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Physical and Occupational Therapist

 

Physical Therapy

Physical therapy (PT) is a related service that is provided to support the Individualized Education Program (IEP) for students ages 3-21, who have a disability that interferes with their educational performance and ability to benefit from their education program. The PT designs and performs therapeutic interventions, including compensation, remediation and prevention strategies and adaptations, focusing on functional mobility and safe, efficient access and participation in educational activities and routines in natural learning environments.

 

Occupational Therapy

What is Occupational Therapy?  

Occupational Therapy (OT) is a health profession, in which therapists help individuals participate in daily life activities or “occupations”.  Everyone has an occupation or job.  A child’s occupation is to grow, learn and play.  Occupational therapy helps children with disabilities be as independent as possible.

 

What is the Occupational Therpist’s role in the educational setting?

In the schools, occupational therapists use their unique expertise to help children to be prepared for and perform important learning and school-related activities and to fulfill their role as students.  School-based occupational therapy is designed to enhance the student’s ability to fully access and be successful in the learning environment.  Using direct and consult (indirect) services, as well as assistive technology and environment modifications, occupational therapists collaborate with teachers, other educational staff, and parents to help implement a child’s special education program.

School OT intervention is limited to those services that are required for a student to benefit from their educational program.  There may be aspects of a student’s disability that do not interfere with education but could be addressed by an occupational therapist in another setting.  The goal of school OT intervention is to assist a student to function within the school setting. Children utilize occupational therapy to prepare them for the school environment.  Students may have difficulty adjusting to classroom demands due to neurological, physical and environmental factors.  With occupational therapy intervention, a child may develop age-appropriate proficiencies.

 

What areas do Occupational Therapists address in the educational setting?

  • Self-care skills – manage clothing in the school setting (i.e., buttons, zippers, snaps, tie shoes), feeding skills, and use of adaptive equipment
  • Exploration and purposeful play skills - interacting with age-appropriate toys, games, equipment and activities
  • Fine motor tasks – hand development, hand strength, grasp patterns, pencil grasp, handwriting, dexterity, scissors skills, shoulder/trunk strength and stability
  • Writing skills – Forming shapes, letters, or numbers correctlySpacingOrganizing written work on paper
  • Organization/attention skills -Following directions
  • Developing visual perceptual and visual motor skills  – To improve reading, writing and math
  • Proper use of school tools  – Scissors, Crayons, Fasteners, Computers
  • Sensory Integration - how we receive and organize information from the environment and from our own bodies


Why doesn’t physical therapy and occupational therapy routinely provide services to the student on a daily basis?

Because physical therapy and occupational therapy are related (support) services, and one of our main goals is to assure that the child receives recommended programs and adaptations throughout each school day. To accomplish this, the staff is trained by the physical therapist and/or occupational therapist to carry out these programs in all areas of the child’s educational environment. Working together as a team, the physical therapist and/or occupational therapist and school staff are able to provide the optimum means of achieving the IEP goals. Federal law mandates that each child should be served in the least restrictive environment. This often means that the child is working daily with his/her classroom teacher on a program recommended by the physcial therapist and/or occupational therapist.

 


School Based vs. Clinical Based Therapy

 

School-based Therapy

Clinical-based Therapy

 

 

(also referred to as medical based or community based)

Governed by

Governed by federal and state laws.  Therapy is a related service to special education and is provided only if the child needs therapy to function in the educational setting.

Governed by state and national practice guidelines that focus on a child’s medical/functional needs in home and community settings.

Determination for Therapy

In the school, the need for therapy is determined by the IEP Team. Parents are a part of this team. The team determines the amount, frequency and duration of therapy— not the physician alone.

In clinical-based therapy, the physician, family and therapist make the decision regarding amount, frequency and duration of therapy recommended. The amount of therapy actually received may be affected by whether or an insurance company, Medicaid Program or other funding sources reimburse for the recommended services.

Methodology of Therapy

Therapy may be provided individually or in small groups by a therapist or therapist assistant. Intervention may or may not be provided directly with the child. Collaborating with educational staff to modify the child’s environment and daily school activities is always a part of school therapy.

A therapist typically provides individual treatment. Individualized home programs and ongoing caregiver training are necessary parts of the service to encourage carryover outside of treatment.

Location of Therapy

Therapy takes place where the child receives education. Appropriate intervention may be provided in classrooms, hallways, gyms, playgrounds, lunchrooms, bathrooms, or in a separate therapy room.

Community-based therapy is provided in clinics, hospitals, homes and community settings.

Therapy Services

Therapy services can be provided via direct intervention, consultation with staff, provision of adaptive equipment, individual exercise programs, safety training (including transfer training, lifting and back care), recommendations for classroom/school equipment, as well as fine and gross motor training.

Families have the opportunity to seek out services from a therapist with specialty training in areas such as soft tissue mobilization, post surgical intervention, sensory integration, aquatic therapy or neurodevelopmental treatment.

Modalities

Treatment techniques, such utilizing physical modalities such as heat/cold, electrical stimulation and biofeedback training are typically not provided.

Treatment techniques utilizing physical modalities, such as hot/cold, electrical stimulation and biofeedback training may be utilized.

Dismissal of Services

The decision to discontinue therapy is made by the IEP Team. This may occur when the student no longer is eligible for special education, when other members of the IEP Team can provide necessary interventions, or when the child can perform school tasks without therapeutic intervention. There may still be a need for community-based services.

Intervention is discontinued when any of the following occurs: functional skills are achieved, a plateau in progress is reached, participation in service is limited because of various circumstances, child is stable with therapy maintenance program, discharge is requested. At discharge, indicators for potential follow up are identified. There may still be a need for school-based therapy