Physical therapy services are provided across a continuum and are determined by the Individual Education Plan (IEP) team. Based on these student's needs, the physical therapy service delivery model includes consultation and training with education team members and direct "hands on" intervention, individually or in groups.
The provision of school-based therapy is governed by federal and state laws. Therapy is a related service to special education and is provided only if the student needs therapy to benefit from their special education program.
Therapy is determined by the Individual Education Plan (IEP) team members. Parents are a part of this team. The team determines the amount, frequency and duration of therapy.
Therapy may be provided individually or in groups by a therapist. Intervention may or may not be provided directly to the child. Collaborating with educational staff to modify the child's environment and daily school activities is always a part of school therapy.
The decision to discontinue physical therapy is made by the IEP team. This may occur when the student is no longer eligible for special education, when other members of the IEP Team can provide necessary interventions, or when the child can perform school tasks without therapeutic intervention.
In some instances, students whose disability affects their participation in school but who do not qualify under the Individuals with Disabilities Education Act (IDEA), may be eligible to receive occupational therapy under other federal laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act.
Eligibility Criteria for PT Services
In order to receive PT services, a student must demonstrate a clustering of delayed standardized test scores and/or delays in educationally related functional skills.
Functional Performance Areas:
Mobility: Students have difficulty moving about the school environment, navigating halls, stairs, and curbs, and have difficulty with transitions in/out of seating in school and on/off floor.
Postural Control: Students demonstrate significant difficulty maintaining functional positions, upright posture for engagement, and movements which support educational tasks.
Motor control/coordination: Students have difficulty performing necessary motor skills to engage in class with appropriate timing and coordination.
Gross motor skills: Students demonstrate difficulty engaging in age appropriate ball skills, locomotor skills, and physical education and recess related activities with peers
Strength/endurance: Students have significant difficulty with stamina and strength to participate and engage in their school day activities.
Functional activities of daily living: Students require assistance with toileting, hand washing, lunch and snack time activities, and dressing skills for outerwear due to strength, balance, or motor coordination delays.
Dismissal Criteria for PT Services
PT service may be discontinued when any of the following occur:
The student's performance is assessed to be within age expectation, based on the student's chronological age or is commensurate with cognitive abilities.
The established goals have been met.
There is a plateau in the student's performance. The student is no longer making progress toward identified goals.
The difficulties the student demonstrates no longer interferes with academic performance in special education.
The service is not needed for the student to benefit from his/her special education.
The student's parents request the termination of services.
Therapists use a lens of universal design for learning to consider the needs of all students, especially those with diverse learning. The goal of UDL is to use a variety of teaching methods to remove any barriers to learning and give all students equal opportunities to succeed. It’s about building in flexibility that can be adjusted for every student’s strengths and needs.
UDL is weaved into our everyday lives and school settings such as:
Curb cut-outs, ramps, automatic doors, and elevators
Accessibility features on a smart phones
Using closed caption, digital or audio text
Flexible work spaces and task lighting
Lever door handles and flat panel light switches
Presenting a visual schedule to the whole class
Assignment options - multiple means to demonstrate knowledge including oral presentations and group projects
By applying UDL principles, therapists assist schools to effectively instruct a diverse group of learners. They do this by building in flexibility in the ways learners can access information and in the ways students can demonstrate their knowledge.
For more information on UDL, visit www.understood.org
Adaptive physical education (APE) may also be referred to and known as specially designed physical education (SDPE). APE is provided by the physical education teacher in addition to or in replacement of regular education physical education class. From Wisconsin DPI:
The term “specially designed physical education” is special education (specially designed instruction) as specified in the student’s IEP, and may occur during the regular physical education class if that is the least restrictive environment for the student. It is recognized that students with disabilities benefit from appropriate physical education programming, specifically one that will meet the individual child’s diverse needs.
The physical therapist is available as a resource and support to consult and team with the physical education teacher to identify strategies, modifications, and adaptations to increase independence and participation in physical education related activities and overall mobility and gross motor activities. Adaptive PE provides additional practice, a more controlled, less chaotic environment, and more individualized instruction to build on motor skills and work toward a student’s goals.
School physical therapists serve as a resource and an advocate to foster awareness and an emphasis on health and wellness for all students. Schools play an important part of meeting physical activity needs for students. It is recommended that all children participate in 60 minutes of daily moderate to vigorous physical activity. Movement is critical for learning and engaging the brain.
Physical therapists play a unique role in society in prevention, wellness, fitness, health promotion, and management of disease and disability by serving as a dynamic bridge between health and health services delivery for individuals and populations. This means that although physical therapists are experts in rehabilitation and habilitation, they also have the expertise and the opportunity to help individuals and populations improve overall health and avoid preventable health conditions. Physical therapists’ roles may include education, direct intervention, research, advocacy, and collaborative consultation. These roles are essential to the profession’s vision of transforming society by optimizing movement to improve the human experience.
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