FCPS preschool, elementary, and secondary students receiving special education services, who are determined by the Individual Education Plan team to require physical and/or occupational therapy services, receive intervention and supports to assist their access to and participation in their instructional programs during the school year and during the summer months.  During the 2022-2023 school year, physical and occupational therapists provided services to 2938 students receiving special education services (Physical Therapy – 582; Occupational Therapy 2356).  Additionally, consultative and evaluation services were provided to an additional 1151 students (Physical Therapy – 170; Occupational Therapy – 981).

Physical and occupational therapists contribute to FCPS’ effort to educate diverse learners, support student participation, and promote success in the least restrictive learning environment.  Physical and occupational therapy services are designed to enable students to access, participate in and benefit from the curriculum.

• In support of the Strategic Plan – Student Success – Physical and Occupational Therapy Services assists students by addressing needs that impact ability to participate and access instructional programs and school settings and promote skill practice in natural settings.  They help build capacity through instruction and support provided to members of the school team and families and they facilitate safe and accessible environments for student participation.  They work with education staff to develop and design curricular accommodations and modifications that enable a student to access the general education curriculum. 
• In support of the Strategic Plan – Caring Culture – Physical and Occupational Therapy Services support students in contributing effectively and productively within their school and community.
• In support of Portrait of a Graduate – Goal-Directed and Resilient Individual – Physical and Occupational Therapy Services provide services and/or resources to improve participation in daily school routines and life skill outcomes that support students’ abilities to engage meaningfully in role of life-long learner, self-advocate, friend and community member.
• In support of new Teacher Performance Standard 6/Culturally Responsive and Equitable Teaching Practices, Physical and Occupational Therapy Services embraces Affirming, Assessing and Advancing Equity; by supporting students and teams through remaining strengths based in their evaluations, building relationships and centering the student voice in conversations.

Services Provided to Students

Physical and occupational therapists conduct evaluations to collect information concerning the performance of a student either identified with a disability or referred for consideration of a disability in areas that may be supported by therapy intervention in accordance with provisions mandated and outlined by the Individuals with Disabilities Education Act (IDEA) (34 CFR § 300.34 (a) and (b)) and the Virginia Department of Education (VDOE) (§22.1-213).  At the request of teams and with the written permission of parent/guardian, evaluations are conducted by licensed therapists to identify functional skills and barriers that impact the student’s access to, and participation in their learning environment.  Physical and occupational therapy evaluations address:

• The routines and roles that a student needs or desires to perform,
• The skills required to perform those routines and roles,
• The resources needed to accomplish those skills, and
• The remedial, accommodating and/or modifying processes that will enable a student to access, participate in, and benefit from their educational curriculum.

Physical and occupational therapists evaluate students’ performance within the context of the educational environment, assess the activity/task demands impacting performance, and analyze the impact of barriers/supports on the student’s participation at school.  The teacher, parent and therapist observations of the students’ participation and function are major components of the evaluation process.  IDEA mandates that school personnel are to use … “assessment tools and [evaluation] strategies that provide relevant information that directly assists …in determining the educational needs of the child…” (IDEA §300.304(c)(7)).   Assessment tools used by physical and occupational therapists are chosen to evaluate the student’s educational needs and provide relevant information to assist in the development of an individual and appropriate educational program.  Assessment tools vary depending upon the referral, the student’s unique profile as well as concerns presented and observed in school.  Physical and occupational therapists select and administer tests from the FCPS Special Services Approved Test List as well as other appropriate tests and checklists. Evaluation findings and written reports are shared with the school team and family members.  Recommendations are reviewed and decisions are proposed regarding the need for the additional related service of physical or occupational therapy services by the IEP team.

A focused evaluation may also be requested to assist the 504 Knowledgeable Committee in developing appropriate accommodations for that student’s 504 Plan. Written parent/guardian consent is required prior to initiation of an evaluation.

Physical and occupational therapists collaborate with the instructional staff to assess and modify materials, tasks and environments in support of student access and independence and ensure that specialized materials and equipment used support the goals and accommodations stated in the student’s IEP.  Physical and Occupational Therapy Services maintains an array of supplies and tools needed to modify existing equipment/materials for student needs.  Specialized and adapted equipment and materials are available for students who require them to participate in and safely access school routines and benefit from the curriculum.  When adapted or specialized equipment is required for a student to participate in school is not available, the therapist identifies appropriate equipment to support the student’s needs.  The program maintains a working inventory of equipment used by students in FCPS schools.

The Occupational and Physical Therapy Services Program focuses on providing quality related services to students receiving special education by addressing needs that impact their ability to access, participate, and progress in their instructional programs and school settings in the least restrictive educational environment, using research-based and educationally relevant interventions that support participation and learning safely and successfully. Physical and Occupational Therapy Services seeks to improve outcomes for all students through the use of:

• Evidence based practice and individualized interventions;
• Collaborative supports that facilitate inclusive opportunities for children with disabilities and their families, and
• Training, consultation and support to students, school teams, and families.

By June 30, 2024, 85% of program staff will complete at least 15 hours total of self-directed and program/division provided professional development focused on evidence supported interventions relevant to school-based practice, as well as learning opportunities that support the division’s mission (e.g., Equity centered professional development) as measured by program manager and supervisor through the therapist evaluation cycle and program data collected during the given/specific school year.

By June 30, 2023, 65% of physical and occupational therapists will conduct a formal training to a specific audience (e.g. content or grade level CLT, student specific team, paraprofessionals, lead teachers) in order to build capacity of special and/or general educators around such topics as the role of physical and/or occupational therapists in the educational setting, referrals, motor development, benefits of movement, mealtime support, physical management and environmental adaptations/modifications to support learning.

Future Focus

Occupational and physical therapists will assist school teams in achieving positive student outcomes related to student progress, access, and participation through:

• Increased participation in formal trainings with school teams aimed at sharing expertise and developing common purpose that builds teacher capacity and facilitates positive student outcomes.
• Advancement of research based physical and occupational therapy practices that result in high level student achievement.
• Expansion of data-driven evaluation and authentic assessment practices that center the student voice and inform team decision making regarding instructional and intervention practices.
• Effective data-collection and documentation practices that build a body of evidence of student progress and program effectiveness.
• Increased participation in data-based growth and professional development training.

Therapy Services focuses on providing quality related services to students receiving special education services by addressing needs that impact their ability to access, participate, and progress in their instructional programs and school settings, using research-based and educationally relevant interventions that support participation and learning. 

Goal: By June 30, 2023, 80% of program staff will complete at least fifteen hours of self-directed continuing education on evidence supported interventions relevant to school-based practice, as measured by program manager and supervisor through the therapist evaluation cycle.

Evaluator data sources gathered through the therapist evaluation cycle were aggregated to reveal that 99% of therapists completed at least 15 hours of professional development and logged a total of 879 courses, earning 2,426 CEUs in Summit Education online training (self-directed continuing education) on evidence supported interventions relevant to school-based practice.

Goal: By June 30, 2022, 60% of physical and occupational therapists will conduct a formal training to a specific audience (e.g. content or grade level CLT, student specific team, paraprofessionals, lead teachers) in order build capacity of special and/or general educators around such topics as the role of physical and/or occupational therapists in the educational setting, referrals, motor development, benefits of movement, mealtime support, and environmental adaptations/modifications to support learning.

Sixty four out of 100 therapists logged trainings for school year 2022-2023. Each therapist (n=100) conducted (on average) four point eight four (4.84) trainings over the course of the 2022-2023 school year. About ten percent of these trainings educated school teams about the role of therapy services. The majority of the trainings covered areas such as safe lifting and transfers, equipment use, mealtime support, motor development, curriculum adaptations, school-based self-care, tool use, and vocational support. Most of these trainings occurred with smaller groups, rather than CLTs, and were focused on either an individual student or a subset of students with similar needs.

Data that supports the methodology of these goals: Physical and Occupational Therapy Services supports students’ physical and performance needs to ensure safe access and successful student participation in their educational program.  Student and school specific training and data based professional development was provided to build capacity of school teams to include teachers, instructional assistants, and support staff (e.g. bus drivers and attendants).  Essential topics included positioning, safe lifting, transfers and physical management of students, safe equipment use, bathroom set-up and personal care support, and mealtime support for students.  Disability and intervention specific topics related to the physical needs of students are also provided. Trainings that were completed during the 2022-2023 school year directly correlated to safe participation by students, safe student handling by staff/caregivers, and increased participation by students.

Essential Trainings and Professional Development 2022-2023

Additional:

• OT/PT Intern orientation, 2 sessions, 9 participants

The unique body of knowledge required of occupational and physical therapy practitioners working in school settings is dynamic and it changes rapidly with local, state, and federal regulatory changes, the promulgation of scientific evidence, and the development of best interdisciplinary practices.  Occupational and physical therapy practitioners engage in educationally relevant and job specific training to maintain licensure, ensure ongoing competency in accessing and analyzing scientific information and incorporating scientific evidence into student planning and interventions and to fulfil the following federal, state, local and association mandates:  

• VA Department of Health Professions in the Commonwealth of Virginia Board/Board of Medicine (18VAC112-20-131 [PT]/18 VAC 85-80-10 et seq. [OT]) requires 20 (PT) and 10 (OT) contact hours per year of American Physical Therapy Association (APTA), American Occupational Therapy Association (AOTA), American Physical Therapy Association Virginia (APTA Virginia), and/or Virginia Occupational Therapy Association (VOTA) approved discipline specific training.
• APTA and AOTA require ongoing professional competency maintenance in their Standards of Continuing Competence and Code of Ethics.
• Current licensure is required to work as a physical or occupational practitioner in Fairfax County Public Schools.
• IDEA 2004 Statute: Part D; § 1450.6-7 requires that related services personnel receive professional training that improves student accessibility, participation and learning outcomes for children with disabilities and their families.
• Council for Exceptional Children Ethical Principles and Professional Practice Standards for Special Educators – Special Education Professional Ethical Principles requires ongoing professional development planning, participation in ongoing self-assessment and professional development activities to support continuous improvement of professional performance. 
• Federal Medicaid and Virginia Department of Medical Assistance Services require that all providers of physical and occupational therapy services maintain a valid license to practice in the state in which they are providing billable service.

Training, co-constructive and collaborative face to face and on-line learning models were used to develop collaborative, accessible, and dynamic evidence-based practices, knowledge translation capacities, and research-practice partnerships that sustain change in clinical practice and improve student and program outcomes.