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One For All, And All For One

Schools are just one setting where PTs, OTs and SLPs can team up to ensure top outcomes for young patients

The latin phrase un pour tous, tous pour un-translated as all for one, and one for all-dates back to the 1844 novel The Three Musketeers. As the story goes, the French musketeers remain loyal to each other through thick and thin.

Similarly, inter-disciplinary collaboration can function as a form of strategy in rehabilitation services. Schools are just one setting where physical and occupational therapists need to team up with speech language pathologists to ensure that their clients are functioning at the best level they can.

In Rhode Island, the Newport County Regional Special Education Program was formed to provide the full continuum of special education services for children identified with disabilities. Under contract with the program, Bristol County Rehabilitation Services of Middletown, RI, specializes in the delivery of physical and occupational therapy services in the public school setting.

"We support regular education," said Julie Almeida, PT, president and chief executive of Bristol County Rehabilitation Services. "The way these kids learn is by their peers. So if we can keep these kids in their home schools and in their communities, then we do. That's where PT, OT and SLP come in."

Students identified with a disability which adversely impacts their educational performance and as a result requires specialized instruction, may be eligible for special education services. "Using a transdisciplinary approach allows the members of the team to view students holistically in order to meet all physical, social and emotional needs necessary to participate in the school curriculum," relayed Megan Silvia, MS, OTR/L.

Working with the speech language pathologists employed by Newport County Regional Special Education Department and various other team members, the PTs and OTs endeavor to keep children with physical and mental impairments in the mainstream schools.

"We look at the child's school functioning to determine their ability to access the curriculum," explained Leslie Brow, assistant director, Newport County Regional Special Education Department. "We work with the OTs to address fine motor limitations, for example, or with the PTs if a child is having physical difficulties in the building or classroom."

According to Almeida, rehab services cannot stand alone. To keep the students independent, the PTs, OTs and SLPs need to collaborate with other departments and educational experts such as special education or adaptive physical education.

"Collaboration among a student's team within the school setting allows us to provide a more comprehensive and effective program for that child," said Shanan Brissette, PT, DPT, Bristol County Rehabilitation Services.

As a physical therapist, Dr. Brissette needs to know how to effectively communicate with the students to have a more productive session and to allow them the comfort of understanding. "I work with the SLP on how to best achieve this interaction with the student," she explained. "I consult with the occupational therapist regarding sensory interventions to moderate a student's level of arousal, or positioning of a student's desk for proper hand alignment to allow for function within the classroom."

In turn, Dr. Brissette told ADVANCE, the SLP or OT may ask her to determine the ideal positioning for optimal fine and oral motor performance.

"Collaboration between a multidisciplinary team benefits students with disabilities by providing them with comprehensive therapy that takes into account the big picture when making and implementing a treatment plan for a child," said Lindsay Z. Jacobs, MS, CCC-SLP. "The success of a student in any one therapeutic area depends on the knowledge and input of the other disciplines involved in the treatment plan."

"This team approach can only benefit the children, allowing them functional access to their educational environment across all domains," shared Dr. Brissette.

"We use a team approach and Bristol County Rehabilitation Services is part of the team," Brow said. "We look at the student as a whole and make sure they are able to access the curriculum and the school building."

Keep an eye out for a full cover feature and photo gallery on this team in the September 3, 2012 issue of ADVANCE.


Rebecca Mayer is senior regional editor at ADVANCE and can be reached at



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