Physical therapy is an evolving health-related practice that involves restoring and maintaining the highest achievable psychomotor functionality of the individual. The field grew out of the first and second World Wars, and, over the past few decades, has increased its educational requirements. Pediatric physical therapists are PTs that have chosen to receive specialty training in order to lend their talents to children and their families. PTs who work in schools collaborate with educators and family members in order to design a regiment that balances a child's rehabilitation with his or her non-physical needs such as social integration, self-esteem and cognition.
Keywords Adapted Physical Education (APE); Commission on Accreditation in Physical Therapy Education (CAPTE); Direct Service; Individualized Education Program (IEP); Individuals with Disabilities Education Act (IDEA); Least Restricted Environment (LRE); Motor Delay; Physical Disability; Physical Therapy; Related Services; Special Education
Physical therapy, or physiotherapy, is the provision of services designed to diagnose and treat health-related issues that limit or will limit an individual's ability to move or go about their daily activities. Such issues can be caused by a wide variety of congenital and acquired conditions including but not limited to cerebral palsy, juvenile rheumatoid arthritis, spina bifida, traumatic brain injury and other physical injuries.
Physical therapy is administered by nationally licensed health-care providers called physical therapists. These professionals are trained to properly assess and diagnose the severity and nature of a patient's condition(s), formulate a rehabilitation program tailored to the individual and finally execute the treatment. The population that requires physical therapy is incredibly diverse, spanning all age groups, social classes and ethnicities. Therefore, physical therapists must be thoroughly trained to ensure they are able to meet the needs of the public.
It is difficult to say exactly when the practice of physical therapy was born. However, it is generally accepted that physical therapy in the modern sense took shape during World War I in order to care for injured civilians and military personnel. The physical therapists trained by the Army were exclusively women, most of whom had a background in physical education. It was not until the 1940s and 1950s, though, that a combination of injuries from World War II and the nation's poliomyelitis epidemic showed how great the need for rehabilitation was becoming on and off the battlefield.
During the peace of the decades that followed, physical therapists began moving beyond hospital-based practice. While many went back to military service (by now the Army was allowing men into the program) some formed autonomous organizations that pushed to professionalize the occupation. One of the key factors that led to the eventual success of this movement was the shift from certificate programs to academic programs with higher standards based in colleges and universities. These new degrees (bachelor's, master's and eventually clinical doctorate) and the better education associated with them gave physical therapists a chance to better specialize for specific communities. It is now common to find physical therapists working not only in hospitals and rehabilitation facilities but also schools, occupational environments and fitness centers. Some therapists have specialized in sports medicine which focuses on athletes' bodies and the physical stresses they are under.
This section discusses the changes to the physical therapy degree over the past century. Modern physical therapy began development during World War I when women were recruited by orthopedic surgeons to assist in the rehabilitation of wounded civilians and servicemen. These early physical therapists (then known as reconstruction aides) were members of the Division of Special Hospitals and Physical Reconstruction which was established by the Surgeon General's Office in 1917. The following year, Mary McMillan became the first physical therapist appointed by the United States Army. In 1921 she would become president of the American Women's Physical Therapeutic Association, an organization which would eventually admit men (late 1930s) and change its name (late 1940s) to the American Physical Therapy Association (APTA) as it is still known today (Wakiji, 1997). Physical therapy training in these decades was little more than an apprenticeship which involved some classroom instruction as well as supervised practice in a hospital that was run by the military. However, after World War II, it became apparent that physical therapy had applications in civilian hospitals as well and that these facilities could also train physical therapists through a certificate program. Most of these curricula required a bachelor's degree prior to admission. These certificate programs, however, would be relatively short-lived.
Increasing Educational Requirements
In 1960, the American Physical Therapy Association House of Delegates passed a resolution stating that the minimum educational requirement to become a physical therapist was a bachelor's degree. This change spelled the end for the certificate programs as the universities offering them began concentrating on undergraduate programs for physical therapy. This coincided with the developing concept of schools and colleges of allied health professions whose growth was spurred by the federal government's emphasis on job creation and subsequent education for these emerging fields. This culminated in the passage of the Allied Health Professions Personnel Training Act of 1967 which allowed the development of assistant-level programs such as the physical therapist assistant (PTA).
The next big leap in physical therapy education started in the late 1960's to early 1970's when the United States was in a state of political unrest. Physical therapists began asking why their post-baccalaureate work, often an additional two years of study, yielded a second baccalaureate degree rather than something higher. By 1979, the American Physical Therapy Association House of Delegates passed another resolution requiring a post-baccalaureate degree for physical therapy education after 1990. In 1987 the number of schools that made the transition was relatively small. However, the movement led to the formation of the Commission on Accreditation in Physical Therapy Education (CAPTE) which gave the American Physical Therapy Association the autonomy to oversee its own degree programs (previously managed by the American Medical Association). This new leadership allowed the transition from a baccalaureate to master's as the first professional degree (Echternach, 2003).
The final change to physical therapy education began approximately a decade ago and is still in progress. In the early 1990's there was a push to go from a master's to a clinical doctorate as the first professional degree. By 1996, the first doctor of physical therapy (DPT) program graduated its first class. Currently, 75% of physical therapy programs have converted to a clinical doctorate while the others intend to make the switch in the future (Wojciechowski, 2006).
Physical Therapists as Educators
According to the American Physical Therapy Association website, 4.4% of practicing physical therapists work in a school system (preschool/primary/secondary). Pediatric physical therapists are PTs that have chosen to receive specialty training in order to lend their talents to children and their families. It is their goal to rehabilitate children with temporary injuries and promote independence in handicapped children by attaining maximum function relative to the individual's disability.
In children with temporary injuries, the duration of physical therapy is generally relatively short, rarely lasting more than six months except in extreme circumstances (severe car accident, etc). However, pediatric physical therapists often work with disabled patients from birth (or onset of the disability) until late adolescence after which they continue their treatment with a general physical therapist. Physical therapy for children, particularly those with an ongoing...
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