Physical therapists have worked in school settings from almost the beginning of the profession. Work in these school settings requires collaboration with teams of individuals, including numerous professionals, paraprofessionals, and, of course, the child and parents. School systems are major employers of pediatric physical therapists and are interesting, fun places to work. In this chapter, the unique aspects of school-based physical therapy will be discussed. Local, state, and federal laws regulate all school services and are discussed in some detail. The most significant law is the Individuals with Disabilities Education Act (IDEA). You have probably gone to school with children with disabilities because of this important United States federal law, first enacted in 1975. This law has a major impact on the education and delivery of related services for preschoolers and school-aged children with disabilities, and is the focus of this chapter.
History of Physical Therapy in Schools
Physical therapists have a long, rich history of serving children with special needs, in special schools set aside for those with physical disabilities. Those schools, many of which were residential, were started in the late 1800s and became common in the early 20th century. Most major cities had special schools for “crippled children” where physical therapists worked. In fact, in the 1930s, a master's thesis was written on physical therapy in the Chicago city schools (Vacha, 1933). Since that time, services to children with disabilities have expanded from serving just those with physical disabilities to including children with a wide range of disabilities, including intellectual impairment and mental illness, children who were not adequately served until the late 20th century. The role of physical therapists in schools continued to expand slowly, until the exponential increase in responsibility and need resulting from major federal legislation in 1975, when the United States Congress passed PL 94-142, the Education of All Handicapped Children Act. This landmark legislation provided that all children aged 6 to 21 years were entitled to a free appropriate public education that included “related services” such as physical therapy, occupational therapy, speech-language pathology, and transportation. Until that time, each local school system had the privilege of determining which children would receive an education. Some systems, especially in large cities, provided extensive services to many children with special needs. Other systems had requirements, such as that the child must to able to walk, independently use the bathroom, or not have mental retardation, to be eligible to receive an education. This national inequity in the availability of a public education, which forced families to move to areas that would serve their children with special needs, ended with PL 94-142.
Since 1975, the Education of All Handicapped Children Act has been amended seven times. In 1986, the reauthorization included the provision of early intervention (EI) services for infants and toddlers with disabilities, as discussed in Chapter 11. In 1990, the act's name ...