Physical Therapy

What Do Physical Therapists Do?

Physical therapists make sure that children can move about in their school setting, playground, bus and anywhere else that students go. Their role is to ensure that children with motor needs have full physical access to all aspects of their school life.

PT in School

The primary role of Physical Therapists and Physical Therapy Assistants in school-based practice is to work with a team to ensure that students are able to physically access their educational environment. This can be done by remediating and strengthening, by helping to design and implement accommodations, by working with families and community providers around equipment, and by educating and advising the staff that work with students daily. Assessment, treatment, communication, written reports, and keeping up with best practice are all parts of the job of a School-Based PT.
School-based PTA's share in all of these responsibilities as well, under the supervision of a PT.

Definition

According to the Virginia Regulations governing Special Education Programs for children with Disabilities, “Physical therapy” means services provided by a qualified physical therapist or under the direction or supervision of a qualified physical therapist upon medical referral and direction.(Regulations Governing the Practice of Physical Therapy, 18VAC112-20; 34 CFR 300.34(c)(9))
PT’s Role In School.

PT’s Role In School

• Part of the special education team
• Helps to identify barriers to participation in and benefit from educational setting
• Helps to make a better “match” between the student’s skills and the demands of the school setting
• May use consultation to staff & family and/or direct work with the student

PT is a “Support Service” In Schools

• This means that PT is added on to an IEP or 504 to support the primary service providers:
  • Special educators
  • Speech & Language Therapists

Students must first be found eligible for special education services before schools are required to consider providing direct PT services.

Process To Determine Need For PT Services

• Often, a request for assessment is made by the special education team.
  • This can be part of initial or triennial evaluation, if it is strongly suspected that PT will be needed.
  • It may be a result of discussion around developing an IEP.
• Following assessment by an PT, the educational team will meet to consider the results of the assessment and determine whether it is necessary to add PT services to the student’s plan.

What Are The Criteria For PT Services?

• IEP or 504 Team decision, given the guidance of an PT (after observation &/or assessment)
• Services must be driven by the IEP/504 goals
  • There should not be “PT goals,” but educationally-related goals that the PT is helping to work towards

Differences Between Medically-Based and School-Based Physical Therapy

Many people are familiar with Physical Therapy (PT) through a medical setting. They may have a family member who received therapy after an injury or as part of rehabilitation in a clinic or hospital in their community. Parents may receive a referral for Physical Therapy for their child from their pediatrician. However, there are some differences in PT delivery within the school setting from the medical or health-related setting.

Things You Might Observe PTs Doing

Medically-Based

• Use heat/cold, Electrical stimulation (TENS), ultrasound, etc.
• Assign exercises for home programs to strengthen specific muscles
• Teach patients and care-givers transfers (between chair and bed, chair and bathtub, for instance)
• Use bars, balance boards, etc. to work on gait training and use of mobility devices
• Perform hands-on muscle releases, wound management, massage etc (as qualified)
• Work with people of all ages post-injury to regain strength and range-of-motion, under doctor’s guidance
• Be part of an athletic training team with a focus on avoiding injury
• Assess aspects of gross motor skills to find areas of dysfunction, weakness, or limited range of motion and recommend goals for those sub-skills (for example: increase strength of deltoids to “fair-plus”)

School-Based

• Work with community providers to select, adjust, and monitor assistive devices for mobility and positioning (wheelchairs, for example)
• Teach classroom assistants and students how to maintain students’ strength and range of motion through the school day
• Teach classroom staff and student how to safely transfer in school (between chair and toilet, for ex.)
• Work with students in actual daily setting to work on positioning & mobility (stairs, playground, doors…)
• Help find ways that students with physical disabilities can actively participate with their peers in activities (phys. ed. class, recess, and fieldtrips are some examples)
• Assess and modify furniture for positioning of students with special needs (add a footrest to a chair, for instance)
• As part of a team, address safety concerns in the design and emergency plans of schools
• Assess PT needs functionally and specifically to the school setting