School Based Physical Therapy
What is school based physical therapy?
The role of the Physical Therapist (as a related services provider) is to help children:
- Access the physical setting of the educational environment.
- Participate in the curriculum as defined by the educational system and documented in the Individual Family Service Plan (IFSP) or Individualized Education Program (IEP).
The educational system or environment includes any of the following:
- Early Intervention Programs
- Preschool Handicapped Programs
- Public Schools
- Private Schools
- Department of Human Services Regional Schools (state)
- Regional Day Schools (county)
The students capabilities and needs in relation to his/her present level of educational performance are the focus for programming to promote functional independence within the educational environment. The educational environment includes the educational curriculum, physical environment, and social aspects that are encountered throughout the school day. For the home-bound student, physical therapy services may be provided in the home as it relates to their educational needs in the IEP.
Physical therapists in the school system have expertise in the following:
- Administer and interpret appropriate clinical tests and prioritize results related to the students educational needs
- Discuss evaluation findings with parents and appropriate school personnel on the team
- Develop appropriate measurable objectives and strategies within the Individual Family Service Plan (IFSP) / Individualized Education Program (IEP)
- Make recommendations for transition into community activities
- Identify appropriate time for discharge
- Design a physical therapy treatment plan that will have a beneficial impact on the students educational program
- Implement this program
- Assess this program
- Reports, written in lay terms, according to school district policy
- Documentation of each treatment session according to the New Jersey Physical Therapy Practice Act
- IEP, IFSP reports including annual reassessment
- Consult with educational staff and family members to provide appropriate intervention and management strategies to facilitate learning
- Evaluate the students environment and make appropriate recommendations to ensure success in the least restrictive environment
- Provide training for school personnel
- Provide training for family members
Physical therapy service delivery models:
The following models of service describe options for delivery of educationally related physical therapy. These models are not hierarchical with regard to benefit or time commitments. Each model has its own characteristics.
Direct Service Model:
In the direct model, the therapist is the primary service provider to the child. However, the therapist using this model should involve the students teachers and parents. Physical therapy may occur in an isolated environment due to the need for a distraction free environment and/or specialized equipment. Direct service delivery can also occur in the natural environment. The emphasis of direct physical therapy is usually the acquisition of new motor skills.
In the integrated model the physical therapist is not the childs only contact. The teacher, aide, and family may provide intervention. The emphasis is on practice of newly acquired motor skills in the natural environment.
In the consultative model, the physical therapist consults with the teacher, staff, parents, and student regarding student-specific issues. The physical therapist is not the primary individual responsible for implementing the activities. Service is provided in the learning environment by support personnel. The physical therapist helps to develop the goals and demonstrates activities to all appropriate staff.
In the monitoring model of service delivery the physical therapist remains responsible for the outcome of the intervention. Staff are instructed as appropriate, but the physical therapist, although not providing direct intervention, maintains regular contact with the child to check on status. Monitoring is important for follow-up of children who have musculoskeletal, neurologic, or cardiopulmonary impairments that might deteriorate over consultative intervention.
Services in a collaborative model are provided by all team members, but the degree of crossing of disciplinary boundaries is greater that in an integrated model. The team assumes responsibility for developing goals and objectives and the implementation of the program activities. The activities are educationally relevant and are implemented in the natural routine of the school and the community.
When is physical therapy not appropriate for school?
The role of the physical therapist as a related service provider is not to meet the total medical needs of the student. Students may have a medical diagnosis or motor impairment that does not interfere with their educational performance. Each area of need is closely scrutinized to determine its impact on the educational environment. The therapist will identify the performance problems in terms of functional criteria within the educational setting relating to the students educational goals and needs.