The primary therapist model: addressing challenges to practice in special education

When occupational therapy (OT) and physical therapy (PT) are provided as related services in educational settings, federal law, professional guidelines, and validated practices have pointed to appropriate models of service provision. Issues such as personnel shortages, professional isolation, and questionable educational relevance of services all create barriers to use of recommended practices. The overlap between OT and PT in special education suggests one strategy to help address these barriers: a primary therapist model. In this model, an OT or PT is assigned as primary therapist, with consultation from the other discipline as required to meet student needs. Potential benefits of the model, challenges in implementation, the best practice framework needed to support the model, and the need for research on costs and benefits are discussed.