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If you have a child that has a functional limitation or disability, and if this limitation limits their participation in school, they may be a candidate for school-based physical therapy (PT). Physical therapists who work in schools are integral members of the educational staff, and they provide several benefits to children with and without disabilities in the school environment.
If you are injured or ill and have pain or difficulty moving around, you may benefit from the skilled services of a physical therapist on a temporary basis. Your therapist should work with you during rehab to quickly help you recover to your previous level of function.
Physical therapists in schools are different from your standard therapist; they help children have equal access to quality education. This may mean access to the physical space in school and learning opportunities that may be difficult to achieve due to their physical disability.
Federal law states that all children are entitled to free and public education. But if a child has a condition that causes a functional limitation, their access to this education may be compromised. Physical therapists who work in schools ensure that all children have the ability to fully participate in school activities, regardless of their disability status.
So, if a child with cerebral palsy has difficulty moving about in the classroom, the school physical therapist will work with them to ensure that they have the necessary skills and tools to be able to move through the school and within the classroom.
Those in between the ages of birth to 21 years old may participate in school-based physical therapy and special education. But not every child is able to receive in-school physical therapy services.
There are specific federal laws that govern the provision of therapy services in schools. The first is called Individuals with Disabilities Education Act (IDEA). This act guarantees free and public education access to people with disabilities. Part C of IDEA governs the provision of special education services for children from birth to age 2. Part B governs the provision of services from age 3 to 21.
One important aspect of special education law is that the services provided should be done so in the least restrictive environment possible. This means that, to the greatest extent possible, children with a disability should learn and receive services in classrooms with their peers who are not disabled. The physical therapist should, when possible, provide services in the child's natural environment in school.
The second law is called the Every Student Succeeds Act (ESSA) and was signed into law by President Obama in 2015. In it are provisions to hold schools accountable for providing high-quality education for all students. This includes those students with special needs and who may qualify for special education services in school.
Each school district must meet certain benchmarks under the ESSA law. This means that they must have a plan in place for academic standards, testing, and achieving goals. And this also means that school districts must have a plan in place for children with disabilities to have full access to education programs provided by the school.
School-based physical therapy services are provided by a physical therapist who is licensed by the state in which they are working. Most therapists hold a doctoral level degree. These professionals work as part of a team of healthcare and rehab professionals that ensure children with disabilities are able to participate fully in school.
A physical therapist assistant (PTA) may also provide rehab services to children in schools. These professionals work under the plan of care established by the school's physical therapist.
Other members of the school therapy team may include:
These specialists all work together to ensure your child has equal access to educational services as compared to their peers.
If anyone suspects your child is having difficulty participating in school due to a functional limitation, they may start the process for school-based therapy services. This may be done by a parent or caregiver, a teacher, or a school staff member. Your child's pediatrician may also initiate school PT services.
Once a child has been identified as potentially requiring services, they will be screened by a team of healthcare professionals in the school to see if they meet the necessary criteria to be offered school therapy services. Your child may be assessed by a social worker, school psychologist, occupational therapist, speech therapist, and physical therapist.
Once all of these team members have assessed your child, they will determine if your child meets the criteria for requiring services. Then, a specialized plan of care called an individualized education plan (IEP) will be developed.
If your child has an IEP, then they have been determined to potentially benefit from school-based therapy. The IEP will outline:
Your child's IEP will be updated regularly as your child progress in school. Each member of the rehab team will be required to update your child's progress at regular intervals.
If your child has been assessed and does not qualify for services, then the school's educational coordinator may meet with you to discuss recommendations, but no physical therapy services will be provided. Your child's participation in school may simply be monitored. If this happens, you may wish to receive private physical therapy services at a local clinic.
There are two types of physical therapy sessions that happen in schools: pull-out sessions and push-in sessions. During a pull-out session, the student is removed from the classroom and engages with a physical therapist in a separate area. This may be in the school's special education room or in the gymnasium.
During a pull-out session, the physical therapist may work with your child to improve movement and motor control. Typical interventions may include:
Push-in physical therapy sessions occur when the physical therapist works with your child in their classroom and with their peers. This situation fulfills the least restrictive environment requirement of the IDEA law, and it is a great way for your child to have PT services in their natural learning environment.
During a push-in session, the physical therapist may work with your child to ensure that their physical and functional limitations are not affecting their ability to participate in class with their teacher and peers. Special supports, like assistive devices and positioning devices, may be used to ensure that your child can move and function appropriately in the classroom.
During the COVID-19 health pandemic, many people started receiving their healthcare services through telehealth, where a provider meets with patients and caregivers over a secure internet connection. And many schools have moved to remote learning models, where students stay at home while interacting with their teachers via the internet.
If your child has an IEP and receives school-based physical therapy, then the therapist may meet with you and your child via telehealth to discuss barriers to learning and how your child's disability may be affecting their access to school services. Recommendations may be made that may help your child be successful while learning remotely.
Obviously, telehealth services have some limitations, but it is a great way for you and your child to stay connected with your IEP care team during times of remote learning.
One of the most important components of school-based physical therapy is supportive parents or guardians at home. There are several things you can do to ensure your child has a successful outcome during school-based therapy. These may include:
At regular intervals, your child's IEP team may re-assess your child and make changes to the care plan. If your child improves to the point where their disability does not interfere with learning, then the IEP may be ended. If your child's disability once again limits their educational opportunities, the process of starting school-based services may be started once again.
Every child in the U.S. is entitled to free public education. Some children require special education services that help them be successful students and participate fully in school.
If your child has special needs, they may work with a physical therapist in school as part of the individualized education plan. The therapist at school will ensure your child can function in the school environment so they can participate with minimal obstacles to learning.
There are many resources out there for children with disabilities. Working with a therapist as part of an educational healthcare team can ensure your child has access to high-quality educational programs, and their disability does not limit that. If you are unsure if your child qualifies, contact your child's teacher and/or school administration to discuss their options for physical therapy services.
School-based physical therapists are members of a team of healthcare providers who ensure that children with a functional limitation or disability receive equal access to educational programs provided by the school. In addition, they are responsible for working with you and your child to remove barriers to education that a disability may cause.
Is school-based PT free?If your child qualifies for school-based physical therapy, the services will be provided at no cost to you. Special education programs for schools are paid for by taxpayer dollars from the federal and state levels.
How do physical therapists collaborate with school staff?Physical therapists who provide in-school services to children are required to meet regularly with the IEP team and school staff members. Your child's progress will be discussed during these meetings, and changes may be made to your child's IEP.
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By Brett Sears, PT
Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy.
