For almost 20 years I have worked as a physical therapist assistant in various settings, including long-term care, acute care hospitals, short-term rehabilitation, and the school system. For the last three years, I have also worked as a teacher of students with visual impairments. Initially, it seemed as if those professional worlds would be quite separate, but each day in my practice as an educator I am realizing how well both roles complement each other. Positioning and physical functioning Part of a physical therapist's job is to determine which seating systems, braces, or other pieces of equipment help promote optimal functioning to allow individuals to perform well in their daily lives, adjustments that can help the students to access the curriculum in the best way possible. Proper positioning from a physical therapy standpoint can help maintain good skin integrity, prevent muscle tightness, provide support, and help reduce abnormal muscle tone. Teachers of students with visual impairments realize, from a different perspective, how crucial positioning and physical functioning can be to these students. For example, it is common for a student who has multiple disabilities and is dependent for mobility to undergo several positioning changes throughout the school day. These changes may include time spent on different surfaces such as a mat table or in various pieces of equipment like standers or supportive classroom chairs. Teachers of visually impaired students take this into consideration when making recommendations about where to present materials and position assistive technology as these changes take place throughout the day. We must also understand how a student's physical strengths and deficits contribute to that student's ability to utilize their vision in different situations. Reviewing a student's physical therapy evaluation can provide important information about physical strengths, deficits, and limitations. Through direct consultation, a physical therapist or physical therapist assistant and the vision professional can establish what a student's unique vision and physical needs are and the challenges each student faces. Together, the two professionals can come up with strategies to make sure that the student's overall needs are being met in order for that student to function optimally from a physical and a visual standpoint throughout the day. Having a basic understanding of each other's roles is important, and the objective of each specific activity needs to be understood. There are times when students may be working on increasing overall head and neck strength as part of a physical therapy objective, requiring them to have less support in order to practice lifting their muscles against gravity. A student with poor trunk and head control may find it challenging to visually fixate and attend to materials while they are working so hard to stabilize their bodies. During these moments, vision goals may be secondary to physical therapy goals. When vision is the focus, having the proper support is imperative in order to have the stability and energy to function well visually. Working together to determine the best interventions Collaboration between the physical therapist and teacher of visually impaired students can help determine the best intervention methods for the student, especially during the most visually challenging activities of the day. In some cases, braces may be necessary and can help improve a student's overall level of stability and support and can, therefore, allow the student to channel more energy into visual activities. Examples of when braces can be useful would be when a student appears to be experiencing problems during ambulation or to have overall balance issues. Sometimes a student may be experiencing muscle weakness that may cause a toe to catch on the floor or weak trunk muscles that may make it difficult for him or her to maintain sitting in one place for too long. …
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