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 (IEP).
3. Students may undergo a Full and Individual Initial Evaluation to determine eligibility for special education and PT is included as part of the process.
4. It is determined at the Review of Existing Evaluation Data (REED) meeting that updated assessment from physical therapy is needed.

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

• Determine if there is an educational need for a PT consultation/evaluation.
  • If yes, a REED will be held and parent consent obtained to generate a physical therapy consult/evaluation which will be emailed to Carlene Bexley at CarleneBexley@katyisd.org  .
  • 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.
• Consider campus-based support and intervention strategies to benefit all students that are available to campus personnel on the OT/PT/MT Canvas Course that may address the identified barrier or additional area of difficulty.
• If the 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 ARD committee should request a consultation/evaluation for PT.

2. For students who move into the district with physical therapy as part of their Individual Education Plan (IEP):

• The Diagnostic Specialist will notify the therapist(s) of the move-in utilizing the appropriate special education referral form and email it to Carlene Bexley at CarleneBexley@katyisd.org.
• 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 service page
  • a physician referral

Without these, the PT could only provide general intervention strategies.  If a current and adequate PT evaluation does not come with the student's paperwork, the PT will update the students' present level of performance in the current educational setting and complete a PT consultation/evaluation.

3.  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 determine if the related service of PT would be necessary in the event the student qualifies for special education.
• If it is determined that physical therapy is needed to participate in the Full and Individual Evaluation, the diagnostic specialist or speech therapist will send a referral to physical therapy utilizing the appropriate special education form and email it to Carlene Bexley at CarleneBexley@katyisd.org.

4.  For students who are undergoing a re-evaluation process, it is determined that an updated PT evaluation is needed:

• The diagnostic specialist or speech therapist will procure parent permission for a physical therapy re-evaluation and send a referral to physical therapy utilizing the appropriate special education form and email it to Carlene Bexley at CarleneBexley@katyisd.org.

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.

In responding to the request for consultation/evaluation, the PT 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.
• If no additional support is indicated and it is determined that the area of concern can be addressed through general strategies (including classroom level interventions), the PT will complete the HCDE PT Consultation Services form describing any observations/considerations and suggestions or follow-up that are recommended, review this information with the ARD committee and provide this form to the campus diagnostician or speech therapist to file in the state folder.

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 integrated support. Integrated PT service time may be used to work with the student in 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.
• A physical therapist is assigned to each campus in Katy ISD and is available as a campus resource.