Do Children with Special Needs Benefit from Receiving Functional, School-Based Therapy Services?

King, G., McDougall, J., Tucker, M., Gritzan, J., Malloy-Miller, T., Alambets, P., Cunning, D., Thomas, K., & Gregory, K.,
CanChild Centre for Childhood Disability Research

©1999 King, G., McDougall, J., Tucker, M., Gritzan, J., Malloy-Miller, T., Alambets, P., Cunning, D., Thomas, K., & Gregory, K.
 
Why research this topic?

Reductions in health care dollars have led to an increased need for evaluations of pediatric therapy services to determine their effectiveness. There is a critical need for documentation to support the role of therapists in providing school-based therapy services, such as the School Health Support Services Program (SHSS). Policy makers need this information to be assured that health care dollars are being well spent. Service agencies and therapists need assurance that these therapy programs are effective and that clients are satisfied with these services. Educators need to be assured that the time they spend supporting these school-based interventions is worthwhile. Finally, parents need evidence that these programs have the potential to assist their child in the school setting.

Who looked at this topic?

This study was a collaborative effort and included research team members from Thames Valley Children's Centre (Gillian King, Mary Ann Tucker, Janet Gritzan, Janette McDougall, and Theresa Malloy-Miller), the Community Care Access Centre of London and Middlesex (Pamela Alambets), the Thames Valley District School Board (Karen Gregory and Kathleen Thomas), and the London District Catholic School Board (Dee Cunning).

What was done?

• Fifty children (aged 5 to 12) receiving SHSS from the Community Care Access Centre of London and Middlesex via Thames Valley Children's Centre (TVCC) were involved in the study during the 1997-99 school years. TVCC subscribes to a family-centred, functionally-oriented model of service delivery, where parents and teachers are invited to work together with therapists to set functional goals (activities required at school) for the children.
• For study purposes, the children had functional goals set using the Goal Attainment Scaling procedure in one of three target areas: productivity, mobility, or articulation. The children's level of goal attainment was assessed at the end of intervention (the end of the 1998 school year) and at a five- to six-month follow-up.
• Standardized measures also were administered pre- and post-intervention, and at follow-up for the three target areas to determine children's change in functional status.
• Parents and teachers completed questionnaires about their satisfaction with services after the intervention period.
• Aspects of the intervention process (i.e., types of goals set and intervention methods used to assist children in achieving their goals) were examined to better understand how school-based therapy is carried out.

What was found?

• After receiving therapy services, 98% of the children made improvement on their functional goals and maintained that improvement at follow-up. The outcome scores for each child were expressed as T-scores. A T-score of 50 represents the level of attainment the children were expected to meet by the team (parent, teacher, and therapist) after receiving therapy. The average T-score for all children in the study was 58 at posttest and 61 at follow-up.
• Average scores on the standardized measures indicated statistically significant and often clinically meaningful change in children's functional status for the three target areas of productivity, mobility, and articulation at posttest and at follow-up.
• Parents and teachers were highly satisfied with therapy services delivered according to a family-centred, functionally-oriented model of service delivery. Out of a possible perfect rating of 4, the average ratings given for satisfaction with therapy services by parents and teachers were 3.4 and 3.5, respectively.
• The types of goals set for children were relevant to the school setting. The most common productivity, mobility, and articulation goals were: written communication, advanced gross motor skills, and speech sound production, respectively.
• The types of intervention methods used by therapists reflected common learning strategies used in the school setting (i.e., teaching/learning techniques and cognitive strategies).
  

How are the findings useful?

• For parents, the findings should give confidence in the utility of school-based therapy.
• For therapists and service agencies, the findings provide assurance that school-based interventions are effective and that clients are highly satisfied with these services.
• For educators, the findings indicate time spent supporting school-based therapy is worthwhile. This information also can enhance awareness of how the therapy process reflects and supports the educational teaching process.
• For policy makers, the findings should give confidence in funding school-based therapy delivered according to a family-centred, functionally-oriented model.
• This information will be used to help advocate for the continuance of and improvement in school-based therapy, which in turn, will ensure that children with special needs are given every opportunity to succeed at school.

The citation for the published article is:

King, G., McDougall, J., Tucker, M. A., Gritzan, J., Malloy-Miller, T., Alambets, P., Cunning, D., Thomas, K., & Gregory, K. (1999). An evaluation of functional, school-based therapy services for children with special needs. Physical & Occupational Therapy in Pediatrics, 19(2), 5-29.