Physical Therapy

What's Required

Physical Therapy

(9) Physical therapy means services provided by a qualified physical therapist. (§300.34, Federal Regulations).

"Physical therapists are health care professionals who help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life." The Physical Therapist Scope of Practice (2015).  American Physical Therapy Association.

As providers of Physical Therapy in the school system, Physical Therapists provide services under Part B of the Individuals with Disabilities Education Act (IDEA).  Under IDEA physical therapists, "work collaboratively with a student's IEP team and participate in screening, evaluation, program planning, and intervention. As a member of the IEP team, physical therapists design and implement physical therapy interventions - including teaching and training of family and education personnel and measurement and documentation of progress - to help the student achieve his/her IEP goal. Physical therapists assist students in accessing school environments and benefiting from their educational program." Fact Sheet on Providing Physical Therapy in Schools under IDEA 2004 (2009). American Physical Therapy Association, Section on Pediatrics. 

What We Do

Referral Process

When a campus or parent concern arises for a student in special education that involves a student's positioning, mobility or gross motor performance as it relates to the student's educational needs, the campus will consider whether a referral to physical therapy is warranted. There are several circumstances under which a referral to physical therapy may be generated.

1. Students may be currently receiving special education services and demonstrate a lack of progress on a goal in an area that may require the addition of physical therapy in order to allow the student to make satisfactory progress on that goal. 
2. Students may move in to the district with physical therapy as part of their individual education plan.
3. Students may be undergoing an initial full and individual evaluation to determine eligibility for special education and the assessment team identifies the need for information from physical therapy to assist in making the eligibility determination.
4. It is determined at the Review of Existing Evaluation Data meeting that updated assessment from physical therapy is needed.

For students currently receiving special education services:  The campus team will:

• Determine whether the Checklist for OT or PT Referral form indicates the need for a physical therapy consult/evaluation.
  • If yes, generate a referral for a physical therapy consult/evaluation utilizing the Request for Special Education Services form and email to Teddy Ott at ottt@ocisd.net.
  • If no, move to the next step in the referral process as follows:
• Review the student's progress in the identified IEP Goals and Objectives.
• Use measurable data to determine if there are barriers limiting the student's progress in the identified goals and objectives or if there are additional areas of difficulty for the student not previously identified.
• When the school has tried the pre-referral intervention strategies for a period of 4-6 weeks, data shows that the strategies have not resulted in adequate improvement in performance, and the barriers limiting student progress involve performance skills in the areas of positioning, mobility or gross motor functioning the campus team may request technical assistance from the campus physical therapist.
• Tech assists are often completed through consultation with the teacher and can be scheduled during the teacher's conference period with no student observation needed. Recommendations may be given that are general in nature; strategies suggested are those that could benefit a similar group of students and are not specific to the student receiving the tech assist. 
• In responding to the request for technical assistance the PT practitioner may do any or all of the following: 
  • Review information such as work samples, report cards, outside evaluations, district evaluations, teacher observations, and previously attempted strategies. 
  • Collaborate with the student's teacher(s) regarding the student's history and progress in relation to the identified educational concern.
  • Observe the student in the educational setting during the time and in the environment(s) where the problem(s) occurs.
• Upon completion of the technical assist:
  • If no additional support is indicated: The therapist will complete the HCDE OT/PT or MT Documentation of Technical Assistance or Consultation Services form describing any observations/considerations and suggestions or follow-up that are recommended, review this information with the instructional team, and provide this form to the campus diagnostician or speech therapist to file in the state folder.
  • If a physical therapy evaluation is indicated: The therapist will complete the HCDE OT/PT or MT Documentation of Technical Assistance or Consultation Services form recommending an occupational therapy consult/evaluation. The campus will follow steps to procure parent permission for a consult/evaluation.

5. For students who move into the district with physical therapy as part of their individual education plan:

• The Diagnostic Specialist will notify the therapist(s) of the move-in utilizing the Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net
• The student will be ARDed for 30 school days according to the provisions in the IEP from the previous school district. 
• The therapist will use this time to collect data needed to determine recommendations for physical therapy services in the new setting.  
• Please Note:  Due to the Texas PT licensure rules that govern physical therapy practice, the therapist must have the following in order to provide physical therapy services:
  • a current evaluation in hand (accurate/within last 3 years)
  • goals that indicate PT support
  • PT time, frequency and duration specified on the services page
  • a physician referral

Without these, the therapist can only provide general technical assistance.  If a current and adequate PT evaluation does not come with the student's paperwork, please request and hold a REED to obtain parent permission for a PT consult/evaluation.

6.  For students who are currently undergoing a full and individual evaluation to determine eligibility for special education:

• On occasion, the evaluation team may determine that information from physical therapy is needed in order to assist the team with making the eligibility determination.
• If it is determined that physical therapy is needed to participate in the initial full and individual evaluation, the diagnostic specialist or speech therapist will send a referral to physical therapy utilizing the  Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net

 7.  For students who are undergoing a re-evaluation process and it is determined that an updated physical therapy evaluation is needed:

• The diagnostic specialist or speech therapist will procure parent permission for a physical therapy consult/evaluation and send a referral to physical therapy utilizing the Request for Special Education Services form and emailing it to Teddy Ott at ottt@ocisd.net

Evaluation Process

"Physical therapists engage in an examination process that includes taking the individual's history, conducting a standardized systems review, and performing selected tests and measures to identify potential and existing movement-related disorders."  Guide to Physical Therapist Practice 3.0. Alexandria, VA: American Physical Therapy Association; 2014. School-based PTs may evaluate students with disabilities to determine the need for services in the educational setting. As a related service to special education, physical therapy services may be recommended to the individualized education program (IEP) team if the expertise of a PT is required for students to access the general education curriculum, to participate in their educational environment, and to benefit from their specially designed educational program.

Service Delivery Models

• Student specific services are provided in an integrated model to facilitate the implementation of the individualized educational program (IEP) in the natural environment at school (including classrooms, hallways, cafeterias, gym, playground, etc.) Student specific PT services are available for all students receiving special education services if an educational need is identified by the ARD Committee. PT services are provided as an integrated support. Integrated PT service time may be used to work with the student in the classroom or other school environments to determine appropriate strategies, interventions and adapted equipment, and to train instructional staff on how and when to use strategies, interventions and adapted equipment. The PT provider will participate with the collaborative team on the campus to assess the effectiveness of interventions and to revise/adapt interventions as needed.
• Technical assistance may be provided to students who are in either special education or general education. Technical assistance is provided in the form of general recommendations for instructional strategies that may benefit groups of students with needs similar to the student for whom technical assistance is being requested.
• A physical therapist is assigned to each campus in Ore City ISD and is available as a campus resource.