Study of the Relationship of Student Outcomes to School-Based Physical Therapy Services

PT related Child Outcomes in the Schools (PT COUNTS), is a funded study supported by the US Department of Education, Institute on Education Science (R324A110204). It is a prospective, multi-site observational study, undertaken to describe the changes in students’ participation in school activity, self-care, posture and mobility, and recreation and fitness outcomes and the relationships of these changes to identified characteristics of school-based physical therapy intervention, including service delivery models, activities, procedures, and dosage. The School Function Assessment (SFA) and Goal Attainment Scaling (GAS) were used as measures to describe the outcomes that 296 students with disabilities from 26 states achieved when receiving physical therapy within schools over a period of 6 months during the 20012 -2013 school year. The physical therapist’s intervention services were recorded using the researcher-developed School-Based Physical Therapy Interventions for Pediatrics (S-PTIP) data collection system. Physical therapy interventions were provided by 111 physical therapists from 59 different school systems. The relationship of physical therapy service delivery models, activities, interventions, and dosage to changes in students’ participation in school; self-care; posture and mobility; recreation and fitness; and academic outcomes are being analyzed and will be disseminated across the nation at various conferences as noted below  and in publications. The importance of both services to the student and services on behalf of the student has provided some significant findings and implications for practice.  Knowing relationships between student outcomes and physical therapy intervention, as currently provided in schools, will influence physical therapy practice, future research, and professional development.  

Directors

Materials from PT COUNTS

• Executive Summary
• Goal Attainment Scaling (PowerPoint)
• Goal Attainment Scaling (YouTube)
• Goal Attainment Scaling Manual
• School Functional Assessment (PowerPoint w/ audio 28 MB)
• School Function Assessment Presentation (YouTube)
• G.O.A.L.S for Student Participation: Goal Development Tools
  • Goal Development Worksheet
  • Goals for Student Participation
  • Goals for Student Participation Worksheet

S-PTIP Manual and Forms:

• Training Manual: School - Physical Therapy Interventions for Pediatrics (S-PTIP) Data Form
• S-PTIP Form Example 1
• S-PTIP Form Example 2
• S-PTIP Form

Click here to view PT COUNTS Study abstract

What’s new in the literature?

A must read article for all pediatric PTs is Novak and colleagues’: A systematic review of interventions for children with cerebral palsy: state of the evidence. Developmental Medicine and Children Neurology, 2013, 55:885-910. Click here to read the article (PDF).

Publications

• Jeffries, L., McCoy, S. W., Effgen, S.K., Chiarello, L.A., & Tezanos, A.G. (2019). Description of the services, activities and interventions within school-based physical therapy practice across the United States.  Physical Therapy, 99(1), 98-108. doi:10.1093/ptj/pzy123
• Wynarczuk, K., Chiarello, L., Fisher, K., Effgen, S., Palisano, R., Gracely E. (2019). School-based physical therapists’ experiences and perceptions of show student goals influences services and outcomes. Physical and Occupational Therapy in Pediatrics. Epublished 15 Jan, E https://doi.org/10.1080/01942638.2018.1546254
• McCoy, S. W., Effgen, S.K., Chiarello, L.A., Jeffries, L., & Tezanos, A.G. (2018). Relationship of school-based physical therapy services to student outcomes on the School Function Assessment. Developmental Medicine & Child Neurology, 60, 1140-1148. DOI:10.1111/dmcn.13748 
• Effgen, S.K., McCoy, S. W., Chiarello, L.A., Jeffries, L., & Bush, H. (2016). Physical therapy related child outcomes in school: An example of practice based evidence methodology. Pediatric Physical Therapy, 28(1), 47-56. DOI: 10.1097/PEP.0000000000000197
• Chiarello, L.A., Effgen, S.K., Jeffries, L., McCoy, S. W., & Bush, H. (2016). Student outcomes of school-based physical therapy as measured by Goal Attainment Scaling. Pediatric Physical Therapy, 28, 277-284.DOI: 10.1097/PEP.0000000000000268
• Effgen, S.K., McCoy, S. W., Chiarello, L.A., Jeffries, L., Starnes, C., & Bush, H. (2016). Student outcomes of school-based physical therapy as measured by the School Function Assessment. Pediatric Physical Therapy, 28, 371-379.DOI: 10.1097/PEP.0000000000000279
• Jeffries, L., McCoy, S.W., Chiarello, L.A., & Effgen, S.K. (2016). Measurement development of the School – Physical Therapy Interventions for Pediatrics System to document physical therapy services. Submitted to Pediatric Physical Therapy.
• McCoy, S. W., Effgen, S.K., Chiarello, L.A., Jeffries, L., Tezanos, A.G. (2017). Relationship of school-based physical therapy services to student outcomes on the School Function Assessment. Submitted to Developmental Medicine & Child Neurology.

Resources

• Effgen, S. (2013). Advocacy and School Resources. Lexington, KY: University of Kentucky. Read more.
• Executive Summary

National and International Presentations 

• Evidenced-Based School Practice: Implications from the Literature & PT COUNTS Study. California American Physical Therapy Association Annual Conference, San Diego, CA, Sept 17, 2017; APTA Academy of Pediatric Physical Therapy. Innovations in School-based Physical Therapy Practice. Seattle, WA, July 27, 2018 (Effgen, S.K.)
• School-based physical therapy services: for students with Down syndrome within the United States. APTA Combined Sections Meetings, San Antonio, TX, Feb. 2017. (Jeffries, L., Neal, G., Effgen, S.K., McCoy, S.W., & Chiarello, L.A.) Poster.
• What is happening in schools?   Are we doing the same interventions for the same amount of time and having the same outcomes across the USA? APTA Section on Pediatrics Annual Conference, Keystone, CO, November, 2016. (Jeffries, L., Chiarello, L, Effgen, S., & Westcott McCoy, S.) Concurrent session
• Changes in School Participation by Students with Disabilities After Physical therapy services. APTA, IV STEP: Prevention, Prediction, Plasticity, and Participation. The Ohio State University, July 2016. (Effgen, Jeffries, McCoy, Chiarello, & Bush) Poster
• Relationship of School-based Physical Therapy to Outcomes for Children with Disabilities in the United States. International Conference on Cerebral Palsy and other Childhood-onset Disabilities, Stockholm, June 2016. (Effgen, S.K., McCoy, S.W., Chiarello, L.A., Jeffries, L., & Bush, H.) Platform
• Example of Practiced-Based Evidence Research Design Methodology to Study School-Based Practice. APTA Combined Sections Meetings, Anaheim, CA , Feb. 2016. (Effgen, McCoy, Chiarello, & Jeffries) Poster
• Characteristics of School-Based Physical Therapy for Children with Disabilities in the United States. World Confederation of Physical Therapy Congress, Singapore, May 5, 2015. (Effgen, Chiarello, McCoy, Jeffries, & Bush). Platform Handout.
• Outcomes of School-Based Physical Therapy for Children with Disabilities in the United States. World Confederation of Physical Therapy Congress, Singapore, May 4, 2015.  (Effgen, McCoy, Chiarello, Jeffries, & Bush). Poster.
• Relationship of School-Based Physical Therapy Services to Outcomes for Children with Disabilities in the United States. World Confederation of Physical Therapy Congress, Singapore, May 4, 2015. (McCoy, Effgen, Chiarello, Jeffries, & Bush). Poster. 
• Association of Student Outcomes and School-Based Interventions. APTA Combined Sections Meetings, Indianapolis, IN, Feb. 5, 2015. ( Effgen &  Chiarello). Handout.  
• School-based physical therapy services: An analysis of individualized student outcomes using Goal Attainment Scaling. APTA Combined Sections Meetings, Indianapolis, IN, Feb. 6, 2015. (Jeffries, Effgen,  McCoy,  Chiarello, & Bush). Poster.  
• Relationship of School-based physical therapy services to standardized students outcomes on the School Function Assessment. APTA Combined Sections Meetings, Indianapolis, IN, Feb. 2015. Platform Session. (McCoy, Effgen, Chiarello, Jeffries, &  Bush)
• PT COUNTS Study:  Relationship of School-based Physical Therapy Services to Student Outcomes. APTA Section on Pediatrics Annual Conference, St. Louis, MO, Oct 24, 2014 (McCoy, Jeffries, Chiarello, Effgen, & Bush)
• PT COUNTS:  Student Outcomes After School-based Physical Therapy,APTA Section on Pediatrics Annual Conference, St. Louis, MO, Oct 24, 2014 (Effgen, Chiarello, McCoy, Jeffries, & Bush) 
• Impact of Participation in the PT COUNTS Research Study on School-Based Physical Therapist’s Practice. APTA Section on Pediatrics Annual Conference, St. Louis, MO, Oct 24, 2014 (Ward, Chiarello, Jones, & Stoner) 
• School-based physical therapy services for children with cerebral palsy in the United States. American Academy of Cerebral Palsy and Developmental Medicine, San Diego, CA, Sept, 2014 (McCoy, Chiarello, Jeffries, & Effgen)
• National Trends in School-Based Physical Therapy Service Delivery. 22nd Ohio Institute for OT/PT School-Based Practice, Columbus, OH, August 12, 2014 (Effgen)
• Evidenced-Based School Practice: Implications from the Literature & PT COUNTS Study. APTA Section on Pediatrics Innovations in School-basedPhysical Therapy Practice. July 11, 2014, Atlanta, GA (Effgen) 
• Interventions in School-based Practice: Opening the Black Box. APTA Combined Sections Meetings, Las Vegas, Feb. 2014. (McCoy & Jeffries)
• Reliability of the School - Physical Therapy Interventions for Pediatrics Data System. APTA Combined Sections Meetings, Las Vegas, Feb. 2014.  (Effgen, McCoy, Jeffries, Chiarello, Smarr, Bush, & Smith)
• Use of the School Function Assessment and Goal Attainment Scaling in Monitoring Student Progress: Application to Three Cases from the PT COUNTS Study. APTA Section on Pediatrics Annual Conference, Anaheim, CA, November 8, 2013 (Chiarello, Stoner, & Effgen)