Prescriptions for physical and occupational therapy in school

Area of Science:

• Pediatrics
• Rehabilitation Medicine
• Special Education

Background:

• Physician prescriptions are essential for initiating occupational and physical therapy (OPT) services in schools.
• Effective communication between physicians and school-based therapists is vital for student care.
• The quality and content of these prescriptions can significantly impact therapy delivery and student outcomes.

Purpose of the Study:

• To analyze the form and content of physician prescriptions for occupational and physical therapy in a metropolitan school district.
• To identify deficiencies in prescription clarity, specificity, and completeness.
• To evaluate the relative value of prescriptions for optimizing therapy services for students.

Main Methods:

• A review of 226 prescriptions for occupational and physical therapy services was conducted.
• Prescriptions were completed by 14 therapists (7 PT, 7 OT) in a school district.
• Each prescription was independently assessed for form, content, and therapeutic value, with a focus on specificity and clarity.

Main Results:

• Over half (52%) of prescriptions were for students with cerebral palsy, with 93% involving students in special education programs.
• Prescription content was often vague (30% open comments), illegible (6%), or lacked specific dosage/intensity details (5%).
• While standardized forms were used, only 48% contained checklists, and few requested feedback (7%). Physiatrist prescriptions were rated slightly higher.

Conclusions:

• Physician prescriptions are a necessary but insufficient tool for effective communication in school-based therapy.
• Significant improvements are needed in the specificity and clarity of prescriptions to ensure optimal therapy delivery.
• Enhanced communication strategies beyond the prescription itself are required to bridge the gap between physicians and school staff.