Zimmerman teaches the correct method for lowering a wheelchair down the bumper of the bus. She says that physical and occupational therapists can be a great asset in bus evacuation training, planning and drills.Riding with bus drivers will answer their questions about students' posture
Why does a student lean to the side during the bus ride? If the student's head is moving up and down during the bus ride, is that going to hurt him or her? What about their arms hanging off the arm rests or their legs not staying on the foot rests — can this hurt students?
These are all questions that should be directed to PTs or OTs, and it is yet another way to include therapists in the transportation process. Invite them to ride the school bus and observe what happens to students' posture during the ride.
Involve therapists in evacuation training and drills
When therapists prescribe a mobility device for a student, their goal is not just to help the student get around. The goal in prescribing a wheelchair in particular is also to help the student achieve proper body alignment while he or she is seated on the bus. Pads may be put along the student's legs and trunk to keep them as straight as possible. A student with a serious trunk problem who could not sit by himself would be prescribed a custom-molded seating system.
Because one of the goals in prescribing mobility devices is support for proper body alignment, lifting students from their mobility devices requires specific directions and training from PTs or OTs to maintain the alignment.
Find the students' therapists and ask them to provide in-service training on how to lift them. Pupil transporters should be highly engaged in the training, asking the therapists such questions as "How much does the wheelchair and student weigh?," "Do they have significant orthopedic deformities?" and "Does the student have severely increased tone when you lift him or her?" (Tone is the reaction of muscles to movement. Hypertonic tone can cause muscles to become very stiff and difficult to move. The other type of tone is hypotonic tone — the muscles are loose and floppy; thus, more support is needed to lift a student.) This information and training will become especially valuable during evacuation drills and in the event of an actual emergency.
In addition to providing training on proper lifting techniques, therapists should be involved in evacuation training, planning and drills. As a team, you will decide the best way to evacuate students with special needs, whether it is transporting them in their wheelchairs or on an emergency evacuation device.
Whatever the decision is, therapists will be a great asset to the team. Although we are not trained specifically in school bus evacuations, as previously mentioned, we know the type of tone the student has as well as lifting techniques to accommodate students' physical deformities and minimize injury to the children and to the adults doing the lifting.
However, just as transportation personnel do not like to think about having to evacuate students from a school bus, neither do PTs and OTs. When you seek out help from therapists, do not start by asking them to help with evacuations.
Get them hooked on assisting in transporting students with special needs first by helping them see how much they have to offer to the team and the critical role they will play. Ask them for help with body mechanics, disabilities and mobility devices and then gradually invite them to participate in discussions about evacuations.
Jean Zimmerman is a physical therapist and supervisor of occupational and physical therapy for the School District of Palm Beach County (Fla.). She frequently speaks at pupil transportation conferences and heads special-needs training sessions for school bus operations around the country. Zimmerman can be reached at firstname.lastname@example.org.