Description of the Services, Activities, and Interventions Within School-Based Physical Therapist Practices Across the United States

Abstract

Background Students with disabilities receive school-based physical therapy services under the Individuals with Disabilities Education Improvement Act of 2004. Little research exists regarding therapy services in schools. Objective This study explored the school-based services that students received and the activities and interventions that physical therapists implemented, and determined if services differed based on the student's functional gross motor ability and age. Design This was a prospective observational cohort study using a practice-based evidence design. Methods Data were collected by 109 physical therapists for 296 students, aged 5 to 12 years, receiving school-based physical therapy. Physical therapists completed the School-Physical Therapy Interventions for Pediatrics data form for 20 weeks during 1 school year. This evaluation included the type of service delivery, the amount of time spent on each student (consultation/documentation), minutes spent in activities, the specific interventions implemented, and the student's level of participation. The Gross Motor Function Classification System (GMFCS) was used to describe the students' functional ability. Results Physical therapists provided an average of 26.7 min/wk (standard deviation [SD] = 15.1) of direct services and 13.1 min/wk (SD = 7.7) of services on behalf of the student. Primary activities were physical education/recreation (7.7 min/wk, SD = 8.2), mobility (6.7 min/wk, SD = 7.9), and sitting/standing/transitions (6.3 min/wk, SD = 8.1). Primary interventions were neuromuscular (32.5 counts per student, SD = 15.9), mobility (15.3 counts per student, SD = 14.65), and musculoskeletal (14.4 counts per student, SD = 10.3). Differences existed based on GMFCS but not student age. Limitations Physical therapists reported School-Physical Therapy Interventions for Pediatrics data weekly, not necessarily after each therapy session. The GMFCS was used as a proxy of students’ functional gross motor ability. Conclusions Our description of services is provided to encourage physical therapists to reflect on the services they provide and to foster future examinations of service effectiveness.

Physical, occupational, and speech therapy for children with cerebral palsy

“…Family‐centeredness was associated with developing ‘more than expected’ in family/recreational participation frequency, which agrees with previous research . This was also associated with the 6MWT distance, which suggests a relationship with activity outcomes.…”

“…Family-centeredness was associated with developing 'more than expected' in family/recreational participation frequency, which agrees with previous research. [10][11][12][13] This was also associated with the 6MWT distance, which suggests a relationship with activity outcomes. Parents' rating of the extent they perceived services were meeting their children's needs was associated with family/recreational participation frequency and is consistent with our earlier Move & PLAY study.…”

“…This relationship may reflect that children with higher functional abilities participate in more community programs. Further analysis of the amount of occupational, physical, and speech therapy revealed a primary relationship to the functional ability of the children, that is, the lower the functional ability of the children, the greater the amount of therapy services provided …”

“…Further analysis of the amount of occupational, physical, and speech therapy revealed a primary relationship to the functional ability of the children, that is, the lower the functional ability of the children, the greater the amount of therapy services provided. 3,11 A systematic review of interventions for children with CP concluded that infants with CP respond best to interventions that include task-specific practice of child-initiated movements, environmental modifications, and parent education. 12 Another systematic review concluded that constraint-induced movement therapy, goal-directed training, bimanual training, home programs, and context-focused therapy show evidence of effectiveness in improving motor activities, function, and self-care.…”

A Critical Examination of School-based Physiotherapists’ Perceived Aptitude and Willingness to Facilitate Health and Wellness Promotion

“…Through this study, it was uncovered how SBPTs can contribute to the CSPAP and inclusive physical activity programs for CWD through collaboration with schools, communities, and families to facilitate fitness, health, and wellness among CWD and to positively affect health determinants. School-based physical therapists have the training and skillset to promote health and wellness, provide specialized exercise intervention, facilitate participation in an adapted sports program, and to consult with other school staff on modifications and accommodations to improve the accessibility of the school setting (APTA, 2019a;Jeffries et al, 2019). School-based physical therapists' role in the school setting are limited to services prescribed on the IEP and often does not include health and wellness for CWD (APTA, 2019a).…”