Physiotherapist

Physiotherapists are employed by the Ministry of Education, Special Education (GSE), special schools, some schools with special education units and early intervention Accredited Service Providers (ASPs).

Southland's special attitude towards kids a plus for GSE physio

One of the things South African-born Anne most admires about the people of Southland is their inclusive attitude towards children and young people with special education needs.

Rarely do the students Anne works with miss out on the full range of education experiences that occur throughout the mostly rural community.

Students might be non-verbal, wheel-chair bound and reliant on support to go to the toilet, but they still participate in school camp, school theatre productions, swimming and so on, says Anne, a GSE physiotherapist.

"This community is tremendous at making sure all children take part in life - they have a `can do' attitude and simply make things work," she says.

Recently one industrious dad built and fitted a makeshift carry box to the outside of the school bus so that is daughter had somewhere to stow her wheelchair while she travelled 30 kilometres to school. Another child was pulled around the cross country by a teacher in a special cart.

Southland has a small, widely scattered population and people travel a lot to access the most basic services, says Anne.

Based in Invercargill, Anne travels an hour east to Riverton and Tuatapere, one-and-a-half hours west to Riversdale, two hours north-west to Te Anau and half-an-hour south to Bluff - a round trip she describes as quite manageable compared to her colleagues based in other parts of rural New Zealand.

Anne works with staff and students based in more than 30 Southland primary and secondary schools. Over a year, she sees up to 60 children but usually has a case load of about 20 children at any one time.

Anne's qualifications and training

Anne trained and worked in South Africa before heading overseas to the United Kingdom, then in the early 90s, to New Zealand. She graduated in 1981 with a bachelor's degree in physiotherapy from the University of Cape Town.

Her four-year degree involved studying physics, chemistry, biology, anatomy, physiology, physiotherapy and a range of clinical sciences including medical surgery, paediatrics and obstetrics. In the final year of her degree, Anne studied the range of facilities available in Cape Town for people in wheelchairs as part of a special research project. She also gained work experience in several children's hospitals.

Since finishing her degree, Anne continues to build on her knowledge and skills, taking courses (here and overseas) in children's brain development, children's health, and ways to test and measure physiotherapy. She regularly attends Starship Children's Hospital's biannual conferences in Auckland to keep abreast of what's happening in physiotherapy in the health sector.

Working with Anne - the process

Anne works with school-aged children and young people assessed as having `high' or `very high' special education needs, who have successfully applied for the Ongoing and Reviewable Resourcing Schemes (ORRS).

Her role is a part-time or .5 position of 19 hours per week.

Usually a child is referred to Anne by their health sector physiotherapist or education specialist who's worked with that child from when they were a baby.

Once a referral is made, Anne talks with the child's support team to find out what support she might provide and how she might provide it.

A child's support team can be made up of their mum, dad, teachers, teacher aide, caregivers, wider whānau and other specialists such as a child's occupational therapist. Anne works closely with the support team during each step of her process.

Next, Anne observes and assesses the child's needs in a one-on-one, classroom and (very occasionally) home context.

She then shares her findings with the child's support team and provides them with a physiotherapy programme for their feedback and ideas.

She demonstrates how to safely and effectively carry out the programme's different strategies. For example, she might show a teacher aide how to safely and effectively lift, handle and position a student.

Eventually, the student's physiotherapy programme is finalised and becomes part of their individual education plan (an individual education plan is sometimes made up of several programmes each tailored to meet a child's different learning needs).

Next, the physiotherapy programme's actions, strategies and exercises are carried out. Everyone works together to monitor, review and adapt the programme for as long as the student needs and as long as the child is eligible for Anne's service.

Working with physiotherapists - a point to note

Physiotherapists work with children before they go to school and when they are school aged. They also work with children and young people with a range of needs, for example, they work with children and young people assessed as having `moderate', `high' or `very high' needs - not just `high' or `very high' like Anne.

Physiotherapists don't all work in exactly the same way either. They adapt what they do to suit the needs of individual children and young people, the needs of families, whānau, educators and specialists, and to suit the context in which children and young people live and learn.

They may also adapt the way they work as new research evidence emerges and as their knowledge and experience grows.