E93: Physical Therapist [IEP Team BONUS Series]
Did you know that Physical Therapists can write emergency evacuation plans into the IEP? Did you know that they also can help with adapting Physical Education? I didn't either until working in the schools alongside some amazing PT's!
Did you know that Physical Therapists can write emergency evacuation plans into the IEP? Did you know that they also can help with adapting Physical Education? I didn’t either until working in the schools alongside some amazing PT’s!
In this week’s IEP Team BONUS Series we cover:
1) Qualifications of physical therapists
2) What PT’s can do in the educational environment that you may not have known about!
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E93: PT
[00:00:00] Physical therapists do exist in the schools. I promise they are pretty spread out and we are going to talk about this a little bit. But sometimes it can be a little bit tricky to have them serve your child in the school setting, or you might be getting them from one service, not understanding everything that they could be doing for your kid.
So on this episode of the IEP team bonus series, we are talking about physical therapy today, their qualifications and what they actually do within the school setting. So stick with me.
You are listening to the parent IEP lab, the podcast that helps you get an effective IEP plan for your child so that you can get them supported and learning in school. I’m Beth LEAs and Feld occupational therapist, who started to notice trends in parents who got effective IDPs for their kids
without having to fight the school. My mission is to help you turn insider knowledge from the school side into effective parent advocacy for your child, the parent IEP lab focuses on preparing you for your next IEP meeting, but also talks about the commonly missed opportunities for parents to get an effective IEP outside of the IEP meeting too.
So let’s dive into today’s [00:01:00] topic and think about what we can change and tweak to get the right formula for success for your child to learn and grow at school welcome to the lab.
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Like I said in the introduction physical therapists do actually exist in the schools, they are related service providers, which very similarly to occupational therapists. They don’t necessarily have a huge caseload concentrated in one building. So you might actually not see them, not know that they’re there because typically they cover a lot of buildings or in some cases,
Or in some cases they might cover an entire district by themselves. So in today’s episode, we are diving into the qualifications of a physical therapist. So you actually see what education they have, what kind of licenses they have. And then we’re going to talk about what they actually do. And this is really interesting because I didn’t think that they did as much as they actually do until I started working with physical therapists in the school setting as [00:03:00] well.
It’s really kind of cool. And I have a whole list to share with you of what they actually do. So you can say, oh, And this need is there for the safety thing. And so you can understand what they do and be able to advocate for that. Now, if you are new to the IEP team bonus series, then welcome. I’m so excited that you’re here.
We have actually covered a decent amount of the staff members going through the same format, where we talk about their qualifications and what they actually do, like what their sessions actually look like and what their services look like. So if you want to scroll back and find special education teacher or speech and language pathologist, or maybe deaf and hard of hearing teacher, those have been covered, they’re just released every Thursday.
So you can scroll back in your podcast player and kind of look through every other episode because the Tuesdays episodes are the regular ones. And then Thursdays are this. Special IEP team bonus series. So just to let you know that they’re out there also, if you’re new to the podcast, I am based in Colorado. So I love to give examples. And of course I can’t give an example from every single state[00:04:00]
but this is applicable to everybody, but I use Colorado’s qualifications just as an example to say, Hey, you know, this is what Colorado requires. Your state probably has something very, very similar in their state. So if you have any questions about what they do in your state, if you want to look up their qualifications,
In your particular state, you can go ahead and ask those questions in the Facebook group. So there’s a link below this podcast in your podcast player to join the Facebook group, you can go ahead and make a new post, introduce yourself, say what question you have and everybody in the group is so supportive and we will help you find what you need. So let’s go ahead and dive into qualifications of a physical therapist. So if you’ve listened to the episode from last week, we talked about occupational therapy and why I mentioned that is because occupational therapists and physical therapists are very similar in that our requirements have changed as far as education level over the last 20 years.
So you have people out in. The workforce that are physical therapists right now and OTs right now. [00:05:00] That have different levels of education because the requirements were different when they went through school and now they’re grandfathered in by this time. So it’s the same thing for PTs. So PTs, officially the requirements are that they have a bachelor’s degree or higher degree from a regionally accredited institution.
Now, right now you actually can not be a physical therapist without a doctorate. So it is not like a PhD doctorate, though. It is a doctor of physical therapy. So you’ll see their initials be like DPT. And I’m sure there’s a couple of different ones, cause there’s a couple of different ones for OT as well.
Um, but just know that anybody kind of knew earlier and I’m talking about like, gosh, it’s been like 15 or 20 years now we’ll have a DPT or you can go back to get your DPT afterwards too. But if you see anybody who has a bachelor’s degree, they’ve probably been practicing for really long time. And their knowledge is probably pretty stellar by this point, too.
So that’s why they grandfather us in because there’s nothing like having experience. But they want to [00:06:00] make sure that everybody is trained. To the level that they need when they go through school. So that’s why you might see some differences in training, but as far as Colorado goes and probably every state, the minimum that you have to have is a bachelor’s degree from a regionally accredited institution. The next kind of qualification is completion of the American physical therapy associations commission on the accreditation of physical therapy, education accredited physical therapy program.
The next one is completion of practicum or internship as required by the physical therapy program attended.
They’re very similar to OTs in that we have a couple internships that we do. Same kind of thing. They practice and they do a field work or a practicum in two different settings and they get supervised for that, so that they have hands on experience in a setting and that the supervisor can like check off that they actually have the skills to graduate. And then the last thing is a valid physical therapy license issued by the Colorado department of regulatory agencies.
And of course that’s [00:07:00] Colorado specific, right? So. Um, they also have a board exam that they take, in order to have that license as well. It’s not listed here. Like they listed it in the OT. I don’t know why, but that is a thing as well. So that kind of goes over the publications. A lot of them have a ton of experience, a ton of them just like OTs. We can work in many, many different settings so we can work in schools. We can work in inpatient rehab settings. Rehab is rehabilitation.
So say somebody had a knee surgery or knee replacement. Then they transfer to a rehab center we can work in that setting. We can work in home health so we can go in and, um, help adults after they’ve had been discharged from the hospital, maybe they have CLPD or something else. And they need to work up their strength. We can do that. We can do home health, pediatrics, where we go into homes.
And really help. Children and their families access their environment at home. We can work it in schools. We can work. In hospitals, like one of my field works was actually in the medical ICU,
and [00:08:00] I’m sure I’m missing other settings too. So you might have a PT that comes in just like an OT. You might have a PT that comes in, that’s new to this particular setting. And so sometimes, you know, they’ll be an outpatient therapist. That’s actually contracted to cover the school that happens too.
So just know that even though they have all these qualifications, sometimes they don’t necessarily have a ton of experience in this setting. And so that’s also why it’s helpful for us to talk about what they actually do in the settings, what they can do.
Because that physical therapist might not realize that that’s their role in this setting, which I know. Sounds weird, but it happens all the time. And there was definitely a learning curve. When I started in schools trying to figure out what was my job. Versus what the special education teacher did versus what the PT did. Like there’s a lot of overlap, right? So.
Sometimes it depends on the team. And then sometimes it just depends on what the district is having them do as well. So let’s transition into talking about what they actually do. So again, they are related service provider. So just like OT, what they do has to [00:09:00] be like school or education related or job related after school.
And so it, it can be pretty limiting from what we do in the outpatient clinic. We can pretty much justify a lot of things in the outpatient clinic. A lot of times we get shut down or we get really limited by the school setting so sometimes. We can’t exactly do what we do in outpatient, in the schools as well.
And the other thing is that just like some OTs will say, oh, you know, I just work on handwriting in the schools. Well, that’s not actually true. We can work on a lot more than that. Sometimes a physical therapist will be like, I’ve actually had a physical therapist. Tell me, well, unless they’re like falling down and hurting themselves, I can’t really justify picking them up.
Which again is kind of untrue. They can have much more wiggle room to pick kids up and to actually see them. But you might have some limited beliefs as far as like the district goes or the PT themselves in really knowing [00:10:00] what their role is in the schools. Right. Does that make sense? So then I’ve also seen, especially when a physical therapist is contracting with the school, because there’s not a huge caseload for PT. Let’s just be very honest. That’s a lot of times why they cover like a whole district in like a mid-sized district or maybe a smaller district, they will cover every single building in that district because their caseload just isn’t huge.
So what happens sometimes is they’ll go to a local clinic and they’ll say, Hey, do you have the physical therapists staffing in order for us to contract with you? And maybe they have like three days a week that they can fill a PT schedule. And so they’ll do that. So it just depends, right? But sometimes those outpatient therapy clinics that they contract with, sometimes those PT goals.
Don’t necessarily relate to the educational curriculum because that PT might not know a lot about the school setting in general. So a lot of times I’ve seen goals like standing on one foot or skipping. And that’s not necessarily [00:11:00] related to educational curriculum unless they’re doing it in PE. So really this is all just to tell you that sometimes it varies district to district and PT, to PT in what they say. And I’m saying that in air quotes,
What they say they can do within the educational environment. So just know that that varies. This is going to help you though. Cause I have a whole list of what they can do in the schools. And so if you are stating again, just like OT, state, the need, don’t go to your team and say, they need PT. They need physical therapy. Don’t do that with an OT. Either you are going to come to the team with the actual need that is there, that is not getting supported. And then you can say, Hey, I’ve heard that OTs are really specialists in this, or, oh, I’ve heard that PT generally covers this.
Do you have that service? Can they evaluate my child to see if they qualify for PT services? And that’s how you really set that up for success. Instead of just going in saying they need PT without a justification or a need, that’s not getting met. [00:12:00]
So let’s talk about some clear ways that they do intervention for children that are pretty universal across the United States. These are pretty fun. And the first one is one that I did not know about until I started working in schools. And this is emergency safety. This is huge. So this can look like the physical therapist.
Uh, planning routes outside of the building, if there’s a fire or any other emergency. I remember in my last district, the PT having to write some emergency plans, like a little blurb into the IEP. So if you’re wondering like, oh my gosh, my child is a wheelchair user. You know, they have an elevator, but what happens if the elevator is breaking and there’s an emergency.
Really there should be kind of plans for that. There should be equipment for that. And so that was the physical therapist job where I worked at least. So she advocated for ordering an evacuation chair, which is just, it has tracks on the bottom, and then she also was in charge of training all of the staff
and how to use the evacuation chairs. And I actually jumped in [00:13:00] and helped her with this. With training everybody and all buildings and how to use this, but really it was kind of up to her to do it. And then I just jumped in to help her because she needed somebody else to help her. Um, also the second thing that they can do is like safety, safety. So this can be, if your child is tripping and falling on the playground.
Or, and sometimes like, they’ll even bring up functional vision because if they can’t see the curb, then they’re probably going to trip on it. So that sometimes comes into play and things that they look at. And they can work on strengthening and exercise programs when this works really well. It’s pretty cool because instead of like you having to fit in a strengthening program at home, which you absolutely can do as well, and that PT can help you put together a strengthening program at home, if you want to do that. But also I’ve seen them delegate the strengthening and exercise programs to the special education teacher at school so that they have that in their schedule every single day that they’re at school and they have like 10 or 15 minutes, it’s [00:14:00] kind of like a brain break.
It’s a movement break, but they’re doing specific exercises every single day. And that special education teacher is there guiding them through the programs and making sure that they’re getting their exercises done. And then they check it off the list and they report back, you know, if this is becoming really easy, then they’ll, they’ll consult with the PT and say, okay, like we’re ready for the next exercise.
Or can you change this out? They’re getting bored with it. Um, and so that’s really cool that that carry over can happen within the setting as well. The third thing that they do is seeding and transfers. So they will train staff on how to do transfers safely. A lot of times they will do transfers for toileting during the day. So sometimes students will need like a whole year lift, which is a more mechanical lift to help. And so they will train all the staff. They’ll check them off for safety.
And training for using some of these Hoyer lifts, or maybe it’s a stand uplift, um, for toileting or changing. So they’ll have changing tables. Um, and so they’ll help the staff really understand how to transfer [00:15:00] safely. That student back and forth and check them off as well. Also like sometimes it’s not really about a transfer, but it’s about how to adjust themselves in their wheelchair. So sometimes power wheelchairs, you can like tilt them back in space. Like if somebody is starting to lean forward or their hips inch forward, then they will train other staff and they’ll train the kid in how to fix their positioning.
If it’s just getting really wonky. Because that’s really important. Right. It affects so many different things. Positioning is like where you start. When you’re talking about like attention and really visually able to see the board and things like that. If they’re in the wrong position, then that obviously needs to be addressed first
before they can actually access their education, if that makes sense. So, um, they will also work with outside companies to source wheelchairs or other DME, which is durable medical equipment. So. If there is a Walker that they need or a standard. You know, sometimes that goes through insurance. So sometimes that’s a private, physical therapist.
That does that. But if you don’t have a private [00:16:00] physical therapist, a lot of times that can be done through the PT at school as well. So also there’s just, you know, Mechanical issues on the wheelchair there, as you know, how do we hang the book bag from the wheelchair? Like things like that to problem solve how this is actually going to work.
Sometimes that gets done with the OT. A lot of times we’ll do that problem solving kind of thing together. And we’ll say like, how can we work this out? Like, how can we figure this out?
But a lot of times that falls directly on the PTF they’re on caseload as well. And then the fourth thing is access to play structures. So strengthening for stepping over curbs or moving on uneven surfaces, like wood chips. Sometimes, if your child has HFOs, which are braces that go on their legs, they will make sure that that child can take it off. So like, if there’s a wood chip stuck in there, so they can take it off, dump it out, put it back on. And, or the staff actually knows how to take it off, put it on what it should look like.
Um, So that they’re able to manage their equipment [00:17:00] at school as well. Also if the environment has stairs on it, um, or if there’s any kind of stairs outside, like on the play structure, if there’s a transfer that needs to happen to adapted swing on the playground, then that would be handled by the physical therapist as well. And then the last one is.
Physical education. So PE. Especially if they don’t have an adapted PE teacher, which I’ve never worked with an adaptive PE teacher, especially like that’s a thing. It is out there. It can be a service on the IEP, but sometimes that’s not available. And so the physical therapist just meets that need. Does that make sense? So again, like, this is a really great example from the other way around, like if adapted PE is not available in your school, then.
You know, if you go into the principal and you’re like, Hey, I want to advocate for adapted PE. And they say they don’t have that service. Then a lot of times that conversation just gets ended. Right? You’re like, I don’t know where to go from here. But if you’re saying, Hey, [00:18:00] my child is in this unit of golf for PE and nobody is in there like teaching or helping the PE teacher understand how he can participate because he totally can’t. Right. Or maybe there’s like a jump rope unit or there’s a basketball unit and it’s not really getting adapted.
Guess what if you advocate for the need and you’re saying they’re not able to access this. Then somebody will step in and pick up that need to make sure that serviced. And a lot of times that’s the physical therapist that jumps in on that need because it’s appropriate. Right. Does that make more sense?
So this is pretty helpful, huh? Like most of these, I did not understand that they did inside the school setting until I was there. And I worked with some amazing physical therapists in my years at the school. So I really, really loved working with them so collaborative and we overlapped so much. It was so, so nice.
So again, I just want to emphasize if you’re going to like listen to this episode and you’re like, my kid needs PT. Just remember to phrase it as the need that needs to be met instead of saying they need PT. [00:19:00] Right. And hopefully that makes sense. I mentioned it several times. Please please never come to your team and say they need more PT. Instead, you’re going to be more specific and say, Hey, I’ve noticed that they’ve been falling on the playground.
You know, I know physical therapy is available in the schools. They haven’t had it, or they haven’t been evaluated for it. Can we get the PT to address that and see if they can pick them up on caseload? Because this is a safety issue and that’s way more likely to be. I guess to that question than just saying they need PT, right?
So much better. You’re working with the system in that way. You’re not like fighting against it or going out of order.
So hopefully this episode was really helpful if you feel like this IEP team bonus series is really helpful. Can I ask for a favor, if you wouldn’t mind reading and reviewing this podcast this helps this podcast get in front of other parents who might be looking for this information or not even knowing that they need this information to help them advocate for their child
coming into the next year. Right? So please, if you would be so kind to take a couple minutes, I would love it. If you would give me a five star [00:20:00] review and also leave a comment on why you think it’s so helpful to you. Just real quick before I sign off. Also, I announced that we are doing a bootcamp in late January to help you understand what you are looking at in your child’s IEP. So if you want to jump on that and register for the bootcamp, it’s a very, very, very, very affordable.
So hop on over to the IEP lab.com/bootcamp to save your seat for that bootcamp. And you will understand what you’re looking at when you look at your child’s IEP, which that’s, the first step that’s where you need to start to really understand what you’re going to advocate.
When we get into 2023. thank you so much for listening and again please rate and review this podcast if you found it helpful and i will talk to you same time same place next week thanks so much