*This article taken from Today in PT, Volume 4, Issue 2. February 15, 2010*

by Marnie McLeod Santoyo

A preschool-aged girl takes to the stairs of a play structure and makes a beeline for the slide. Not an unusual scene for most children her age, except for one small difference: She requires assistive devices to get around.

Her gregarious nature draws other children to play with her. As the girl takes her turn on the slide, playmates rush to grab her walker and bring it to her at the bottom of the slide.

It's even better than what Dawn Graeme, PT, ever could have expected. "I simply gave her the techniques to walk up the stairs by holding the rail and then go down the slide, without looking to an adult for help," says Graeme, a full-time physical therapist with the San Ramon Valley Unified School District near San Francisco. "Teaching her those skills was the biggest freedom I could give her. The rest she did on her own."

Schooling PTs

In traditional clinical environments, PTs treating children with gross motor impairments or delays generally perform their work in the confines of well-equipped therapy rooms. PTs working in schools, however, may not have more than empty classrooms available to conduct one-on-one therapy. So their therapy rooms become the classrooms, playgrounds, school libraries, and even field trip destinations--any place where students work and play.

School-based PTs see that as a plus: By bringing therapy to the children instead of pulling them away from their learning environments, it helps students build meaningful skills right in their own worlds.

"School-based PTs shouldn't pull from classes. Instead, they should provide their consultation and therapy support in the student's environment," says Susan Effgen, PT, PhD, in the Department of Rehabilitation Sciences at the University of Kentucky.

Educating the Educators

Even when working in the child's environment, a PT can't do it all in one or two therapy sessions or consultations a week. So educating and working with teachers, parents, and caregivers is critical.

Athena Oden, PT, worked in a consultant therapist role more than 20 years ago, long before the model became widely used in the schools. She was the only therapist servicing all the special needs students in a 640-square-mile rural school district in Texas.

From her experience, Oden developed the "Ready Bodies, Learning Minds" program, a sensory and motor activity regimen that addresses vestibular, proprioceptive, and tactile systems as well as gross motor demands and primary movement patterns--all of which can be done in the classroom.

"What I can do on campus in one day is only as effective as what the teachers or parents can do after I leave," Oden says. It's that kind of collaboration in the school environment that Graeme and Effgen agree will ultimately improve future outcomes for children with disabilities.

"As a therapist in the schools, it is our role to engage everyone working with that child--the teacher, aide, other therapists, parents, librarian--anyone," Graeme says. "They each work with the same child in a different way. It's about getting a child as functional and independent as we can, in his or her environment."