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Learning Objectives


  • Discuss the characteristics of contemporary school-based services.

  • Analyze key legislation impacting the delivery of school-based services.

  • Discuss contemporary school-based practice management issues.

  • Analyze the work of physical therapists in public schools.

  • Determine the managerial roles and challenges to managerial responsibilities.

  • Analyze managerial decision-making in given school-based situations.

Part 1 The Contemporary Setting

Overview of School-Based Rehabilitation Services

Although school systems are not part of the health-care system, many of the 6.5 million people ages 3 to 21 in special (sometimes labeled exceptional) education receive interdisciplinary rehabilitation services in the schools they attend.1 In addition, almost 300,000 infants from birth through age 2 receive early intervention services through local school systems or other approved agencies to improve their opportunity for success when they enter school.2 These special education and related services are provided by each state through federal legislation mandates, primarily the Individuals With Disabilities Act (IDEA).

The Individuals With Disabilities Education Act (IDEA) and the Individuals With Disabilities Education Improvement Act (IDEIA)

Initiated in 1975 with subsequent revisions—IDEA was reenacted and revised in 2004 as the Individuals With Disabilities Education Improvement Act (IDEIA) to align with the No Child Left Behind Act (NCLB) in 2001. The IDEIA has four parts: Part A deals with the administrative components of the Office of Special Education Programs, Part B lays out the educational requirements of the act, Part C creates guidelines for children with special needs who are under 2 years of age, and Part D creates national grants and resources for implementation of the act.3

Of these parts, Part B is of particular interest to managers in school systems. Part B of IDEIA defines children with disabilities as individuals between the ages of 3 and 21 who have one or more of the following conditions that adversely affect their educational performance:3

  • Mental retardation

  • Hearing impairment (including deafness)

  • Speech or language impairment

  • Visual impairment (including blindness)

  • Serious emotional disturbance

  • Orthopedic impairment

  • Autism

  • Traumatic brain injury

  • Specific learning disability

  • Attention deficit disorder (ADD)

  • Attention-deficit hyperactivity disorder (ADHD)

  • Other health impairment

School systems are required to provide a free and appropriate education, although what that is has not been clearly defined, and the support or related services necessary for each student in the least restrictive environment to achieve his or her educational goals. These related services include:4

  • Speech-language pathology and audiology services

  • Psychological services

  • Physical and occupational therapy

  • Recreation, including therapeutic recreation

  • Social work services

  • Orientation and mobility services

  • Medical services for diagnostic and evaluation purposes

  • Interpreting services

  • Psychotherapy

  • One-to-one instructional aide

  • Transportation

  • Art therapy

  • Technological devices

  • School nurse services

Least Restrictive Environment

A key element of IDEIA is that special needs students receive an education in ...

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