Goals and Objectives for the Physical Therapist

Outcome Objectives: Level One

These initial objectives introduce rules and procedures that students will need to know for community travel lessons. Level One is an introduction to power wheel chairs (drivers training), proper seating techniques, and adaptative skills (so that students can handle money, eating, toileting, reaching and grasping). The therapist (or a staff member) is with students almost constantly during level one, and the rules and procedures are repeated during each intensive lesson day and during the entire first year.

The student will have the following experiences:

01. Practice driving a power wheelchair in school hallways and in an indoor mall
01. Look forward while driving
02. Stop or move to avoid a crowd; look right and left before entering a hallway
03. Move carefully around corners
04. Follow at a safe distance
05. Travel an appropriate speed; drive the same speed people are walking
06. Turn around by moving forward rather than backing up
07. Look behind when backing up; ask permission to back up
08. Move up and down an incline with control
09. Explain wheelchair reaction on inclines/declines
10. Do not block aisles and doorways
11. Travel on the right side of hallways
12. Pass through open doorways without bumping
13. Pull and or push doors to move safely through
14. Open and close doors independently
15. Ascend and descend at least four steps (if appropriate)
16. Wear a seat belt when moving; undo/reattach the belt when appropriate
17. Position the wheelchair to allow access to lockers
18. Turn off the chair when not moving; set brakes when appropriate
19. Actively assist with toilet transfers
20. Hold the head up to face people when communicating or listening

02. Practice driving in and out doorways

03. Practice driving in and out of classrooms

04. Practice appropriate (adaptive) eating skills

01. With a spoon
02. Pierce food with a fork
03. Spread with a butter knife
04. Cut with a knife
05. Cut with the side of a fork
06. Use adaptive devices as is appropriate
05. Practice appropriate toileting skills
01. Use adaptive devices as necessary
02. Correct positioning for security and comfort
03. Self-cathing
04. Appropriate self-cleaning (wiping, washing, drying)
06. Practice appropriate telephone skills
07. Practice handling money
08. Practice on ramps (driving or walking) and steps
09. Practice driving outdoors on sidewalks and ramps (near curbs, etc.)
01. On grass
02. On level paved surfaces
03. On gravel
04. On sand
05. Up and down an incline
06. From one kind of surface to another
10. Practice transferring when appropriate (to and from a chair, the floor, from a toilet, to and from a car, etc)

The student will attain the following knowledge (repeat to the therapist):

01. How to drive a power chair independently while seated properly (the student will be positioned for maximum upper extremity function)
02. How to transfer safely
03. Safety procedures necessary for proper use of equipment
04. Precautionary procedures for taking care of skin to avoid tissue breakdown
05. List appropriate eating skills
06. List appropriate toileting skills
07. List telephone skills (or speaker phone skills) using fine motor control
08. How to correctly do transfers
The student will demonstrate competence in the following:

01. Safe driving skills in an indoor environment using appropriate equipment (power chair, crutch, amigo, etc.)
02. Safe driving skills environment using appropriate equipment
03. Student will be able to operate a wheelchair for an entire school day
05. Proper transferring techniques
06. Demonstrate activities that help prevent breakdown
Outcome Objectives: Level Two

The student will have the following experiences:

01. Practice maintaining (caring for and operating correctly) a wheelchair
02. Practice backing onto the lift bus
03. Practice following the drivers directions for positioning the wheelchair on the lift bus
04. Practice watching the staff and bus driver tie down the chair on the lift bus
05. Practice (role play) telling the driver about problems with chair security
06. Practice driving off the lift without turning too soon
07. Practice driving outdoors near curbs
08. Practice using automatic door openers
09. Practice going through an automatic door immediately after it opens
10. Practice driving on the right side of a hall way with staff prompting
11. Practice being independent in mall bathrooms (lock and unlock stalls, use urinals (do not pull pants down), wash and dry hands, cath if necessary)
12. Practice eating in a food court
13. Practice keeping a locker open with a wheelchair (no staff prompting)
14. If time allows and if the student is ready or capable:
A. Independent handling of moneys
B. Independent use of watches and calculators
C. Independent telephone skills
d. Independently put on and remove clothing as needed

The student will attain the following knowledge (repeat to the therapist):

01. How to maintain and operate a wheelchair

01. Fasten and release seat belts
02. Fasten and release brakes
03. Explain braking procedures
04. Remove and replace armrests
05. Remove and replace footrests
06. Turn power chair off on and off
07. Adjust speed control of a power chair
08. Explain a maintenance check list for a wheelchair
09. Explain procedure for wheelchair repair
10. Explain how to charge a power wheelchair
11. Explain basic wheelchair adjustments
12. Place own equipment in a car
13. Place equipment in a safe place in the classroom when not in use
14. Explain proper skin care needed to avoid breakdown
15. Explain the rules for proper driving (how fast to drive, how to turn around, etc.)
02. How to back up safely, especially onto the lift bus
03. How to position the wheelchair on the lift bus
04. How to tie down their wheelchair on the lift bus
05. How to explain to a lift bus driver what is wrong with chair security
06. How to drive off the lift without hitting the frame
07. How to drive safely outdoors near curbs
08. How to use automatic door openers
09. How to go through an automatic door immediately after it opens
10. Where the right side of a hall way is and why we drive on that side
11. How to be independent in mall bathrooms (lock and unlock stalls, use urinals (do not pull pants down), wash and dry hands, cath if necessary)
12. How to eat in a food court (Explain the rules)
A. Get in a line (be careful not to run into people)
B. Have your money ready before you get to the casher
C. Order food to go (do not drive while trying to carry lunch)
D. Make sure your drink is in a secure position on the chair before driving
E. Drive the wheelchair to a table near the perimeter of the food court (avoid congestion)
F. Eat neatly (eat at thye same time as everyone else)
G. Throw your own trash away
13. How to keep a locker open with a wheelchair
The student will demonstrate competence in the following:

01. How to operate and maintain a wheelchair
02. How to back up onto the lift bus independently
03. How to correctly follow the bus drivers directions for positioning the wheelchair on the bus
04. Instructing a lift bus driver to properly tying down their wheelchair on the lift bus
05. How to explain wheelchair security issues to a lift bus driver
06. How to smoothly drive off a lift without tipping the chair
07. How to drive safely outdoors near curbs
08. How to use automatic door openers
09. How to go through an automatic door immediately after it opens
10. Where the right side of a hall way is and why we drive on that side
11. How to be independent in mall bathrooms (lock and unlock stalls, use urinals (do not pull pants down), wash and dry hands, cath if necessary)
12. How to eat independently in a food court
Outcome Objectives: Level Three

The student will have the following experiences:

01. Practice driving a wheelchair across a quiet residential street
02. Practice driving a wheelchair in various weather conditions and dressing appropriately
03. Practice driving safely on sidewalks (driving around residential blocks)
04. Practice driving down and up driveways
05. Practice driving down and up blended curbs
06. Practice driving on a quiet road
07. Practice passing parked cars
08. Practice crossing in the middle of a block (up and down driveways
09. Practice crossing residential streets parallel to a moderately busy (two lane) street
10. Practice crossing residential streets parallel to a busy (five lane) street
11. Practice crossing a traffic light controlled intersection
12. Practice crossing streets in a small business district
13. Practice crossing streets in a downtown area
14. Practice semi-independent lessons handling all PT issues (eating, bathrooming, seating, driving, etc.)
The student will attain the following knowledge (repeat to the therapist):

01. How to safely drive across a quiet residential street (explain what an intersection is and why it is dangerous for wheelchair users)
02. What a sidewalk is and what it is used for (how to avoid edging trenches, drop offs, obstacles)
03. How to dress for various weather conditions
04. How to handle outdoor ramps, blended curbs and driveways
05. How to handle outdoor ramps, driveways
06. How to drive on a quiet road
07. How to passing parked cars
08. How to cross in the middle of a block (up and down driveways
09. How to cross residential streets parallel to a moderately busy (two lane) street
10. How to cross residential streets parallel to a busy (five lane) street
11. How to cross a traffic light controlled intersection
12. How to cross streets in a small business district
13. How to cross streets in a downtown area
14. How to do semi-independent lessons handling all PT issues (eating, bathrooming, seating, driving, etc.)
The student will demonstrate competence in the following:

01. Independent crossing of quiet residential streets
02. Independently select the correct (adaptive) clothing for the weather conditions (dress independently)
03. How to drive safely on a sidewalk
04. How to handle outdoor ramps, blended curbs and driveways
05. How to handle outdoor ramps, driveways
06. How to drive on a quiet road
07. How to passing parked cars
08. How to cross in the middle of a block (up and down driveways
09. How to cross residential streets parallel to a moderately busy (two lane) street
10. How to cross residential streets parallel to a busy (five lane) street
11. How to cross a traffic light controlled intersection
12. How to cross streets in a small business district
13. How to cross streets in a downtown area
14. How to do semi-independent lessons handling all PT issues (eating, bathrooming, eating, driving, etc.)
Outcome Objectives: Level Four

The student will have the following experiences:

01. Practice driving independently in a novel mall
02. Practice handling lockers independently in a novel mall
03. Practice eating in a restaurant independently in a novel mall
04. Practice using public bathrooms independently in a novel mall
05. Practice asking for help independently in a novel mall
06. Practice shopping independently in a novel mall
07. Practice fixing (or getting help) for wheelchair problems
08. Practice 1 through 7 above for a hypermarket
09. Practice 1 through 7 above for an outdoor mall
The student will attain the following knowledge (repeat to the therapist):

01. How to be independent in a novel indoor environment (drive, eat, bathroom, etc.)
02. How to get wheelchair problems solved when out in the community
03. How to eat in a restaurant independently in a novel mall
04. How to use public bathrooms independently in a novel mall
05. How to ask for help independently in a novel mall
06. How to shop independently in a novel mall
07. How to do 1 through 7 above for a hypermarket
08. How to do 1 through 7 above for an outdoor mall
The student will demonstrate competence in the following:

01. Independently handling a novel indoor mall
02. How to handle a simulated (or real) wheelchair breakdown while independent in the community
03. How to eat in a restaurant independently in a novel mall
04. How to use public bathrooms independently in a novel mall
05. How to ask for help independently in a novel mall
06. How to shop independently in a novel mall
07. How to do 1 through 7 above for a hypermarket
08. How to do 1 through 7 above for an outdoor mall
Outcome Objectives: Level Five

The student will have the following experiences:

01. Practice a totally independent lesson handling all wheelchair maintenance issues
02. Practice a totally independent lesson handling all locker challenges
03. Practice a totally independent lesson handling all eating issues
04. Practice a totally independent lesson handling all bathrooming issues
05. Practice a totally independent lesson handling all shopping issues
The student will attain the following knowledge (repeat to the therapist):

01. How to do a totally independent lesson handling all wheelchair maintenance issues
02. How to do a totally independent lesson handling all locker challenges
03. How to do a totally independent lesson handling all eating issues
04. How to do a totally independent lesson handling all bathrooming issues
05. How to do a totally independent lesson handling all shopping issues
The student will demonstrate competence in the following:

01. How to do a totally independent lesson handling all wheelchair maintenance issues
02. How to do a totally independent lesson handling all locker challenges
03. How to do a totally independent lesson handling all eating issues
04. How to do a totally independent lesson handling all bathrooming issues