Special Education Services: A Manual of Policies, Procedures and Guidelines

D.5 Physiotherapy/Occupational Therapy

Purpose
Physiotherapy is a professional health discipline primarily directed toward the prevention and alleviation of movement dysfunction to promote maximal independence for the student in his/her home, school and community. Physiotherapists provide services to children with orthopaedic, neurological, muscular, spinal, joint or sensory dysfunction. These services include assistance in physical positioning to promote optimal physical access, assistance in maximizing independence for students who have limited mobility, and prevention and alleviation of movement dysfunction. The services performed by a physiotherapist in schools may include screening, assessment, consultation, program planning, and assistance in diagnosis, treatment, equipment selection/adaptation, administration, education and research.

Occupational therapy is a professional health discipline that utilizes the analysis and application of activities specifically related to performance in the areas of self-care, productivity, and leisure. Occupational therapists work to promote, maintain, and develop the skills needed by students to be functional in a school setting. Occupational therapists provide services to children with orthopaedic, neurological, muscular, spinal, joint or sensory dysfunction, as well as those with cognitive and complex neuro-behavioural disorders. The services provided by the occupational therapist in schools may include assessment, consultation, program planning, and assistance in diagnosis, treatment and equipment selection/adaptation.

Description of services
Physical disabilities and developmental delays may be noted in students who have other special needs, but they can also occur in isolation. Not all students with physical disabilities or delays will require physical/occupational therapies or consultation Referrals should be handled through the school-based team management process, to ensure that appropriate services are considered for every child.

A student's needs in the area of physiotherapy or occupational therapy services should be determined by the appropriate health professionals after reviewing reports, interviewing parents or guardians, observing and assessing the learner's needs, and consulting with education staff and/or appropriate medical personnel.

Educators and therapists should collaborate to optimize the student's physical functioning and to integrate the student's therapeutic goals within all of the student's educational routines.

Access to Physiotherapy/Occupational Therapy services
School boards should secure the services of an occupational therapist or physiotherapist for students when the absence of basic services provides an impediment to their learning in the school. These services may include:

• screening/assessment;
• consultation for school staff/families;
• training of staff to carry out routines such as positioning, seating, feeding or motor activities for optimal maintenance of students in classroom settings during the school day; and
• monitoring and ongoing evaluation of students in classroom settings.

When "direct" service (i.e. direct treatment) is required, either temporarily or long-term, the student's physician makes a referral to a community-based physiotherapist. This kind of service is considered to be a matter between health professionals and the family, and is beyond the realm of the school district's responsibility. Given these dual responsibilities, there is a need for locally negotiated agreements between health agencies and school districts.

In those instances where students are enrolled in ongoing therapy programs, communication links should be well established between health personnel, the student's home and school staff to ensure that consistency is maintained.

Students with physical disabilities may require adaptations to facilities or provision of specialized equipment or technologies. The physiotherapist and occupational therapist will often be able to provide useful advice to school personnel in these matters.

Personnel
Standards of training for physiotherapists are determined by the College of Physical Therapists of British Columbia, which has the authority to issue licences to qualified practitioners. The CPTBC sets standards for entry into the profession, registers physical therapists, sets and enforces a set of rules that registrants must follow and develops programs to promote the highest standards of physical therapy practice. Registration with the CPTBC is mandatory to work as a physical therapist/physiotherapist in British Columbia.

Standards of training for occupational therapists are determined by the College of Occupational Therapists of British Columbia, which has the authority to issue licences to qualified practitioners. Possession of a current licence is a requirement for practicing occupational therapists in British Columbia. Those who provide occupational therapy services in schools should meet standards established by the College of Occupational Therapists of B.C.

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