Physical Therapy

The Application of Physical Therapy in Public Schools

I came across this article as a result of a conversation with my younger sister, who recently informed me that she intended to use her DPT (Dr. of Physical Therapy) to become a school based physical therapist. As I read through the section in our Wiki Forum that described physical disability, I began to wonder about how physical therapists fit into the daily lives of public school students (especially because the school that I work for only employs an occupational therapist on a part time basis). The article that I refer to in this synopsis is entitled “Decision Making for Physical Therapy Service Delivery in Schools: A Nationwide Analysis by Geographic Region.”1 The study that is detailed within the article assesses both the context (inclusion, pull out, or combination) and frequency with which physical therapists from the Northeast, South, Midwest, and West recommend services for four different children. 626 school-based physical therapists were included in the survey and the four children that they made recommendations on were a four year old girl with motor and cognitive delays, a girl of the same age with motor delays and typical cognitive development characteristics, a six year old boy with spastic diplegic (spasticity in two limbs) cerebral palsy, and the same boy at age 12.

Findings of the Study

The authors of the article identified two significant findings of this study. The first major finding was that in the Northeast, physical therapists recommended more therapy sessions per month overall (for all four children) than in the other regions of the country. The West recommended the next highest number of sessions per month for each child. There is a second statistically significant finding that was common to all four geographic regions. This is that the most frequently noted factor in the process of determining whether or not to provide services was budgetary constraints. In addition to these two significant findings of the study, I was struck by the fact that in the Northeast many more therapists were apt to recommend pull out or combination sessions than in the other geographic regions of the nation.

Ramifications and Questions

The many findings of this study all point to the fact that there is little consistency to the implementation of accommodations for those students who are eligible for IEPs under IDEA. While this is not a new revelation, it is interesting to consider the advantages of living in the American Northeast and West. For example, the article pointed out that in the Northeast, school based physical therapists reported fewer students under their care. When we take into account the smaller, wealthier school districts in that region we might come to the conclusion that they are able to employ more PTs. On the other hand, Northeastern physical therapists might be able to see more students because the urban and suburban schools that they work in are closer together than the rural schools of the South and Midwest. As I mentioned, the fact that Northeastern PTs were more apt to recommend pull out accommodations for their students was intriguing to me. I wondered if the comparative wealth of the region allowed students to attend private, specialized schools wherein individualized instruction is standard.

To my mind, the importance of this article was not about what I learned about the role of physical therapists in public education but in the telling nature of the results. IDEA is a piece of federal legislation and I always find myself wondering about its efficacy when we take into consideration that it is implemented differently in each state. More to the point, I wonder if increased physical therapy sessions are beneficial to physically disabled students. Supposing that this is so, how then can we recreate Northeastern programming throughout the country?

Wikipedian research contributed by Rachel Fries