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.
