CLINICAL BOTTOM LINE
“How should I apply this information?”
Through the use of goal attainment scaling (GAS), this study demonstrates that students receiving school-based physical therapy typically meet or exceed goals related to posture/mobility, recreation/fitness, and self-care despite gross motor level or diagnosis. GAS can be used by school-based physical therapists for a variety of purposes such as monitoring student progress, promoting collaboration among team members, determining effectiveness of services, self-evaluation, and program evaluation. GAS allows for individual assessment of progress toward meaningful functional activities that are integrated into school activities and routines. GAS allows the therapist to consider personal and environmental factors affecting student progress and can identify functional gains that may not be reflected when using standardized testing. The study also showed that very few individualized education program goals were written at the generalization level. Therefore, school-based physical therapists may need to provide interventions and write goals that ensure that students are able to use mobility, recreation, and self-care goals within a variety of school-based activities and settings.
“What should I be mindful about when applying this information?”
Therapists should be mindful that the Gross Motor Function Classification System was used across all diagnoses, not just cerebral palsy, and data were collected on children between the ages of 5 and 12 years. Thus, the findings are limited to elementary school children. Although the study showed that younger students had higher goal attainment than older students with regard to primary and recreation goals, the possible reasons for this trend are unclear. However, school-based therapists should carefully review the recommended dosage, level of the goal, and need for activity or equipment adaptations when working with older students to facilitate goal achievement. As experts in movement and adapted function, school-based physical therapists should address relevant and functional tasks/routines throughout the school day in both mobility-based and academic activities.
Dawn James, PT, DPT, PCS
West Coast University
Los Angeles, California
Sharon Antoszyk, PT, DPT, PCS
Cabarrus County Schools
Concord, North Carolina