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LEARNING OBJECTIVES
Upon completion of this chapter, the reader will be able to:
Appraise the current federal laws that govern early intervention and school-based practice and how they impact physical therapy decision-making.
Analyze the philosophies of early intervention and school-based practice.
Describe evaluation and eligibility determination for Parts C and Part B of the Individuals With Disabilities Education Improvement Act.
Describe how physical therapy interventions may be embedded into natural environments and daily routines for children in early intervention and school settings.
Discuss the physical therapist’s role as a member of a multidisciplinary team in early intervention and school-based settings.
Explain the physical therapist’s role in planning and documentation in early intervention and school-based environments.
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The purpose of this chapter is to describe physical therapist practice in early intervention (EI) and school-based settings under Parts C and B of the Individuals With Disabilities Education Improvement Act (IDEA) of 2004. The law mandates family-centered and educationally relevant services and supports for children with or at risk for disabilities from ages birth through 21 years. Providing services through IDEA can be a rewarding yet challenging endeavor. Physical therapists who provide EI and school-based services have the opportunity to influence child and family outcomes in the places where children spend their days—in their homes, schools, and communities. However, providing physical therapy in these settings can be demanding as therapists navigate federal and state laws and regulations, strive to implement evidence-based practices, collaborate on multidisciplinary teams, and advocate for families and children. In this chapter, we will describe the context of EI and school-based physical therapy; outline the laws, philosophies, and evidence that guide best practice in these settings; and provide examples of what physical therapy looks like in these settings.
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To understand the context of EI and school-based practice, therapists must consider the intersection of health/medical models of care and the developmental/educational framework of IDEA. Although IDEA is an education law, it includes direct or related services from health professionals to support children and families. As part of a multidisciplinary team, physical therapists are asked to apply their knowledge, skills, and expertise about health conditions and disabilities to individual service plans focused on participation for children in the context of their home, community, or school environment. Physical therapists are expected to engage in collaborative and team-based decision-making by considering all the factors that contribute to a child’s level of function including family needs and priorities and/or educational priorities. Decision-making is also influenced by mandates outlined in IDEA for determining eligibility and providing services that require therapists to integrate the physical therapy patient management model into the EI and school-based environments.
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As a foundation for the scope of this chapter, the authors acknowledge the unique factors that influence practice for providers in EI and school-based settings. Physical therapists must adhere to their state practice act regarding their jurisdictional scope ...