Have you taken advantage of everything your workplace offers? You show between two workers you are not even contributing one maximum to retirement. As a teacher, your wife may have many options that you didn't even look at when she started working, but make sense now that y'all are earning more. Does your health plan allow for HSA? If not, is an FSA appropriate for your family?
Is $195k gross? If so, you could probably both contribute to Roth IRAs. You can use what you would have put into your EF for this, as you will have access to the contributions if you need them. If the $195k is adjusted, it might be time to switch to traditional 401k to have access to the Roth IRA for your EF.
How much of your cable bill is TV vs internet. If you cut the TV, can you meet your needs for less with streaming?
Does your mortgage include PITI? If not, you haven't included taxes and insurance in your budget.
How many cell phones does $170 get you?! We pay $30/mo for two phones, with 3GB each. The phones themselves tend to be around $200 every 3-4 years, so you could annualize them at another $10/mo.
How important is the house cleaning to you? If the kids are old enough for cell phones, they are old enough to clean.
If someone needs PT, they need PT. However, have you looked closely at all of your insurance options to verify that you are maximizing benefits, as well as minimizing premiums? Is the PT so specialized that she couldn't explore other options that might save money? DH gets more out of Iyengar Yoga than ongoing PT, even though he did need PT to get mobile again. If this is something worth exploring (and I have no idea if it is appropriate or not in her case), you will spend more up front to explore the different options while continuing PT.
How does your water bill compare locally? If it is high, learn water conservation methods. "If it's yellow, let it mellow" can make a big difference when you work from home.
Groceries: already impressive for a family! I spend that every two weeks for the two of us these days, but lamb and seafood are so delicious.
Will your car insurance reduce your rates if the offending driver takes a defensive driving course? Will your state reduce your points if you take a defensive driving course, which might allow you to switch to cheaper insurance?