As the physical therapy consultant for the North Carolina Department of Public Instruction, Exceptional Children Division, Laurie Ray, PT, PhD, provides consultation, technical assistance, professional development, and support to school-based physical therapists (PTs), PT assistants (PTAs), school administrators, parents, and families across the state.
This year, the COVID-19 pandemic posed significant challenges to our public schools and to the students and families they support. Ray said she has received more inquiries for assistance than in years before. As a result of the pandemic, PTs must find innovative ways to work toward their students’ Individualized Education Program (IEP) goals under the Individuals with Disabilities Education Act.
To do this, Ray said PTs and PTAs have supported families, ensured that their students are safe and that basic needs are met physically, emotionally and mentally. Therapists then decide what service delivery might be most effective for each student, including understanding each family’s logistical and technological challenges. These interventions range from ongoing virtual exchanges to recommendations sent to the home, often supported with phone calls or other tools.
Although a tremendous amount of creativity and energy goes into the development of these plans, equity issues can hinder success.
“Families in rural areas, and underserved populations, have always faced issues of equity, but the pandemic has made them more pronounced,” Ray said. Despite these challenges, Ray said she’s impressed with the state’s public school districts and their ingenuity in addressing issues presented by the pandemic.
She described how one district used school buses to transport therapy equipment from the school directly to students’ homes. A PT, wearing protective gear, then made in-home visits to train families so students wouldn’t regress in their skills and in their abilities. Another school district parked school buses, equipped with Wi-Fi hotspots, near homes and apartment complexes without internet access, to provide internet for students.
Since 2005, Ray has used a variety of tools to provide evidence, guidance, and resources for practice as well as support to her colleagues and others in North Carolina’s schools. These methods include direct consultation via phone, email and virtual platform, listservs, websites, conferences, institutes, regional meetings, and technical assistance.
North Carolina is one of very few states in the U.S. to offer the services of a statewide PT consultant. Physical therapists from across the state have expressed their appreciation for Ray’s guidance, the cohesion she brings to the community, and the informative school-based physical therapy website she created.
Despite the challenges presented by the pandemic this year, Ray sees lasting benefits of a remote model. Virtual meetings and intervention sessions have allowed for greater collaboration among PT and IEP team members, especially for parents.
“We have a better understanding of what’s going on in our students’ lives and are able to figure out mutual priorities,” Ray said. “Parents better understand what PTs are working toward with their child.”
After pushing through a steep learning curve this year, Ray sees telehealth as an important tool to leverage for effective collaboration in health care and in education. If coverage is continued by medical insurance, telehealth could bridge equity issues in health care access and provide efficient ways to get skilled services to underserved populations.
“It’s been a hard time,” Ray said. “We’ve learned to be grateful for things we’ve taken for granted in the past. I’m also left with a profound pride in my profession—in particular, with how school-based therapists have conducted themselves, what they’ve managed to accomplish, and the calm, persistent problem-solving spirit they bring to it.”
Laurie Ray, PT, PhD, is an associate professor in the Division of Physical Therapy. She serves as consultant for physical therapy and Medicaid, and as a liaison for adapted physical education for the North Carolina Department of Public Instruction Exceptional Children Division. She also chairs the American Physical Therapy Association pediatrics school-based physical therapy special interest group.
The Division of Physical Therapy is housed in the Department of Allied Health Sciences in the UNC School of Medicine.
-Lizzy Laufters, public relations and communications intern