Hands off: Physical therapy during the pandemic
To remotely offer physical therapy to students, Ashlee McLeod and her colleagues have had to think beyond their hands. They model for parents during videoconferences how to manipulate their child’s movements to help them continue to work on their IEP goals at home.
“We talk through what we want them to do, such as, ‘Put your hand on your child’s shoulder to give him a cue to move his shoulders back,'” says McLeod, a physical therapist at Florence 1 Schools in South Carolina. She uses simple language and leaves the medical terminology at school. “We try to meet parents at their level and tell them not to get discouraged or frustrated. We want them to feel empowered.”
Follow these tips to ensure students continue working on PT goals during the pandemic:
• Recognize when school equipment is needed. Florence let some families borrow equipment, such as walkers and wheelchairs, so students could work on skills at home, says Brian Denny, director of programs for exceptional children at the district. If you do this, don’t forget to regularly check in with families about whether the equipment needs adjustment for student growth. “Kids do grow,” McLeod says. “A student may have grown an inch since leaving school. We have to help tell parents how to adjust the equipment.”
• Address IEP goals in a new way. Students’ IEP goals may have been written for the school setting, but you can help families address them at home, McLeod says. For example, a student who eventually aims to use his knee to get out of a chair independently at school can practice climbing on and off his couch at home. “We’re trying to be as creative as possible,” she says. “IEP goals are written for school, and we’re not in school, but we try to look at how we can meet students’ school needs at home. We’re modifying the location but working on the same things students will need when they get back to school.”
Indeed, students who need to work on trunk extension, for example, can have their parents blow bubbles for them to reach out to or they can reach out to give their parents high fives and the PT can watch, McLeod says. Students who need to work on safely navigating the school hallway can instead practice safely walking to the mailbox at home without going into the street while the PT watches on a phone video chat. Students who use steps for PT at school and do not have steps at home can use a step stool or a porch step. “We ask what kinds of things they have at home,” she says. “The sessions have to be meaningful and educationally relevant.”
• Prevent regression. Find ways to help parents keep their child on track with skills he was building in school, McLeod says. “The biggest thing right now is preventing regression. We at least want to try to maintain skills.” For example, a student who started to stand and walk before the pandemic can continue to practice this with his parents’ help with the PT remotely advising what height to hold the student’s hand so he can begin to use a natural gait, swinging his arms for balance.
McLeod also has a PT assistant on videoconferences with her to keep eyes on the student while she talks with the parent. “It’s good to have an extra set of eyes because it’s hard to see everything through the screen,” she says. This is particularly important if the student is nonverbal and can’t tell you if something doesn’t feel right.
• Advise parents on what is inappropriate. During this time of school closure, parents may come up with something they want to work on with their child and look up advice on the internet for how to do it, McLeod says. Regularly remind parents to ask for input on what they can do with their child so they don’t try something that could hurt her. “We can tell if something is helpful or harmful for a student.”
Cara Nissman covers autism, school psychology, and IEP team issues for Special Ed Connection, a DA sister publication.