Reflections on the PHI Credential:
Part 2

Sherwood J. Best & Kathryn Wolff Heller
This article is the second in a series that was written in 1999 by two members of the DPHD Critical Issues and Leadership Committee. In this article Drs. Best and Heller explore role confusion as a major contributory factor to the loss of disability specific certification in physical/health disabilities.

Who Are You Today?

Two popular phrases in special education today are "role release" and "thinking out of the box". "I am practicing role release" says the teacher as s/he positions a child for an academic activity, reinforces communication skills using an AAC device, performs clean intermittent catheterization, etc. "Think out of the box" says the administrator when the teacher questions whether instructional duties have been subsumed by other activities. We recognize that the duties and roles of special educators today are increasing varied and complex, and believe that collaborative consultation and integration of activities from a variety of disciplines represent best practices in service provision for students with physical/health disabilities. However, role release becomes role confusion when: 1) integrating activities from disciplines other than education into classroom or community activities supplants the need for professional services from members of those disciplines and 2) teachers of students with physical/health disabilities become less responsible for teaching than for implementing a variety of therapy and other related services programs. Examination of these two false perceptions suggests why they contribute to the dilution of disability specific teacher certification in physical/health disabilities.

In addition to their training to deliver varied curricula through appropriate adaptations, most teachers who serve students with physical/health disabilities knowledge and skills that have their genesis in other professional disciplines. They learn to assist students to manage their orthotic devices (physical and occupational therapy), practice gait training exercises (physical therapy), become independent in eating (occupational therapy), assist or become self-sufficient in self-catheterization (nursing), incorporate exercises during recess (adapted physical education), use AAC devices (speech/language therapy), and acquire many other skills in addition to teaching. These skills are vital to mastery, maturity, and self-determination. Indeed, we are pleased that federal law, guided by litigation, has mandated the provision of supplemental supports and services, and has clarified the differences between "related" and "medical services". However, teachers cannot replace the related services personnel whose goals they work so hard to reinforce. Years of training culminated in certification in physical or occupational therapy, adapted physical education, speech/language therapy, nursing, social work, and the other professions that enrich the lives of individuals with physical/health disabilities.

While teachers may acquire many skills in the professions that supplement special education, they cannot replace these professionals. Indeed, acting from this confused position can result in inadequate service provision at best and physical danger or injury at worst. How many of you know a teacher who has a bad back from improper lifting, or a student who choked while being improperly fed?

The primary role of teachers is instruction, which means that they cannot be supplanted by other professionals. Years of training also culminated in certification in special education for teachers who serve students with physical/ health disabilities. These teachers have specialized knowledge and skills that include careful adaptation of core curriculum and specific instructional strategies. Teachers are trained in error analysis, task analysis, and specific instructional strategies. They must be particularly mindful of these strategies if a cognitive or learning disability impacts student functioning. For example, a related services professional might provide catheterization. A teacher of students with physical/health impairments would teach the student to perform or partially participate in this health care procedure.  Too many teachers spend the majority of their time implementing therapy and self-care programs, escorting students to a variety of locations, assisting in the bathroom, etc., without perceiving the instructional aspect of these tasks. Another problem arises when these very important and necessary activities take a back seat to academic instruction, and the teacher is relegated to the position of coordinator of related services schedules. The particular skills provided by teachers are then lost to students.

We believe these false perceptions originate when: 1) inadequate teacher certification fails to address disability specific educational needs; 2) lack of professional clarity leads to role confusion; and 3) lack of appropriately trained personnel results in role "cross over" as a means of providing necessary services. The problem is intensified when these practices are justified based on the perception that there is not much "special" about "special education".

1. Interact with therapists. Read therapy reports, ask about the goals/outcomes therapists have established for your students, and how aspects of these goals/outcomes might be implemented in classroom and community environments.

2. Invite therapists into the realms of classroom and community. You can observe their techniques, which reinforces programming consistency. They can learn instructional strategies and come to a better understanding about the unique educational needs of students with physical/health disabilities.

3. Clearly communicate about block time for uninterrupted instruction. Establishing block times for out-ofclass related services leads to mote efficient and controlled educational planning, reduces the sensation that your classroom is the hub or switching station for related services coordination, and gives you specific times when some students will be out and you can devote intensive time to other students.

4. Try to incorporate therapy within classroom and/or community contexts. This has the advantage of cross training (mentioned above) and is efficient if the therapist has several of your students on his/her caseload.

5. Be open to learning and teaching. Reinforcing the complimentary processes of communication and collaborative consultation is in the best interest of students.

In her Presidentís Message, Sharon Grandinette comments on the situation in which increasing numbers of teachers who serve students with physical and health impairments are doing so through completion of the credential in Moderate/ Severe Disbilities. In the experience of Sherwood Best, one of the authors of this article, many school district administrators are ignorant of the breadth and depth of the PHI credential in California, believing it only allows teachers to serve students with orthopedic disabilities. In addition, because institutions of higher education can more easily sustain a credential program in Moderate/Severe Disabilities, more teachers with this credential become available for hire. As a result, intentionally or otherwise, district administrative personnel frequently hire teachers who do not have the PHI credential. In fact, they may even believe that the PHI credential is no longer necessary or even available in California! You can be active by reminding administrators and district personnel who are involvd with teacher hiring that the PHI credential encompasses orthepedic impairments, health impairments, traumatic brain injury, and multiple disabilities. The PHI credential allows educators to serve children birth-22 years, not just Kindergarten-22 years, as the Moderate/Severe credential does. The PHI credential is worthwhile, alive, and, with your support, better than ever.

This article is from the CAPHI Newsletter, Winter 2006.
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