At Wildwood School, Physical Therapy is a related service offered to students who have delayed or atypical gross motor development. Gross motor development encompasses everyday movement skills such as changing positions, standing, walking, running, hopping, skipping or play skills such as throwing and catching a ball.

“In our role, we observe and analyze a student’s movement to determine what is happening, why it is happening, and if physical therapy services could improve their movement functioning and safety at school, ” Cheryl Nelson PT, our lead school physical therapist, says. “It is seldom one factor and it takes some detective-like work to figure it out.” 

Some key areas that physical therapists evaluate and treat include cardiovascular stamina, muscle flexibility, muscle tone, walking patterns, and posture. Bone structure or bone abnormalities also impact an individual’s movement as does a person’s unique neurology. Neurological factors like reflexes, sensory status, and coordination will all play a combined role in gross motor development and movement. 

“That’s what physical therapists do—we evaluate the physical systems including muscles, joints, the heart, lungs, and nerves then formulate a plan, or set physical therapy goals, for improvement in areas of weaknesses,”  Cheryl says.

All people need to move to complete their daily activities. For a student with a disability, movement needed to complete daily routines may be more challenging and may require a therapist to find creative ways to engage and motivate a student to participate in physically challenging tasks. 

“Sometimes students may be perceived as being lazy, but I believe in many situations they may choose not to move because it is hard for them or may not seem important,”    Diana Millspaugh  DPT,  school physical therapist, says.

Some students will move with atypical movement patterns that are less efficient and may impact their safety at school.  These differences can be related to a person’s physical anatomy or how the brain processes and relays information to coordinate movement.  It is in cases like this that physical therapy analysis is so important.

“At first glance some atypical movements that a student might make won’t make sense because they are capable of moving in a more efficient manner. Then, after analyzing what is happening, we may find that there is a motivation for a typical type of movement” Cheryl says. “For example, a student with typical foot strength and the ability to pick up their feet, may  drag their feet on carpet because they enjoy the sensory feedback it provides. In this example, it may not be feasible to correct the  atypical movement since the student is receiving self-reinforcement by scoffing their feet along.” 

The need for stimuli and the potential to make changes has to be considered when a physical therapy plan is constructed. Even when an individual has what appears to be the physical capacity, it doesn’t mean that the individual can make all the changes that they appear to be capable of making. 

“It isn’t just a matter of repetition and dedication. The ability to attend to a task, consideration of what motivates a student, and a student’s ability to understand why they are doing what they are doing, are all factors. For some students there are factors related to their disability that therapy will not change so instead we focus on ways to substitute or support their needs,” Diana says.

Physical therapy at school is centered on helping a student develop the physical capacity to succeed in a school setting. It is different from physical therapy that is centered on rehabilitation, or regaining physical skills that were lost due to injury or insult to the body. For example, a stroke or car accident. 

“Most of our work is what we call habilitation. It means that we focus on acquiring new skills and abilities to navigate the demands of school.  School demands include things like getting off and on a bus, carrying books or classroom supplies, walking to and from classrooms.  We have a responsibility to ensure our students are successful getting around school, from a physical perspective,” Diana says.