The first thing to understand is that school-based physical therapy is not like what most people think when they hear the term "PT". We don't treat the athletes' injuries, don't have traditional exercise equipment like treadmills and bikes, and don't give heat and ice. Merely getting a doctor's prescription does not qualify your child for physical therapy in school. Services are also not as frequent as most people are accustomed to in the outpatient setting. As an example, the most physically disabled children (in wheelchairs, with walkers) may receive services 2-3 times per 6-day cycle. This frequency is usually weaned down as the student ages. Remember, every service you add takes time away from something else. As our students ascend in grade level, the academic rigor increases, making pull-outs more invasive.
The great majority of students receiving physical therapy services in school are also classified in the special education program. Through a team decision, after an agreed upon evaluation by our staff, the student demonstrates that their gross motor impairment impacts their education, or ability to access it.Non-classified students can also receive services, if deemed necessary. The programs allowing general education students the same supports as those in special education are RTI and 504. RTI is a system that identifies needy students, and implements a step-wise strategy for support. This support is first employed in class, to avoid pull-outs. As time passes and progress is logged, the student may ascend in tier, which also allows for more intensive instruction. 504 accommodations are for students with a medical diagnosis that may be addressed with academic supports.The relation of the motor delay and the student's education cannot be understated in terms of qualification for services. The New York City Department of Education describes it well, and they are the largest school district in the entire country. This is taken from Table 1 of their School-based Occupational Therapy and Physical Therapy Practice Guide, available on their website. It specifically pertains to classified students.How does it start?*Teacher, parent/guardian or other involved person can request the school to consider an evaluation.Who decides need and scope for service?*The IEP Team decides the need and scope of OT/PT services that a student requires to benefit from his/her educational program.*Assessment takes into consideration needs associated with progressing the student in the educational setting.*A physician’s referral alone does not determine the provision of IEP-driven OT or PT services.What is the focus of therapy?*Therapy addresses the student’s access to the academic curriculum and other school functions.*OT/PT works toward the student’s independence and participation in school.Where does therapy occur?*To the extent possible, therapy is integrated and provided in the student’s natural environment (e.g. classroom, lunchroom, stairs, hallways, playground, work‐study sites or other DOE approved instructional settings).How is therapy delivered?*The most common service delivery methods include direct, integrated and consultative, with the latter two being the least restrictive methods.*Therapy is delivered in collaboration with school staff. The student’s teacher, paraprofessional (teacher aide), etc. are trained for effective carryover of skills learned from therapy sessions. However, only a licensed therapist may provide professional therapeutic services.How is the impact of services documented?*Documentation must relate to student’s progress towards his/her IEP goals.*Therapist must use accessible, parent‐friendly language.