Who’s it for, why it helps, expectations for long term, etc.

Approximately 13% of children in the United States have been diagnosed with developmental delays.  Some developmental delays are associated with diagnoses such as congenital muscular torticollis, Down syndrome, cerebral palsy, or autism spectrum disorders, while some children merely display delays in some realms but develop normally in other realms.  These delays can be in gross motor skills, fine motor skills, communication, cognition, adaptive/self-help skills and feeding skills.

Fortunately, there are professionals who are specially trained to help children overcome their developmental delays These professionals include pediatric Physical Therapists, pediatric Occupational Therapists, Speech-Language Pathologists, Infant Stimulation Specialists (AKA Early Interventionists), Recreational Therapists, and developmental Optometrists  This article will go further into depth regarding the roles of the pediatric Physical and Occupational Therapists.

Pediatric Physical Therapy

Pediatric Physical Therapists have specialized knowledge regarding gross motor skills development.  There are many treatment philosophies such as Neurodevelopmental Treatment, Sensory Integration Approach, or a Functional approach, but all have the ultimate goal of maximizing a child’s functional mobility.

Treatment sessions are specific to each child’s needs and may include stretching, functional strengthening, positioning, providing sensory stimulation, balance training, reflex integration, and functional mobility training.  Parent/caregiver training and home program prescription to ensure carryover of skills are also vital components of a PT treatment plan.  If necessary for a child, a pediatric PT can prescribe lower extremity braces, plagiocephaly helmets, positioning equipment, and mobility equipment such as wheelchairs, gait trainers, or walkers.

Pediatric PT sessions incorporate equipment such as mats, swings, balls of all sizes, balance beams, benches, chairs, and toys. Sessions can take place in the child’s home, in a clinic, or in the community.  Preschoolers and older children can also receive PT services through their school, if they qualify for the service.  Playgrounds are always a fun and productive place to hold a PT session because of the ladders, slides, uneven terrain, tunnels, swings, and other amenities that are available in a larger outdoor setting.

Pediatric Occupational Therapy

Pediatric Occupational Therapists have specialized knowledge regarding the development of fine motor skills and adaptive/self-help skills.  Some pediatric OT’s have also pursued further training in Sensory Integration and/or feeding.

Occupational therapy treatment sessions are also specific to each child’s needs and may include stretching, functional strengthening,  positioning, sensory stimulation, fine motor coordination, grasping skills, pre-writing skills, self-feeding, and self-care.  Parent/caregiver training and a home program are also vital to carryover of skills learned in OT.  If necessary, a pediatric OT can prescribe or fabricate custom upper extremity splints, positioning devices and/or wheelchairs to promote optimal functional position for all activities of daily living.  Self-help aids may also be recommended such as adaptive shoe laces, writing aids and specialized feeding equipment for increased independence. The child’s environment may also be adapted to meet their needs such as a lower or higher seat in school to increase stability when sitting in the classroom.

Pediatric OT sessions incorporate much of the same equipment that PT’s use, with the addition of more treatment tools specific to what they do.  For feeding therapy, OT’s will use foods of different tastes and textures, adaptive dishes and utensils, and tools to provide sensory input to the mouth.  For self-help training, OT’s will use tools such as a fastening board to practice lacing, buttoning, zipping and dress up clothing to practice taking clothes on and off.  For pre-writing and other school-related skills, OT’s will use writing instruments of varying lengths and thicknesses, adaptive scissors, and slanted writing surfaces.

Occupational Therapy sessions can take place in the child’s home, in a clinic, or in the community.

Occupational Therapy is very common in the schools for children in special education who need help with school-related tasks that involve writing, cutting, gluing, and self-care.

Non-Developmental Therapy

Pediatric Physical and Occupational Therapists can also be found in hospitals, in private outpatient clinics, and in long-term care settings.  These therapists work primarily to rehabilitate children from illness or injury, but this rehabilitation will often overlap with developmental therapy.  These therapists often work with children who have cancer, long-term chronic illness, post-injury, or orthopedic diagnoses such as juvenile rheumatoid arthritis.

Prognosis

Pediatric Physical and Occupational Therapists work hard to ensure that children can function to the best of their ability.  Children frequently “graduate” from therapy as their skills become age-appropriate, but oftentimes, the child’s diagnosis can be a limiting factor.  In cases such as these, therapists will also play a role in ensuring that these children do not decline in function, or in the case of degenerative diseases, to slow the decline in function.  Regardless of the ultimate outcome, Physical and Occupational Therapy for children is crucial to ensure that their full potential is met.

As you embark on your rehabilitation journey, several terms may be confusing to you.  Two terms that are often confused or misunderstood are Physical Therapy and Occupational Therapy.  What is the difference between the two, if any?

What is Physical Therapy?

Physical therapy is a health profession that aims to rectify impairments and functional limitations caused by a person’s impairments.  Physical therapy also strives to maximize a person’s mobility, functional ability, wellness, and quality of life.  A physical therapist is a medical professional who is licensed to assess and treat impairments, functional limitations, and disabilities in patients.  They often work closely with Physical Therapist Assistants, who are licensed to perform PT treatments.  Physical therapists can also specialize in particular branches of Physical Therapy such as orthopedics, pediatrics, wound care, cardiac rehabilitation, lymphedema, and women’s health.

Physical Therapy treatments often include manual therapy techniques to improve the alignment and mobility of a patient’s bones and soft tissues in order to decrease pain and increase function.  Physical Therapy also incorporates stretching, therapeutic exercise, balance training, functional mobility training, gait training, and caregiver training.   Physical Therapists are also qualified to recommend appropriate medical and assistive devices for patients including shower chairs, braces, walkers, canes, wheelchairs, and standers. Patient education regarding a patient’s condition, injury prevention, proper body mechanics, appropriate recreational activities, and general health is a vital part of Physical Therapy.  To ensure continued progress, a physical therapist will often prescribe an individualized home exercise program.

In order to maintain an active lifestyle, a physical therapist can help you move in an efficient, less painful manner.  With the guidance of a physical therapist, you can assume or continue a fitness program that would be most beneficial for you, whether it be walking, swimming, cycling, dancing, golfing, etc.

What is Occupational Therapy?

Occupational Therapy is another health profession that aims to remediate impairments and functional limitations in order to maximize a person’s ability to perform activities of daily living.  Activities of daily living include dressing, cooking, bathing, toileting, writing, and other common household and work-related tasks.

Occupational Therapy treatments will frequently include manual therapy techniques, stretching, therapeutic exercise, hand strengthening, activities to improve manual dexterity, and caregiver training.  Occupational Therapists may also recommend appropriate adaptive equipment such as reachers, dressing aids, specialized dishes and utensils, and splints for positioning.  Patient education regarding a patient’s condition, accommodations, and proper use of adaptive equipment is an important aspect of Occupational Therapy.  An occupational therapist will also create an individualized home exercise program to encourage a patient’s continued progress.

An occupational therapist can help you continue to perform hobbies and recreational activities that you find enjoyable.  With the guidance of an occupational therapy, you may be able to perform activities that you may have had difficulty doing such as knitting, cooking, gardening, or playing cards.

How do Physical and Occupational Therapy Complement Each Other?

Both Physical and Occupational Therapists work in hospitals, private clinics, schools, skilled nursing facilities, and adult day care centers.  They compose part of a multidisciplinary team that usually consists of doctors, nurses, social workers, physical therapists, occupational therapists, speech-language pathologists, dieticians, etc.  Physical and occupational therapists will often lead community-based exercise and educational programs such as balance classes, fall prevention classes, and aquatic exercise classes.

Traditionally, when working with the same patient, a Physical Therapist will focus on activities involving the lower extremity while the Occupational Therapist will focus on activities involving the upper extremity.  However, when they are able to overlap treatments with a patient, they will often collaborate to maximize the effectiveness of a session.  For example, in a nursing home, the physical therapist may help the patient stand from a wheelchair and maintain standing balance while the occupational therapist assists the patient in hygiene tasks at the sink.  At an outpatient clinic, they can work together to help a person resume gardening – the physical therapist would help with walking outdoors on uneven surfaces, using proper body mechanics while lifting and carrying gardening supplies, and practicing squatting; while the occupational therapist would assist with opening packages, using a trowel, and turning on the faucet.

Together, physical and occupational therapists can help people maximize their function, maintain independence, and continue to lead active lives for as long as possible.  If you are having difficulty living the lifestyle you desire, ask your physician if Physical Therapy or Occupational Therapy would be beneficial for you.