- What are physical therapy services in the school setting and what is the role of the therapist?
- How is a student referred for physical therapy services?
- How is a student assessed for physical therapy services?
- How does a student qualify for physical therapy services?
- What do physical therapy services look like in the school setting?
- When is a student dismissed from physical therapy?
- What is the difference between school based physical therapy and private physical therapy?
- What are the licensing requirements for an physical therapist?
Physical therapy in the school setting is a related service which provides assistance to students already in special education allowing them to benefit from specially designed educational programs. The physical therapist supports the student’s ability to gain access to the general education curriculum in accordance with his/her Individualized Education Plan (IEP) and to function across all educational settings. Federal and state laws mandate that physical therapy services provided in the schools are educationally relevant.*
*20 U.S.C. §§ 1401, 1414, 7801; 34 C.F.R. Part 300; Texas Education Code; 19 T.A.C. Chapter 89
Physical therapists in the schools work with students on skills which typically fall in the areas of mobility, positioning, or management of adaptive equipment to access curriculum and/or the physical environment. The physical therapist uses a problem solving approach to task analyze educational activities in order to
help the student participate more successfully and access the educational environment.
A student must be eligible for special education services to receive physical therapy. Should concerns arise in the areas of mobility, positioning, or management of adaptive equipment the physical therapist should be contacted. Any member of the student’s educational team, including the parent, may raise concerns related to the above areas. The physical therapist then gathers information from the teachers, parents, support staff, and/or the student, including strategies that have been utilized within the classroom setting related to the area(s) of concern. As appropriate, information from private providers may also be considered in conjunction with the information gathered in the school setting. The Admission, Review and Dismissal (ARD) team, including the physical therapist, will consider the information and determine if an evaluation is needed. The physical therapist must be involved in planning for an evaluation.
A physical therapy evaluation can be conducted as part of an initial evaluation for special education services, or the evaluation can be conducted after the initial special education evaluation and placement. In either instance, written consent is needed by the parent/guardian/adult student in order to conduct the evaluation. An evaluation is conducted by the physical therapist to assess if there are mobility, positioning or adaptive equipment needs that are impacting the student’s ability to access the curriculum and educational environment. The evaluation may include standardized tests, checklists, and school observations. Any additional information not previously gathered from parents, staff, student, and/or other outside providers is obtained at this time.
Once the physical therapy evaluation is complete, an Admission, Review, and Dismissal (ARD) meeting is held to review the results. The ARD committee members determine if there is an educational need that is interfering with the student’s success in the classroom that physical therapy services can support to help the student meet his/her educational goals.
Physical therapy services are provided in a variety of settings within the school. The goal is to deliver the services to the student during naturally occurring routines so that the student can practice the newly acquired skills in the environment in which the skill is needed. This could include the classroom, hallways, stairwells, bathrooms, playgrounds, music, art, cafeteria, gym, job placement, etc.
Because physical therapy supports an instructional need, physical therapists become co-implementers on goals and objectives that are developed collaboratively for the student’s IEP. The goals and objectives are integrated in an effort to allow the student to generalize the skills across people and environments and develop strategies for daily task or activity performance. Services are provided in collaboration with general education teachers, special education teachers, support staff, and/or other service providers such as occupational therapists, speech therapists, or adapted PE teachers.
Services may be delivered individually or in a small group setting. The ARD committee determines the frequency, duration and location (general education and/or special education) of services. The physical therapist then determines the exact location and group make-up based on individual student needs.
A student is no longer eligible for physical therapy under one of the following conditions:
- The student is no longer eligible for special education.
- The student has mastered all of the goals agreed upon in the ARD meeting and there are no other identified educational needs where physical therapy is warranted.
- The ARD committee determines other members of the educational team can provide necessary interventions.
A student who is eligible for special education but has been dismissed from physical therapy may be referred after dismissal if new needs develop.
Although physical therapy interventions used with the student at school may be the same as interventions used in private therapy, priorities may be different. Outside the school system, therapy focuses on optimizing the child’s functional and physical performance in relation to medical considerations and needs in the home and community settings. Sessions are typically provided in a one-on-one setting focusing on discrete skill development. In the school setting, therapy focuses on the student accessing the curriculum and school environment and must be educationally relevant. In the schools, the goals and interventions address the student’s present level of academic achievement and functional performance. Eligibility for private physical therapy services does not necessarily mean the student will qualify for physical therapy services in the school setting.
The following criteria must be met to be a practicing Physical Therapist in a private or public school setting in Texas:
- graduated with a Master of Physical Therapy, Master of Science in Physical Therapy, or Doctor of Physical Therapy degree from an accredited physical therapy educational program
- passed a national exam, and
- be licensed by the Texas Board of Physical Therapy Examiners
Texas licensure must be renewed every two years, and 30 hours of continuing education is required during that time frame. In addition, a passing score is required on the jurisprudence exam based on the Texas Practice Act and Rules.