Physical Therapy

A young boy positioned on a Support Bench explores rocks in water with his hands and dirt with pine cones using his feet.
A young boy positioned on a Support Bench explores rocks in water with his hands and dirt with pine cones using his feet and legs.

Physical therapy is one of the related services under Part B of IDEA. According to American Physical Therapy Association:

      • Physical therapy is provided to support the student’s individualized
        education program (IEP).
      • Physical therapists work collaboratively with a student’s IEP team
        and participate in screening, evaluation, program planning, and
      • As a member of the IEP team, physical therapists design and
        implement physical therapy interventions—including teaching and
        training of family and education personnel and measurement and
        documentation of progress—to help the student achieve his/her IEP
      • Physical therapists assist students in accessing school
        environments and benefiting from their educational program.

Providing Physical Therapy in Schools Under IDEA 2004

 American Physical Therapy Association (APTA)

When considering an Active Learning approach for students with significant developmental delays who are also visually impaired, deaf or deafblind, physical therapy and the support of a trained physical therapist is essential. At the developmental age of under 48 months, children learn by doing. This means they need to be able to move their body in and around the environment as much as possible. 

A physical therapist focuses on gross movement and in a school-setting this means helping a child to access instruction and activities as defined by the student’s IEP. Unlike a PT in a medical setting, a school-based PT is not there to meet all of the child’s therapeutic needs. That is the reason some children receive service from a PT at school and also in a clinical setting.


Most children with delays in physical development are seen by a PT at some point in their school career. As part of the full initial evaluation (FIE) children in special education are evaluated to determine if their gross motor skills will allow them to access their educational environment and instruction. A child should continue to receive support from a PT as long as that issue is a need.

PTs complete their assessments using a variety of tools. These tools may or many not include something like the Functional Scheme. However, the PT is an indispensable member of the team when it comes to completing the Functional Scheme. They may collaborate with the OT, teacher of students with visual impairments, orientation and mobility instructor, and others to complete these sections of the Functional Scheme:

    • Gross Motor
    • Perception thru Play and Activity

Providing Therapy and Supporting Programming

Once assessment has been done, the PT develops IEP goals focused on improving the child’s ability to move to access his/her educational environment and activities. Sometimes this may involve one-on-one direct therapy to improve movement, posture and balance (e.g. stretching exercises, use of orthotics). They may help the child to get and use adaptive equipment (e.g. wheelchairs, standers, walkers) in the school. Physical therapists assist with adapting activities. For example, they may assist in gym class with a child who uses a wheelchair, so the student is able to be included in the activities planned. (School-based Therapy, Care for Children website, 2022).

A PT may also work with a child’s team using a consultation model. This means they may develop exercises and activities for the child to practice skills and develop strength throughout the day. They may not directly supervise these activities, but instead role-release them to others to complete. PTs should help guide the team in the selection of Active Learning equipment to focus on goals related to gross movement. To help with this selection they may want to download the Quick Guide to Active Learning Equipment:

PTs can help develop various learning activities and environments to help the child learn to:

    • Move arms/legs
    • Lift and turn the head
    • Develop trunk control needed for sitting, standing and walking
    • Learning to run, jump,:crawl, climb, throw, kick, etc.
    • Have the ability to transition from one position to another (e.g., sitting-standing)

When a child is visually impaired or blind, the PT needs to collaborate with the teacher of students who are visually impaired, and the orientation and mobility instructor since this sensory loss effects movement and the development of gross motor skills. If the child is deaf or hard of hearing, there may be problems with balance which requires collaboration with the teacher of the deaf and hard of hearing in developing activities.

Documenting Progress

The PT is responsible for documenting progress on IEP goals that are written related to gross motor movements. They may choose to do this directly and/or utilize various Active Learning forms that others can help complete to document progress. 

They will also re-evaluate skills to determine 1) if their services continue to be needed and 2) what should be the focus of new IEP goals.

Video Examples

Below are some examples of Active Learning as it relates to gross movement:

Jack’s Progression

In this video we see clips of Jack over a period of about 3 years as he goes from being very limited in his movements to becoming quite active in his movements. These gains were made through the use of various Active Learning equipment and activities in addition to direct therapy.

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Kayden Works on Balance

In this video Kayden is practicing balancing on an Essef Board while she plays with hand bells with he hands and mouth and moves her feet on a musical mat.

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Sonya in the HOPSA Dress

In this video we see Sonya, who has problems with hip dysplasia, learning to move around her environment using a HOPSA dress on a track. Although she may never be able to walk independently, this type of movement helps her to learn about things in her environment and make choices about where she wants to go. Her orthopedist approved of her using the HOPSA Dress.

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Jack on the Support Bench

In this video we see Jack positioned on a Support Bench. This allows him to develop strength in his neck and torso and practice moving his arms and legs freely. He is also learning about things that plants need like water and soil.

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