Pediatric Physical Therapy
Updated: Dec 2, 2021
"So how do you do physical therapy with kids anyway?"
This is a question I am often asked by friends, family and even other professionals! I always knew that I wanted to be a pediatric physical therapist for as long as I can remember (more on that later). To some, it might look like I am just "playing" with kids all day! Especially in the school setting - we are often outside on the playground or in the gym for our PT sessions. Yes - playing games and finding creative ways to work on activities is honestly one of the hardest parts of my job - but there is WAY more that goes into each and every session!
How I became a PT and how I specialized in pediatrics:
PT school is an entry level doctorate program. I first had to get my bachelor of science degree. I chose Kinesiology (exercise science) at UMASS Amherst. I studied there for four years before applying to graduate school and choosing Simmons College in Boston, MA. Three years of intense courses, labs, and clinical experiences later, I received my Doctorate of Physical Therapy.
I then had to sit for a board examination to earn my Physical Therapy license. That was by far the most challenging time in my life - studying for the boards, and passing that test. Of course it is a hard test, but all of the pressure leading up to that exam, the thought of possibly failing and having to re-take it again, and the pressure to start my career were a lot to handle. The 5-7 business days I had to wait to find out if I passed or not were probably some of the longest days of my life! After taking that test, I remember thinking - I hope I never have to take a test like that again in my life!
Well -fast forward five years and I was registering to take another board exam, but this time it was purely my choice. I wanted to expand on my knowledge base of pediatric PT, and I also wanted to show my patients' families that I was a "specialist". I took the 2.5 hour board exam and this time had to wait almost three months to find out if I passed! In 2019, I became a Board-Certified Clinical Specialist in Pediatric Physical Therapy by the American Physical Therapy Association. In order to be able to sit for this exam, you have to meet criteria including having enough hours of clinical experience in pediatrics. There are 10 different clinical specialties a physical therapist can pursue, such as women's health, neurology, geriatrics, sports, and oncology just to name a few.
The diagnoses I typically see:
As a pediatric PT, I might evaluate children with rare diseases and conditions that sometimes I am hearing and learning about firsthand from their parents. The more common diagnoses that we treat and a majority of a pediatric PT's caseload are listed below:
Traumatic Brain Injury
Autism Spectrum Disorder
Brachial plexus injury
Spinal Muscular Atrophy
Developmental Coordination Disorder
This is not an exhaustive list, but certainly the more common diagnoses that a pediatric PT can help treat. Some therapists only work with babies, others work with both pediatric and adult patients. Since graduating PT school, I have focused on the younger patients, but I also have treated adults with the above diagnoses as they age and transition into adulthood. I also used to do aquatic physical therapy, which is bringing kids in the pool and using the water as a therapeutic modality. I have taken numerous continuing education courses, both online and in person. It is important to be a life long learner as a PT, and keeping up to date on evidence based practice.
What a typical session looks like:
After a comprehensive evaluation is performed, no matter the setting that the PT is taking place in, the family and I will create goals for the plan of care. In a clinical setting these goals might have a 4 week timeframe, or an 8 week timeframe. In a school setting, goals are measured across trimesters and the entire school year. The goals help determine what is important to the family, and help structure the treatment plan and activities that are worked on both during sessions and the home program that is taught to parents and families. For example, if a parent's goal is for a child to learn how to skip, we will first work on balance activities, hopping on one leg, core strength, and bilateral coordination to build the foundational skills to be able to skip. I always make sure to give any child that I am treating a lot of activities that their caregivers and parents can work into their everyday routines to build on skills learned during therapy sessions. Depending on the age and developmental stage of the child, I will pick out specific toys and games to use during sessions. Motivation is huge for children to want to "work" with you, and finding out what toys/games/music motivates them is so important! With babies, it is usually toys that light up, toys with high contrast (black, white, red) or mirrors. With older kids, I always make sure I have a plentiful stash of bubbles, stickers and bean bags. Most love bubbles and I can use a wand of bubbles for tons of different activities! Part of being a pediatric PT is being as creative as possible and definitely open to using your imagination. Even older kids like to "play" during our sessions if I find out what interests them.
How do I find out if my child qualifies for PT?
If your child has a diagnosis and has been referred by a doctor for PT, they should hopefully be able to refer you to a PT that specializes in pediatrics near you. If they don't have any recommendations, I would first try contacting your local children's hospital to see if they have a physical therapy department. If your child is under three years old, you can utilize your state's Early Intervention (EI) program, which is government funded and comes at no cost to you. They will come to your home, and complete a full evaluation on all aspects of your child's development to see if they qualify for services. You can find your local EI agency here: https://www.cdc.gov/ncbddd/actearly/parents/states.html#textlinks
If your child is above three years old, then you can use your insurance benefits to pay for physical therapy. You could also find a private therapist who may or may not bill your insurance, or offer cash-based services. You can search for pediatric clinical specialists in your area here: https://aptaapps.apta.org/APTAPTDirectory/FindAPTDirectory.aspx
Have any other questions about pediatric PT? Feel free to comment, or send me an email: email@example.com
Also be sure to follow Inchstones PT on social media for tips from a pediatric PT and to see how I break down the milestones into inchstones!