Providing Pediatric Physical Therapy in School Versus Clinical Settings
Physical therapy in all settings is rewarding; however, there are some differences to expect when providing physical therapy in school versus clinical settings.
Similarities in Pediatric Physical Therapy in School and Clinic Settings
Regardless of where PT is provided, therapists require the proper licensure, are expected to practice ethically, and to adhere to state laws. The goal of PT is always to help the child gain the most function and mobility and to enhance their quality of life. Both school- and clinic-based services require a plan of care and goals. In both settings, the PT is expected to work with other therapists (possibly in other disciplines, such as occupational therapy for example), and to coordinate goals with the family as well as to educate family members on what can be done at home on a daily basis.
Physical Therapy in Schools
School-based services are centered on making a child more functional in the school environment; therefore services are geared towards helping the child in whatever way helps them achieve academically. Services are recommended by teachers, parents, or other therapists, and services are paid for through the school or government programs. Since services are provided through the school, children qualify for services under the IDEA (The Individuals with Disabilities Education Act).
The PT evaluation is done in the school setting and services and goals are offered based on the IEP team’s determination. The therapy then takes place in the school environment. This can be in the classroom, on the playground, in the special education classroom, or anywhere that is beneficial to the child. Progress and goals are documented in the child’s IEP and shared with the parents.
Physical Therapy in Clinics
Clinic-based physical therapy requires a doctor or physician referral and typically requires some sort of medical diagnosis. Therefore, clinic-based PT is about helping rehabilitate or aid in functionality and mobility related to that diagnosis. This could be more complicated like rehabilitation after a brain injury, or a more straightforward diagnosis like torticollis in infants.
The evaluation for PT is done by a physical therapist using a series of tests and is then passed on to the rest of the team who will be working with the child. The plan of care is decided based on the evaluation and takes into account the goals of the patient’s family. Since services are covered through insurance or private pay, the documentation of services in the patient’s medical records involves a variety of diagnostic and billing codes and provide the reason for medical necessity of continued services.
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This article is a summary of the information provided by the Academy of Pediatric Physical Therapy Fact Sheet:
APTA Pediatrics, “Physical Therapy for Education Benefit,” 2015, accessed March 9, 2022, https://pediatricapta.org/includes/fact-sheets/pdfs/15%20PT%20for%20Educational%20Benefit.pdf.