According to IDEA section 34 C.F.R. §300.34(a), physical therapy is a related service that “may be required to assist a child with a disability to benefit from special education.”  PT services must be educationally relevant meaning that it must be needed to enable the child to benefit from his or her educational setting.  In contrast, medically based PT focuses on optimizing the child’s functional performance in relation to medical considerations and needs in home and community settings.  Therefore, a physician’s order alone does not determine the need for educationally relevant PT services.

How does the process begin?

• Teacher, parent/guardian or agency request the school

to consider the need for a PT evaluation.

• The physical therapist will generally begin with a professional observation within the school setting to determine the student’s need for a PT evaluation.
• The PT will assess the student’s functional mobility and ability to safely access his/her school setting as it pertains to the student’s educational program.

Who decides need for PT service?

• The IEP Team which may include parents/guardians, teachers (regular and/or special education) administration, and other related service providers, decide the need of PT services to benefit from his/her special educational program.
• A physician’s referral alone does not determine the need for educational

PT services.

What is the focus of therapy in the educational setting?

• Therapy addresses the student’s access to the academic curriculum and

school environment not limited to but including playground, cafeteria, classroom, restroom, hallways and stairs.

• PT works toward the student’s independence and participation in

all areas of the school setting. 

Where does therapy occur?

• Whenever possible, therapy is integrated and provided in the student’s

most natural environment (e.g. classroom, lunchroom, stairs, hallways,

playground) in order to improve carryover with classroom staff and/or maintain peer interaction. 

How is physical therapy delivered?

• Services are delivered by the physical therapist or certified physical therapist assistant either individually or in a small group setting to best meet the needs of the student.
• Therapy may also be delivered in consultation with classroom and/or school staff to address modifications and adaptations needed to assist the student in accessing their current educational program.
• The physical therapist will consider the needs of the student and his/her participation in classroom activities when determining the appropriate method and setting of service delivery.

Adapted from Holahan, L., Ray, L. (2008). Educational and Clinical Models of Service Delivery,

North Carolina Department of Public Instruction, Exceptional Children Division.