Let’s talk about a topic that school-based physical therapists can assist in addressing but one that may not be our primary focus … activities of daily living (ADLs). What are activities of daily living? Activities of daily living are the tasks we do day to day to take care of ourselves and to take care of our home environment. Essentially they are activities of self care and chores we complete! These basic self care ADLs, such as toileting, handwashing, grooming, etc., children learn at school, especially at the Pre-K/Kindergarten age, and are imperative for them to learn as they grow. Moreover, in many special education classes in high school, students learn functional skills such as cleaning, cooking/meal preparation, and money management. These functional skills are imperative as they transition to adulthood and begin to focus on postsecondary education (college, community college, trade school), vocational activities/employment, and/or independent living if applicable.
There are two types of ADLs: basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs).
- Personal hygiene tasks
- Bathing & showering
- Grooming (brushing hair, brush teeth, washing face, trimming nails)
- Toileting & Handwashing
- Process of getting on/off toilet
- Cleaning/wiping oneself
- Feeding – ability to feed oneself by bringing food to mouth
- Cleaning & maintaining the home environment
- Making the bed
- Preparing meals
- Shopping (groceries, clothes, and other necessities)
- Managing money (paying bills, budgeting, etc.)
- Communication (sending emails, using a telephone, etc.)
- Health (making doctors appointments, medication management, etc.)
Typically, ADLs are one of the major focuses of occupational therapists who work with their students on these tasks. However, there can be some overlap. Since physical therapists are the experts in gross motor movement, they typically are assessing and treating whatever deficits they see that may affect a student’s sitting balance, standing balance, gait (walking pattern), ability to squat, lifting & carrying objects, etc. which are fundamental skills to successfully and effectively perform ADLs. If you are unable to stand or your standing balance is poor then it will be very difficult to get dressed, to sweep or mop, or to prepare meals. If your walking is labored and you display even minimal gait deviations then it can be challenging to do your laundry, go shopping, and make the bed. School-based PTs work to improve participation & independence with ADLs by addressing the gross motor deficits behind them through isolated strength, balance, & coordination exercises as well as by directly practicing the ADL or ADLs with which the student is struggling.
Ultimately, ADLs are a very important component of development and are imperative to the successful functioning of a student in their school environment and beyond. I hope this was informative and uncovers yet another facet of school-based physical therapy!
Catherine C. Skelton, PT, DPT
Pediatric Physical Therapist