Habilitation vs Rehabilitation: What’s the Difference?

Written by Alexandra Inman, PT, DPT

Published on December 12, 2022

• Habilitation is the process of gaining, keeping, and improving new skills. Rehabilitation is the process of returning to a prior skill level.
• Habilitation and rehabilitation refer to therapy areas within healthcare as well as community resources and programs.
• There may be a lot of overlap between habilitative and rehabilitative services. Differences can be found in the population treated and where the patient is in the process of learning to do new tasks. 

Have you heard of these two very similar words: habilitation and rehabilitation? You may wonder what the difference is and why that difference matters.

For parents of an adult or child with special needs, the difference between habilitation and rehabilitation is important. It can influence what kind of services your child receives and how those services are covered by insurance. 

What is Habilitation?

Habilitation refers to gaining adaptive skills for a person to increase their overall independence. For adults, services are considered habilitation if the person has a physical or cognitive disability. For children, habilitation may address disabilities or developmental delays where children are not obtaining motor or other skills by an expected age. 

While habilitation addresses learning new skills, habilitation services also includes treatment to improve skills and maintain, or prevent the loss of, existing skills and knowledge in differently abled individuals.

For instance, children with cerebral palsy may first learn transfers, brushing teeth, or other activities of daily living in outpatient therapy and then continue to address any difficulties that arise with these skills throughout their lives. As they grow up, they may need to learn more functional skills, like performing job-related tasks, and may reenter a habilitation program.  

Habilitation is more likely in community settings like day programs, residential communities, or adult job training centers. It may also be seen in typical healthcare settings—inpatient and outpatient. 

Children may receive habilitation services in both community and healthcare settings but are most likely to receive them in outpatient, school, or home settings. Habilitation in healthcare settings may involve working with physical therapists, occupational therapists, speech-language pathologists, psychiatrists and mental health therapists, and audiologists.  

Examples of Habilitation Services

What is Rehabilitation?

Rehabilitation is what people typically think of when they think of therapy services. In the healthcare world, this refers to a person returning to their prior level of function after a decline in health, often due to injury, illness, or disease. Instead of learning brand-new skills, a person receiving rehabilitation services will relearn skills they previously knew how to do.

For instance, after a traumatic car accident resulting in a broken leg and arm, a person may relearn how to walk in physical therapy and how to bathe in occupational therapy. Similarly, a person may relearn to speak and swallow in speech-language pathology after a stroke.

The “relearning” may not be literally learning the skill again step by step (though this may be the case!). It often means that motor skills must be practiced to perform them again safely, independently, and without using poor movement patterns.

Ideally, a person in rehabilitation due to changes in their health status will be able to perform skills at the same level they were able to previously once they complete their treatment. The nature of their injury or illness often dictates how long the rehabilitation process takes, sometimes requiring only weeks of health care services and other times requiring several years of treatment. 

Your child may require rehabilitation services after a broken bone, sprain, brain injury, recovery from a hospital stay, or a variety of other reasons. For incidents that constitute a major life change, your child may require long-term rehabilitation services (e.g., traumatic brain injury, spinal cord injury, during or after oncology treatments). 

Examples of Rehabilitative Services

Habilitation vs Rehabilitation: Let’s Compare

Habilitation and rehabilitation often overlap, from the settings to the types of skills addressed and interventions provided.

Insurance and Providers

Both habilitation and rehabilitation are now considered essential health benefits under the American Healthcare Act, so insurance coverage has become more widely available. Physical and occupational therapy and speech-language pathology offer both habilitation and rehabilitation, and some providers, particularly in pediatrics, regularly provide both services. 

Adaptive Equipment

Habilitation and rehabilitation may involve obtaining and learning how to use adaptive equipment that assists a person in functioning independently. Adaptive equipment might include wheelchairs, prosthetics, communication devices, splints, crutches, and reachers.

Education on adaptive equipment would be considered habilitation for a patient with a new or existing disability. It would be considered rehabilitation when education on adaptive equipment is given to an adult recovering from an injury or illness and likely will only need the device temporarily.

Interventions

The interventions provided to learn or relearn tasks that affect function and daily living may also overlap and be similar between rehabilitation and habilitation.

For instance, occupational therapists teach activities of daily living, and physical therapists will provide strengthening and gait training under the umbrella of either service. A speech therapist may address articulation with a child learning to speak for the first time or an adult relearning to speak clearly after hearing loss.

However, the strategies a therapist uses to implement these interventions may be different in habilitation versus rehabilitation.

In rehabilitative services, the patient already knows how to do the task, so the provider may focus on helping the patient move appropriately so as not to cause further injury. Or they may need to give the patient adaptive strategies to perform the task as they heal. 

In habilitative services, the patient is starting from square one and must learn not only what the task is, but also the motor skills to be successful. This typically involves a lot of repetition and hands-on assistance from the patient’s therapist. It may require that the therapist test out different learning strategies and ways to teach the task until the patient understands what they are trying to do.   

FAQs

Does health insurance cover habilitative services? What about rehabilitative services?

Health insurance typically covers rehabilitative services for any age group if it is considered medically necessary treatment. However, the number of visits and amount of coverage varies widely across private and federally funded plans. It may also be different for children (ages birth to 21) and adults regardless of disability status.

Habilitative services are covered under the American Healthcare Act when they may not have been previously. However, this is only sometimes implemented consistently despite being considered essential health benefits. Contact your insurance provider directly to discuss coverage of these services.

The information WonderBaby provides is not intended to be, and does not constitute, medical or other health advice or diagnosis and should not be used as such. Always consult with a qualified medical professional about your specific circumstances.