PHYSICAL THERAPY FOR STUDENTS WITH AUTISM: A NATIONWIDE SURVEY OF SCHOOL-BASED PHYSICAL THERAPISTS

Purpose/Hypothesis: Understand the current state of practice for school-based physical therapists (SBPTs) treating students with autism and; further, to understand barriers to care.

Number of Subjects: 113 SBPTs

Materials/Methods: Anonymous electronic 28 question survey

Results: More than 40% of respondents reported 20 or more years of experience working as a pediatric PTs and; further, 25% reported working more than 20 years as a SBPT. More than half of the respondents were DPTs. Nearly half reported the number of children with ASD on their caseloads ranged from 20%-50% and 20% reported more than half of their caseloads consisted of children with ASD. The most common settings for providing SBPT included PT/motor room (85%), P.E./gym (56%), recess/playground (55%), classroom (45%), and hallways/stairs (25%). Nearly 50% reported they had not received any professional development or training from their school districts regarding how to best work with children with ASD and 85% identified at least one training they believed would be helpful to them. Behavioral management training was identified as being the most important. Ninety-five percent of respondents reported barriers were present to providing SBPT to children with ASD with 44% identifying the behavioral challenges of the students as the the top barrier. Other commonly reported barriers included staffing challenges (23%), environment/space/scheduling challenges (14%), and lack of time for collaboration (9%). Years of experience, training, and other intrapersonal SBPT variables did not predict success or failure in managing the barriers to care.

Conclusions: The caseloads of SBPTs are increasingly filled with students with autism. Challenging behaviors, limited attention, and difficulty engaging during physical therapy create a challenging environment for both students with ASD and SBPTs. Many SBPTs blame themselves for not being able to decrease barriers to care; however, personal attributes of the SBPT including additional education do not appear to have an impact.

Clinical Relevance: Our study provides for the first time an understanding of SBPT’s who treat students with ASD, the environment and barriers to care. Understanding the barriers that are impacting SBPTs as they encounter increasing caseloads of children with ASD is a critical piece to providing the most effective services. The results of this nationwide survey suggest the caseloads of SBPTs often consist of large percentages of students diagnosed with ASD. Professional development and ongoing opportunities for new learning is essential to providing evidence-based interventions to children and adolescents with autism. Moreover, we demonstrate the barriers to care identified by SBPT’s participating in this study are not impacted by the demographics of the individual SBPT.