Research Report
Population: Pediatric
Susan K Effgen, PT, PhD, FAPTA, Professor, University of Kentucky seffgen@uky.edu
Lynn Jeffries, PT, PhD, PCS, Associate Professor, University of Oklahoma Health Sciences Center lynn-jeffries@ouhsc.edu
Sarah McCoy, PT, PhD, FAPTA, Professor, University of Washington westcs@u.washington.edu
Lisa Chiarello, PT, PhD, PCS, FAPTA, Professor, Drexel University lc38@drexel.edu
Keywords: Participation, School-based Physical Therapy, Children
Purpose: Participation in the educational setting is critical for students with disabilities. School-based physical therapists (PTs) have a role to facilitate student engagement. There are minimal data indicating the outcomes of school-based PT related to participation of students. A prospective, multi-site observational study, PT COUNTS, describes the status and changes in students’ participation in various school settings after 6 months of services.
Subjects: 109 PTs and 296 students ages 5 to 12 (x=7.3, SD 2.0) from 28 states.
Methods: A practice-based evidence research methodology was used to study the outcomes of school-based PT. After training, PTs completed subsections of the School Function Assessment (SFA) on students. The SFA Participation 6 point scale rates the student’s participation in either the Regular or Special Education Classroom and in the following settings: Playground/Recess, Transportation, Bathroom/Toileting, Transitions, and Mealtime/Snack Time. The scale ranges from 1 (participation is extremely limited) to 6 (full participation). PTs rescored the SFA 6 months later. Students were grouped by Gross Motor Function Classification System levels (GMFCS) I, II/III, IV/V. Descriptive and comparative analyses were conducted on the total Participation scores and the item scores by setting.
Results: The Regular Classroom was the placement for 106 students with an initial Participation mean rating of 4.26 (SD 1.27), and posttest rating of 4.51 (SD 1.24). The initial mean Participation rating for 179 students in Special Education Classrooms was 3.04 (SD 1.34), and posttest rating was 3.43 (SD 1.43). For all children, the pretest/posttest criterion mean scores were: Playground/Recess 3.32 (SD 1.51)/3.66 (SD 1.62); Transportation 3.58 (SD 1.75)/3.94(SD 1.77); Bathroom /Toileting 3.43 (SD 1.83)/3.80 (SD 1.86); Transitions 3.66 (SD 1.57)/4.08 (SD 1.60); and Mealtime/Snack Time 3.79 (SD 1.58)/4.13 (SD 1.61). There were significant differences between pre and post test criterion scores in all settings (p<0.0001).
Participation ratings were significantly different across GMFCS groups for the following settings: playground (p<0.001), transportation (p<0.02), bathroom (p<0.01), and mealtime (p<0.05).
Conclusions: There was significant improvement in participation for students in all settings after 6 months of school-based PT. Students in regular classrooms had higher classroom participation ratings than students in special education classrooms. There were differences in participation ratings based on GMFCS groups.
Clinical Relevance: It is important for school-based PTs to assess and document changes in participation in school settings. Gross motor ability may support participation in school. Research to understand interventions that facilitate change in participation is warranted.
Citation:
Effgen, Susan K, PT, PhD, FAPTA; Jeffries, Lynn M, PT, PhD, PCS; McCoy, Sarah Westcott, PT, PhD, FAPTA; Chiarello, Lisa , PT, PhD, PCS, FAPTA. Changes in school participation by students with disabilities after physical therapy services.. Poster Presentation. IV STEP Conference, American Physical Therapy Association, Columbus, OH, July 17, 2016. Online. https://u.osu.edu/ivstep/poster/abstracts/021_effgen-et-al/