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WHAT IS SCHOOL-BASED PHYSICAL THERAPY?
WHAT IS SCHOOL-BASED PHYSICAL THERAPY?
School-based physical therapists (PT) are part of a team of related service providers who support a student’s ability to access his/her educational environment. As specialists in movement, they assist a student’s physical participation in a variety of settings throughout the school day. The primary role of the school PT is to help students benefit from their educational program within the educational environment.
Physical therapy in the school will address functional skills in the educational environment such as:
• Walking or wheelchair skills
• Stair climbing
• Balance
• Coordination
• Sensory Awareness
• Self-care skills
• Large motor skills
• Positioning
• Assistive mobility and positioning devices
WHY DO CHILDREN RECEIVE PHYSICAL THERAPY IN SCHOOL?
WHY DO CHILDREN RECEIVE PHYSICAL THERAPY IN SCHOOL?
In 1975, Public Law 94-142 was passed. This required all school-aged children with a disability to be entitled to special education and related services at no cost to the parents. Related services include occupational therapy, speech therapy, physical therapy, and more. In 1990, Congress reauthorized Public Law 94-142 and renamed it the Individuals with Disabilities Education Act, or IDEA.
The Individuals with Disabilities in Education Act (IDEA) and the Every Student Succeeds Act (ESSA) are federal laws, with state education agency oversight, that support the provision of public education for all children, regardless of the presence, nature, or severity of a disability.
In these laws, physical therapy is identified as a meaningful service within the school system and considered under IDEA as a related service. Related services are “developmental, corrective, and other supportive services that are required to assist a child with a disability to benefit from special education”.
WHAT IS THE DIFFERENCE BETWEEN SCHOOL-BASED AND CLINIC-BASED PHYSICAL THERAPY?
WHAT IS THE DIFFERENCE BETWEEN SCHOOL-BASED AND CLINIC-BASED PHYSICAL THERAPY?
School-based physical therapy (PT) is different from clinic-based physical therapy and determining the need for each of these services is different.
School-based physical therapy is considered a related service by IDEA. School-based physical therapy is a unique, skilled service that is “developmental, corrective, and other supportive services that are required to assist a child with a disability to benefit from special education”.
PT in the educational setting focuses specifically on assisting the student in accessing and participating in their education. School-based PT services are provided at no cost to the family. Educationally related physical therapy is directed towards adapting the environment, modifying functional tasks, and addressing motor performance in order to maximize the access and benefit from their educational environment. School-based physical therapy should enhance, not duplicate teacher services within the classroom.
Clinic-based physical therapy services follow different guidelines than school-based services. Clinic-based PT focuses on a child’s medical needs. This type of PT is usually recommended by a doctor and is typically provided in an outpatient therapy clinic or hospital. PT in a medical setting assists the client in optimizing function in any areas deemed important by the client. These services' primary objective is to maximize the child’s skill level, quality of movement as well as function. Clinic-based services are typically focused on a student’s physical impairments and clinical deficits. Clinic-based PT is usually paid for by insurance companies or Medicaid.
School-based physical therapy is not intended to replace clinic-based physical therapy.
WHAT ARE SOME SIGNS THAT WOULD INDICATE THAT SCHOOL-BASED PHYSICAL THERAPY MAY BE NECESSARY FOR A STUDENT?
WHAT ARE SOME SIGNS THAT WOULD INDICATE THAT SCHOOL-BASED PHYSICAL THERAPY MAY BE NECESSARY FOR A STUDENT?
There are many signs that would indicate the necessity of school-based physical therapy services for a student. Listed here are several, but not all, examples of what a student may have difficulties with:
Negotiating the school - walking patterns, stair climbing, opening/closing doors, up/down ramps, wheelchair skills, etc.
Gross motor skills (large motor skills) - jumping, skipping, hopping, etc.
Posture - does not sit properly, slumps on desk frequently, etc.
Self-care skills - transferring on/off the toilet, getting their backpack on/off, etc.
Balance skills - falls frequently, stumbles when walking, etc.
Coordination skills - difficulties throwing, catching, and kicking, etc.
Transition skills - on/off the school bus, walking in the classroom line, transitioning from sitting to standing, etc.
HOW DOES A STUDENT QUALIFY FOR SCHOOL-BASED PHYSICAL THERAPY?
HOW DOES A STUDENT QUALIFY FOR SCHOOL-BASED PHYSICAL THERAPY?
A teacher or other service provider, or a parent may request a referral for a student for a physical therapy (PT) observation or screening through the school-based Student Intervention Team. Once it is determined that the student may require physical therapy services, a physical therapy screen or evaluation would be completed. Therapists will use a variety of tools to identify deficits that can impact a student’s learning in the school environment. These can include interviews with teachers, observing the student in the classroom, PE, the playground, and administering standardized tests.
After the physical therapy evaluation is done, the results are discussed with the members of the special education team (which includes the parents). If the PT decides that the student would benefit from school-based physical therapy, how often the student will receive services will then be determined.
Before referring a student to the physical therapist, consider how your concern affects the child’s access to their curriculum. If the student is benefitting from the education program without the service, consider what the benefit of the referral will be. For example, if a student appears “clumsy”, but is safe on the playground and participates in PE class, think about what part of the education he/she lacks access to. Remember that school-based PT must be related to a student's educational needs.
Visit the Referral Process link for more information.
ONCE IT IS DETERMINED THAT THE STUDENT QUALIFIES FOR SCHOOL-BASED PHYSICAL THERAPY, WHAT WILL HAPPEN NEXT?
ONCE IT IS DETERMINED THAT THE STUDENT QUALIFIES FOR SCHOOL-BASED PHYSICAL THERAPY, WHAT WILL HAPPEN NEXT?
In order to ensure that students with mobility needs are able to access their educational environment to the fullest, the school-based physical therapist (PT) supports students with mobility needs in various ways. School-based PT services may be provided directly or indirectly.
For direct intervention, the therapist has face-to-face contact with the student. The physical therapist works with the student on a consistent basis either individually or in a group setting. This can be provided in a common area, the classroom, PE, the playground, or any other location where the student needs to practice motor skills.
For indirect interventions, the physical therapist will consult with classroom staff and other interventionists to make recommendations and suggest strategies to enhance a student’s independence and participation in school. The school therapist will also provide training to school staff in order to support the student safely and optimally in order to allow the student to participate in his/her educational setting. It may be given on a daily, weekly, or monthly schedule. Physical therapy services may be provided in the classroom, communal school areas, the playground, cafeteria, etc.
WHAT TYPE OF ACTIVITIES MAY OCCUR DURING A PHYSICAL THERAPY SESSION?
WHAT TYPE OF ACTIVITIES MAY OCCUR DURING A PHYSICAL THERAPY SESSION?
Listed here are some, but not all, examples of what may occur during a physical therapy session:
Strengthening exercises
Stretching exercises
Instruction/practice of functional skills such as stair climbing, carrying books or a backpack, opening/closing doors, etc.
Walking activities in the classroom, hallway, cafeteria, gym class, etc.
Assessment/modification of adaptive equipment such as classroom desks and chairs, bathroom modifications, positioning equipment, etc.
Activities to improve the large motor skills necessary for physical education or recess
Coordination activities
Activities to improve sensory processing such as obstacle courses, swinging, jumping, etc.
Instruction/practice of wheelchair use
Activities to improve balance
Equipment fitting/management
Instruction to other staff members who work with the student
HOW WILL THE PHYSICAL THERAPIST DECIDE IF A STUDENT CONTINUES TO NEED SERVICES?
HOW WILL THE PHYSICAL THERAPIST DECIDE IF A STUDENT CONTINUES TO NEED SERVICES?
The physical therapists (PT) will complete progress reports during the school year in addition to an annual assessment (IEP) and tri-annual assessments (Re-eligibility) to determine if a student continues to require school-based physical therapy services. When a student makes progress, the amount of physical therapy that the student receives may be decreased. When a student reaches all of his/her physical therapy goals or the student has reached his/her highest expected functional level, physical therapy may be discontinued.
HOW CAN PARENTS AND TEACHERS HELP A STUDENT WHO RECEIVES SCHOOL-BASED PHYSICAL THERAPY?
HOW CAN PARENTS AND TEACHERS HELP A STUDENT WHO RECEIVES SCHOOL-BASED PHYSICAL THERAPY?
You can assist the child who receives physical therapy services in many ways, such as:
Communicate often with the physical therapist - ask questions you may have regarding the student’s treatment and progress.
Ask the physical therapist for activities that can be carried out at home or in the classroom that will help support the child.
Report your concerns regarding the child’s functional skills at home and in the classroom to the physical therapist.
Please reach out to your assigned school-based physical therapist regarding any further questions or concerns you may have regarding school-based physical therapy.
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