School- Based Physical Therapy
Compiled by Ellen Van Vranken, PT, CAS
Definition Physical therapy – a medically based profession oriented
to: Improving sensory/motor function Diminishing pain Preventing future disability Enhancing functional motor skills
School-Based P.T. Related service as defined by IDEA.
Provided to help students benefit from their special education program and/or to access educational activities within the least restricted environment.
Services include direct intervention and integration of that intervention into the school environment.
School Based P.T.Services directed toward:
Prevention of future disability
Developing, improving, restoring sensory/motor function
Collaborating with others to improve accessibility and participation in all school activities
Medical Model Educational Model
Patient Medical Facility Individual /Pull-out
Treatment
Student School Environment Collaborative
problem solving with daily carryover
Concept of Role Release Best practice initiative whereby PT provides training and
consultation with school staff who have daily interactions with student on ways to consistently address physical issues that naturally occur within the school day.
Examples: Transitions, playground access, navigating lunch tray, PE expectations and accommodations, therapeutic exercise, splints, walkers, stander use, braces, positioning for function, transfers, re-design of classroom for wheelchair user, access to transportation, evacuation procedures etc.
Functions of School-Based PT Assessment: evaluate and interpret findings as a
member of multidisciplinary team.
Direct Services: treatment procedures and interventions designed to help student overcome obstacles interfering with educational program or in functional expectations as a student.
Indirect services: consultation and collaboration with parents, school staff, other medical professionals.
Assessment Procedures
Formal Assessment Tools Typically Used:
ROM (range of motion)Testing
Manual Muscle Testing
Reflex Maturation Testing
Peabody Scales of Gross Motor Development
Bruininks-Oseretsky Test of Motor Proficiency
Assessments should include observation within the school environment!
Assessment Procedures Formal assessments used in collaboration with
others: - Pediatric Evaluation of Disability Inventory (PEDI)
- Callier-Azusa - School Functional Assessment (SFA) - Hawaii Developmental Scale - COACH Assessment
Assessments should also address how student’s disability affects progress in their educational program or in access/participation in school activities.
Assessment Procedures Informal Assessment Tools Used: - Functional mobility Check Lists - Teacher/Parent Check Lists - Parent/Teacher Interviews - Sensory Processing Questionnaire - Ecological Assessments - Direct school based observation (PE, playground, school
transitions, positioning in classroom, mobility in class, equipment assessment, ability to use transportation)
- Clinical observations of joint mobility, muscle tone, posture, strength, coordination, motor planning, balance, attention, response, gross motor skills, adaptive equipment
Direct ServicesDirect Services: treatment
procedures designed to help the student overcome obstacles interfering with their educational program or in the many functional skills expected as a student.
- Therapeutic exercise - Coordination training - Strength and endurance
training - Mobility training (gait,
walking devices, transfers, efficiency, endurance)
- Balance / Motor Planning - Motor Skill Development
Direct Services (cont.)
Training in use of adaptive equipment
Adaptation/modification/repair of equipment
Early intervention
Indirect ServicesIndirect services: Consult and collaborate with
parents, school staff, other related service and medical providers.
Facilitate wellness and
disability awareness within the school environment.
Train/Supervise PT assistants,
students, school staff.
In-service education: body mechanics, transfer methods, equipment use, surgery implications, ROM exercises, therapeutic positioning, etc.
Art of Collaboration PT services dovetail with
other professionals Must be flexible and
aware of specific needs of both student and teaching staff.
Input from team members is crucial for effective assessment and intervention.
Collaboration Discussion How does the model of referral
for PT/OT services in your system support a collaborative approach?
Discuss the delivery of related services in your system. Positives and negatives. Share experiences of collaborative problem solving.
Share ideas for promoting a more collaborative approach in meeting the needs of your students vs. a more traditional “pull-out” system for treatment sessions.