|Title:||Relationship of Student Outcomes to Physical Therapy School Services|
|Principal Investigator:||Effgen, Susan||Awardee:||University of Kentucky|
|Program:||Educators and School-Based Service Providers [Program Details]|
|Award Period:||07/01/2011 – 06/30/2014||Award Amount:||$851,822|
Purpose: The ultimate goal of school-based physical therapy services is to enhance students' successful participation in typical school and community activities leading to further education, employment, and independence. Unfortunately, there is a lack of research examining the associations between characteristics of school-based physical therapy and student outcomes.
The purpose of this large-scale, multi-site observational study is to describe the outcomes that students achieve when receiving physical therapy within schools and the relationship of the physical therapy intervention to those outcomes. The research aims to describe the changes in students' participation in school activity, self-care, posture and mobility, and recreation and fitness outcomes and the associations between these changes and identified characteristics of school-based physical therapy intervention, including service delivery models, activities, procedures, and dosage. A better understanding of the relationships between student outcomes and physical therapy intervention has the potential to influence physical therapy practice, future research, and professional development.
Project Activities: During the first year of the project, participants will be recruited and therapists will be trained in the assessments and data collection procedures. Therapists will administer at pretest and posttest the School Function Assessment and Goal Attainment Scaling measures. Throughout the second year, therapists will report weekly on the service delivery models, activities, procedures, and dosage of physical therapy intervention provided for the students using the School-Based Physical Therapy Interventions for Pediatrics, a detailed data collection system developed by the researchers.
Products: The products of this project include a complete dataset and published manuscripts and presentations on the relationship between physical therapy services provided and student outcomes.
Setting: The research will take place in schools in Maryland, Georgia, Kentucky, Washington, and Oklahoma in kindergarten through grade 6.
Population: Participants include 120 physical therapists and 6 randomly selected students—ages 6 through 12—for each therapist, leading to a total sample of approximately 720 students with disabilities receiving physical therapy services in schools.
Intervention: The study examines the provision of physical therapy in school settings. The researchers are interested in key aspects of the physical therapy, including the service delivery model, activities, procedures, and dosage.
Research Design and Methods: The research project is a multi-site, observational study aimed at identifying students' adaptive and functional outcomes and determining associations between these student outcomes and school-based physical therapy intervention. During the first year, participants will be recruited and therapists trained in the direct child assessments and procedures that they will use to collect data at pretest and posttest. Throughout the second year, therapists will report weekly on the service delivery models, activities, procedures, and dosage of physical therapy intervention provided for the students using an online data collection system.
Control Condition: There is no control condition.
Key Measures: The measures to be used include subsections of the School Function Assessment focusing on students' participation in school activity, self-care, posture and mobility, and recreation and fitness. In addition, the researchers will convert aspects of the students' Individualized Education Program related to physical therapy to Goal Attainment Scaling. Therapists' intervention services will be recorded using the researcher-developed School-Based Physical Therapy Interventions for Pediatrics data collection system. Finally, the researchers will collect student transcripts and standardized test scores.
Data Analytic Strategy: Linear and generalized linear mixed models will be performed to investigate associations between physical therapy intervention and changes in student outcomes while accounting for the hierarchical structure of students nested within therapists. Pearson's correlation coefficients will describe bivariate relationships between changes in student outcomes and malleable factors (physical therapy models, activities, procedures, and dosage). Finally, to investigate multi-variable relationships, analysis of covariance will be used to control for potential confounds, such as age or severity of disability.
Journal article, monograph, or newsletter
Chiarello, L.A., Effgen, S.K., Jeffries, L., McCoy, S. W., and Bush, H. (2016). Student Outcomes of School-Based Physical Therapy as Measured by Goal Attainment Scaling. Pediatric Physical Therapy, 28(3): 277–284. doi:10.1097/PEP.0000000000000268
Effgen, S.K., McCoy, S. W., Chiarello, L.A., Jeffries, L., Starnes, C., and Bush, H. (2016). Outcomes for Students Receiving School-Based Physical Therapy as Measured by the School Function Assessment. Pediatric Physical Therapy, 28(4): 371–378. doi:10.1097/PEP.0000000000000279
Effgen, S.K., McCoy, S.W., Chiarello, L.A., Jeffries, L., and 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