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APTA's House of Delegates approved the concept of specialization in 1976 and established the Task Force on Clinical Specialization, which developed the Essentials for Certification of Advanced Clinical Competence in Physical Therapy. The House of Delegates adopted this document in 1978 and appointed the Commission for Certification of Advanced Clinical Competence, the predecessor to ABPTS, in 1979.

As each of the specialty areas was recognized by the House of Delegates, ABPTS appointed a specialty panel that identified and defined advanced skills, established eligibility criteria, and developed the examination.

The Specialty Panel on Cardiopulmonary Physical Therapy was the first to complete the process, and the cardiopulmonary specialist certification examination was first administered in 1985. Since then, 10 additional specialty areas - Clinical Electrophysiology, Geriatrics, Neurology, Oncology, Orthopaedics, Pediatrics, Primary Care, Sports, Women's Health (changed to Pelvic and Women's Health in 2025), and Wound Management Physical Therapy - have been established.

  Established First Exam
Cardiovascular and Pulmonary 1981 1985
Clinical Electrophysiology 1982 1986
Geriatrics 1989 1992
Neurology 1982 1987
Oncology 2016 2019
Orthopaedics 1981 1989
Pediatrics 1981 1986
Pelvic and Women's Health (Name changed from “Women’s Health” in 2025) 2006 2009
Primary Care 2025  
Sports 1981 1987
Wound Management 2019 2022