Getting Therapy


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1-year-old Adam was delayed in his gross motor development and had low muscle tone as a result. Although he was trying to crawl and was sitting for a few seconds by himself, he fell often from a lack of strength and trunk control.

Adam began seeing a physical therapist weekly. The sessions were full of fun and laughter as Adam and his therapist played with his favorite toys. A few months later, he was crawling everywhere and sitting up for longer periods of time. Once he began standing and trying to walk, his therapist moved the sessions to a local pool, where she worked with him to build up his strength and improve his balance. Adam loved the water, and he had much better motor control for standing and walking while in the pool.

After that, he needed the assistance of braces to stand and walk outside the water. Adam loved to stand by himself and bounce up and down to music. Shortly after he turned 2, Adam began taking steps on his own, and his therapist delighted in seeing the big smile on his face (and his family's faces) when he was able to walk to Mom and Dad.

Children typically are referred for physical therapy (PT) from birth to age 3. Pediatric PT helps children with mobility and stability. Gross motor skills, such as sitting, crawling, standing, walking, kicking a ball and jumping are the milestones therapists hope to help kids achieve, depending on their age and skill level. Therapists also assess kids for equipment needs, such as standers or wheelchairs, as well as orthotic needs, and they train families in using the equipment.

Occupational therapy (OT) also helps children achieve independence, says Megan Kaufman, pediatric team supervisor and an occupational therapist with Cone Health Outpatient Rehab in Greensboro. In addition to fine motor skills, OT addresses visual skills, sensory processing and self-care. In OT sessions, kids practice grasping and releasing toys, as well as improving hand-eye coordination and handwriting skills. There are also bathing and dressing skills, and some therapists work with children with feeding difficulties.

"OT can help children with a wide range of special needs by improving the activities of daily living," Kaufman says. "We work on such things as improving a child's fine motor skills, motor planning, coping and problem-solving skills and handwriting."

Early Intervention Helps
PT and OT therapists work with children in the hospital, at home, at daycare and school, and in private clinics.

Kaufman says beginning therapy as early as possible is the key to a child's success, although it's never too late to begin therapeutic intervention. "Depending on the diagnosis, we may see a baby for tight muscles, or we may see a 6-year-old for the first time for handwriting difficulties," she says.

While searching a therapist who is the best fit for their child, parents must trust their instincts and ask as many questions as it takes to get a good understanding of what will take place. Kaufman says that Cone Health Outpatient Rehab offers free screenings so that parents who may have a concern about their child's development can schedule a free evaluation by either an OT or PT and discuss whether or not more extensive therapy is warranted. If so, the therapist will discuss what type of therapy, how often and what will be involved as well as create goals for the child.

Kaufman says most parents wonder how their child will react and respond to therapy. She tells the story of how they often see many 2- or 3-year-olds who are having behavior problems at preschool and on the verge of being expelled. "Sometimes in these cases, the child may show signs of autism or Sensory Processing Disorder or another disorder that is causing what the preschool labels as a 'behavior problem,' " Kaufman says. "We can work with these children to help them develop sustained attention, how to problem-solve and other coping skills. They usually go back to their preschools and learn to behave and interact successfully."

Purposeful Play
Children learn through play, and therapists strive to make each session as fun as it can be with games, singing and favorite toys. "Since 99 percent of kids' daily activities involves playing, therapists use child-directed play, but we play with a purpose," Kaufman says. "We set up the environment so kids are challenged, and are working toward a goal, but they are distracted through play and do not even realize we are doing therapy." Kaufman says that part of this play is also educating parents how to incorporate it at home.

Christopher, 2-1/2, wasn't able to sit down and focus to play with a toy for longer than a few seconds when he first started therapy. He didn't make eye contact with others. After starting OT, Christopher was calmer, more focused and able to sit and attend to a task for much longer periods. His mom learned how to incorporate sensory activities throughout his day, and within weeks, his eye contact improved. The toddler not only began to use a few words and signs to communicate, but he also began to play more appropriately with his toys and interact more with his older brother.

Cristi Driver is a Greensboro-based freelance writer. Lee McCracken is a freelance writer from Charlotte.

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