contract?
• Will you be paid the same amount for summer work? Is your salary dispersed over the entire 12-month calendar year or are you only paid over 10 months? If you are only paid for 10 months, make sure to plan how you will get by without pay for the other two months.

Understanding the Students and Educational Models

The students you serve will require different levels of support as well as knowledge of typical pediatric diagnoses. Some districts have self-contained programs for students who require more support than a general education classroom, and some do not.

It will be important for you to know what programs your district has, where they are located, and how they work. All information about the student, from their diagnosis and service hours to their goals, is documented in their individualized education program (IEP), which is required under the IDEA.

Expert tip: Based on a student’s IEP, they may be either pulled out of class to receive therapy individually or their therapy may be incorporated into the classroom setting. Some IEPs may have a combination of both these options.

Understanding School-Based Intervention

Treating a student in a school environment is different from treating in a clinical environment, which is demonstrated in the educational vs. medical model.

Parents and teachers are often confused by the role of a school-based clinician, reaching out for requests to address skills or activities that impact a child but are not academically relevant such as difficulty getting dressed in the morning. It’s important that you as the clinician know the difference so you can explain to parents and teachers that while getting dressed in the morning is an important skill, it would not be something addressed by the educational model of service.

While this can be a hot-button issue, generally speaking, your treatment should be academically relevant.

Understanding School-Based Documentation

Data-driven documentation focuses on the student’s progress toward their goals. A student’s goals are generally written for the school year, with progress updated on a semester or trimester basis.

Each student’s progress is formally updated on a yearly basis via annual review, and every three years, a student must be fully re-evaluated—usually including formal assessments—to continue to qualify for special education services via triennial review.

Expert tip: There are formal timelines to conduct, complete, and report both annual and triennial reviews. Make sure you are aware of these timelines.

Understanding School Meetings

As a school-based clinician, be prepared to attend a lot of meetings! You will need to participate in meetings to:

• Review the student’s progress
• Change the student’s goals
• Review evaluations
• Determine placement in programs
• Add or discharge services
• Change service hours

Expert tip: Learning about the Individuals with Disabilities Education Act (IDEA) Part B, which covers ages 3-21, is critical to know and understand in your school-based journey. MedBridge’s course library includes several courses for school-based clinicians on IEPs and the IDEA so that you can hit the ground running.

Next Steps

Now that you know more about becoming a school-based clinician, what are the next steps?

• Apply for jobs. The best place to check for recent openings is directly on the district website.
• Join a group or association. There are a lot of groups out there that can help you on your journey, including national, state, and social media groups.
• Earn some CEUs. CE courses are a great way to gain some knowledge. Check out MedBridge’s course offerings for school-based clinicians to get started.