The Division of Labor Among Systems of Therapeutic Care for Children with Disabilities

Abstract

This article demonstrates that there is a division of labor in therapeutic care for children with disabilities (i.e., physical, occupational, and speech/language therapy) between educational and medical systems, with educational systems providing the bulk of that care. Analyses of the 1994—1995 National Health Interview Survey Disability Follow-back show that the majority of children with disabilities who received therapeutic care (75%) received those therapies only through school, whereas the remaining children received therapies only through health insurance (14%) or through other or multiple systems (11%). The majority of children who received therapies through school received speech/ language therapy, whereas most who received therapies through health insurance received physical therapy. Children served through the schools were younger and were more likely to have communication and learning limitations, compared with those who received therapies through insurance. Policy implications regarding payment for pediatric therapies and coordination of care across multiple service systems are discussed.