An Evaluation of Functional, School-Based Therapy Services for Children with Special Needs

Abstract

Millions of dollars are spent each year on school-based therapy services, yet little is known about whether these services improve the educationally relevant, functional outcomes of children with special needs. This program evaluation study used goal attainment scaling to examine whether 50 children with special needs (ranging in age from 5 to 12 years) attained their therapy goals in the real-world, functional areas of communication, school productivity, or mobility. Sixteen children received speech-language therapy for communication difficulties, 21 received occupational therapy for classroom productivity difficulties, and 13 received physical therapy services for mobility difficulties at school. The service delivery model incorporated direct therapy, monitoring, and collaborative consultation between therapists, teachers, and parents. In addition to goal attainment scaling, standardized measures of functional status were used to examine changes in the function of the children from pretest to posttest and at a five- to six-month follow-up. Measures of parent and teacher satisfaction with the services also were employed. The findings suggest that therapy services targeting communication, productivity, and mobility make a difference in how children with special needs function in the school setting. Children showed statistically and often clinically significant change in their outcomes over the intervention period, with these improved outcomes lasting at the five- to six-month follow-up.

Key Words:

• Therapy
• program evaluation
• functional outcomes
• schools
• children with special needs
• rehabilitation

Additional information

Notes on contributors

Karen Gregory

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.