Transcript School- Based Physical Therapy

School- Based Physical Therapy
Compiled by Ellen Van Vranken, PT, CAS
Definition
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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.
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Related service as defined by IDEA.
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Provided to help students benefit from their
special education program and/or to access
educational activities within the least restricted
environment.
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Services include direct intervention and
integration of that intervention into the school
environment.
School Based P.T.
Services directed toward:
Prevention of future disability
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Developing, improving, restoring sensory/motor
function
 Collaborating with others to improve accessibility
and participation in all school activities
Medical Model
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Patient
Medical Facility
Individual /Pull-out
Treatment
Educational Model
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Student
School Environment
Collaborative
problem solving with
daily carryover
Concept of Role Release
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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.
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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.
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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
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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
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Formal assessments used in collaboration with
others:
- Pediatric Evaluation of Disability Inventory (PEDI)
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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
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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 Services
Direct 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.)
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Training in use of
adaptive equipment
Adaptation/modification/
repair of equipment
Early intervention
Indirect Services
Indirect services:
Consult and collaborate with
parents, school staff, other
related service and medical
providers.
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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
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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
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How does the model of referral for
PT/OT services in your system
support a collaborative approach?
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Discuss the delivery of related
services in your system. Positives
and negatives. Share experiences
of collaborative problem solving.
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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.