MadisonMetropolitanSchool District
Occupational and Physical Therapy
Student Affiliation Program
GENERAL INFORMATION
The occupational therapy and physical therapy program is an integral part of the MadisonMetropolitanSchool District’s delivery of service to students with special education needs. Children between the ages of 3 to 21 years receive OT and PT in elementary, middle, or high school around the city. Children are served in schools and community based sites to include day care, preschool, vocational
sites, and home. This is a general guideline for all levels of occupational and physical therapy services in MMSD; some components of this document are not appropriate based on the educational level of the child.
IDEA
State and federal legislation has been enacted which mandates delivery of services to students with disabilities in all schools in the district. The Individuals with Disabilities Education Act (IDEA) Amendments of 1997 is the most important federal law for more than five million infants, toddlers, children, and youth with disabilities in the nation since the original enactment of the Individuals with Disabilities Education Act (IDEA) in 1975. The amendments were the result of years of congressional debate and, in the final months before enactment, was crafted by a unique bipartisan working group. The resulting legislation is significantly different from the preceding law and its changes are of critical importance for educators and parents. Understanding IDEA’s six principles is critical to understanding the spirit and intent of the law. They provide the framework around which special education services are designed and provided to students with disabilities. These principles are:
Free Appropriate Public Education (FAPE)
Appropriate Evaluation
Individualized Education Program
Least Restrictive Environment
Parent and Student Participation in Decision Making, and
Procedural Safeguards
Alone and together, these six principles work to guarantee that students with disabilities can go to school everyday, learn what other children learn, (except perhaps in a different way) and have their individual educational needs determined and addressed. Related services are those necessary to assist a child with a disability to benefit from special education. IDEA specifically includes occupational therapy and physical therapy as related services.
504
Congress enacted Section 504 which provides that no handicapped individual by reason of his/her handicap be excluded from participation in any activity receiving federal financial assistance.
DELIVERY OF SERVICES
Delivery of therapy services are carried out by therapists assigned to schools by teams. A team consists of an OT, PT, COTA or PTA. Each team is assigned a number of schools and caseloads following Department of Public Instruction (DPI) regulations of approximately 30 students for a full-time therapist without an assistant and 45 with an assistant. Number of schools and sites to which a therapy team is assigned is also a determining factor in caseload size. Therapy programs vary greatly depending on the level of service and population being served. School therapy is based on school practice guidelines rather than clinical practice guidelines and varies widely according to the child’s program goals and objectives.
MadisonMetropolitanSchool District therapists are under the direction of a special education coordinator. At the building level therapists are immediately responsible to the building principal and to an area special education coordinator.
MadisonMetropolitanSchool District teachers and support staff (including therapists) are members of Madison Teachers Incorporated (MTI) which is a labor union.
MadisonMetropolitanSchool District follows the rules and regulations of the Department of Public Instruction, which is the state governing body for education. Specific information relating to OT and PT can be found in Occupational and Physical Therapy - A Resource and Planning Guide published by the Wisconsin Department of Public Instruction in 1996.
PHILOSOPHY OF STUDENT AFFILIATE CLINICAL EDUCATION PROGRAM
Since the therapy program in the MadisonMetropolitanSchool District functions within a team model, the student affiliate training program will be similar for OT and PT but will differ in areas mandated by state licensure, national guidelines, and DPI requirements. The general overall goals and objectives, however, will be the same. The affiliating student will have the opportunity to develop special interest areas, participate in assessment and treatment of children, and have an understanding of how therapy operates within MadisonMetropolitanSchool District. Opportunities will be available to the student affiliate to become proficient in evaluation and treatment but an important part of the training will be designed to make them members of the IEP team. This implies that the OT and PT student affiliates will have an understanding of various school and community disciplines and how they relate to these other fields. Physical therapy students will be supervised by a physical therapist and occupational therapy students will be supervised by an occupational therapist but many members of the program to which the affiliating student is assigned will do the overall training. OTA/PTA student affiliates will be supervised by the MMSD OTA/PTA in conjunction with the MMSD OT or PT who is supervising the OTA or PTA.
AFFILIATION REQUIREMENTS AND RESPONSIBILITIES
At the beginning of the affiliation, the student affiliate will be given a general orientation to the various physical and organizational aspects of the specific schools or sites particular to their assignment. Such information will include:
1. introduction to appropriate administrators and school staff
2. information about emergency procedures (fire drills, tornado drills,
bomb threats, unauthorized visitors, universal precautions)
3. physical plant layout
4. basic building procedures such as the daily schedule, keys, petty cash,
lunch, computer access, access to records
5. access to individual school handbook
6. Confidentiality policy.
7. Discussion of student affiliate’s institution’s requirements
The student affiliate will be expected to become familiar with:
1. School handbook(s)
2. IDEA Policies and Procedures Handbook, Special Education Handbook, MMSD Educational Framework, Community vs. School-Based brochure.
3. Medical Examining Board requirements for state certification and licensure
4. Occupational Therapy and Physical Therapy: A Resource and Planning Guide (DPI, 1996)
5. Section 504 Implementation Manual
6. MadisonMetropolitanSchool District OT/PT Evaluation Report Form
7. MadisonMetropolitanSchool District Treatment Plan.
Student affiliates will observe and participate in evaluations/assessments and treatment with supervision. The student affiliates will observe and participate in classroom programming as appropriate. The student affiliate will receive an initial caseload of approximately three to four children and be given time to assess them and carry through with already existing treatment programs. Caseload size, rate of acquisition of additional students, number of evaluations, and project(s) is dependent on the setting and individual therapist and the student affiliate. The student affiliate will be expected to become familiar with the medical and academic folders including the Individualized Education Program (IEP). The student affiliate and therapist will have at least a weekly check in on assignments, progress and needs.
Student affiliates should have access to their own transportation.
COMPETENCIES AND LEARNING OBJECTIVES
Requirements, assignments, and experiences for individual occupational and physical therapy student affiliates will be determined by individual clinical instructors depending on site and student population.
1. Knowledge of handicapping conditions that occur before and after birth and their effects on the sensory, motor, psychosocial, and cognitive development of students with special needs.
2. Knowledge of current federal and state laws, regulations, and procedures affecting therapy services in school settings.
3. Knowledge of major theories, treatment procedures, and research relevant to providing therapy services for children (ages 3-21) who have special needs.
4. Knowledge to utilize a data base to determine treatment goals.
5. Ability to select and administer appropriate assessment instruments and procedures taking into consideration a student’s age, developmental level, handicapping condition, and educational placement.
6. Ability to assess the functional performance of students with special needs within the school environment.
7. Ability to engage in consensual decision making as part of the IEP process.
8. Ability to interpret assessment results appropriately and use results to develop therapy intervention plans.
9. Ability to plan and implement intervention strategies using direct therapy, monitoring, and consultation.
10. Ability to communicate effectively (orally and in writing) with education personnel, administrators, parents, and community members.
11. Ability to explain the role of therapy within the school setting to education personnel, administrators, parents, and community members.
12. Ability to document assessment and intervention results in the proper manner for a school setting and to relate this information to the educational goals of the student.
13. Ability to develop, implement, evaluate, and modify accordingly a therapy program within a school setting.
14. Ability to deliver therapy services in a safe manner that minimizes risk to student(s) in therapy, self, and others.
15. Ability to deliver established plan to reflect respect for and sensitivity to individual differences.
16. Ability to educates others (students, family, caregivers, staff, other health care providers) using relevant and effective teaching methods.
17. Ability to participate in addressing student and family needs for services other than therapy.
18. Ability to manage resources (e.g. time, space, and equipment) to achieve educational goals.
19. Ability to participate in fiscal management of the therapy teamand fiscal decision making for team/department/family (ex: team budgets, equipment/supplies, Assistive Technology, equipment justification).
20. Ability to implement a self-directed plan for career development and lifelong learning.
21. Ability to implement treatment in such a way that it is understood and accepted by the child.
22. Ability to establish therapeutic rapport with students who are receiving therapy.
23. Ability to accurately utilize, interpret, and incorporate medical information into student’s educational plan.
24. Ability to demonstrate competence in implementing therapy objectives in the classroom and incorporating academic objectives into treatment.
25. Ability to demonstrate connection between IEP goals, treatment plan and child’s functional performance in the classroom.
26. Ability to demonstrate an understanding of the roles of other educational professionals.
27. Ability to be cognizant of their own language when working with children, parents and staff.
28. Ability to work as a team member with OT, PT, and therapy assistant(s) and be aware of differing roles and responsibilities.
Examples of DisablingConditions typically seen in the MadisonMetropolitanSchool District
1. Cerebral palsy/static encephalopathy
2. Developmental delay
3. Neuromuscular disorders
4. Down Syndrome
5. Meningomyelocele
6. Autism
7. Other:
a. Spinal Cord Injuries
b. Arthritis
c. Congenital Anomalies
d. Learning or Emotional Disabilities (minimal brain dysfunction)
e. Organic Brain Dysfunction
f. Arthrogryposis and other musculoskeletal disorders
g. Osteogenesis Imperfecta
h. Cognitive Disabilities
i. Hearing/Vision Impairment
j. Motor Incoordination
k. Traumatic Brain Injury
l. Cerebral Vascular Accident
m. Prenatal substance abuse exposure
n. Prader-Willi
o. Seizures
Evaluation Procedures
1. Formal Assessments(Standardized testing – criterion or norm-referenced)
and Informal Assessments
2. Functional Assessments
3. Musculoskeletal assessment including tone, range of motion, posture, strength
4. Sensory/sensory integrative assessment
5. Developmental testing
6. Clinical assessment and observation
7. Assistive devices
8. Activities of daily living
9. Behavior
10. Educational environment assessment
11. Interview parents, teacher(s), other school staff, community providers.
This student affiliate program was developed considering the guidelines established by the American Occupational Therapy Association and the American Physical Therapy Association in conjunction with the requirements of MadisonMetropolitanSchool District.