Posts Tagged ‘PT’

Physical therapy – can it help your preemie?

Wednesday, October 14th, 2015

Preemie walkingMany children born prematurely may need help catching up with developmental milestones such as sitting, crawling or walking. They may need assistance learning everyday activities such as dressing, too. Physical therapy – one type of habilitative service – may help. Habilitative services are those therapies that help a child develop new skills needed for everyday life.

October is National Physical Therapy Month. This is a great time to become aware of the benefits that physical therapy (PT) can offer your child, whether he was born prematurely or full term.

What does PT do?

Physical therapy can help your child increase strength and flexibility. It can also improve posture, balance, coordination and movement. PT usually focuses on large muscle groups, such as the legs, but it can also involve the entire body.

A physical therapist is a professional who has specific training in understanding the way a body works – especially muscle groups. She can assess your child and provide individualized therapy which will help him improve in the areas where he is weak. PTs are very creative in their approach to working with children. In fact, the therapy can be lots of fun, and most children look forward to their PT sessions.

Does insurance cover PT?

Under the Affordable Care Act (ACA), habilitative services must be covered by insurance. They are included in the ACA as Essential Health Benefits, which means they need to be covered under individual and small group health insurance plans. Check your state for specific details. For information on enrolling in your state’s marketplace for health insurance, go to HealthCare.gov or call 1-800-318-2596.

Early intervention may include PT at no cost to parents

If your child is under the age of three, he may be eligible for Early Intervention services, which is a federal program provided in every state. Physical therapy is one of many services available for eligible infants and toddlers if they qualify. Therapy is usually provided at no cost to parents.

If your child is age three or older, he may qualify for PT through your local school district as a Related Service. This post will tell you how to access it.

Bottom line

As with all delays or disabilities, it is important to seek help as early as possible. The sooner your child gets the help he needs, the sooner he can begin improving.

Have questions? Text or email AskUs@marchofdimes.org.

See other posts on Delays and Disabilities: how to help your child.

 

Kids with challenges zoom on souped up kiddie cars

Wednesday, March 26th, 2014

tot in carThere are times when I see someone doing something wonderful to help toddlers and young kids with special needs and I just HAVE to speak up and tell others. Today, I experienced such a moment.

There are all kinds of delays and disabilities: gross motor, fine motor, speech, non-verbal, social, hearing, processing, learning, and the list goes on. Here is something new for tots with gross motor disabilities (problems using large muscles of the body such as the legs to walk, crawl, sit up, etc.).

At the University of Delaware, Dr. Cole Galloway, a professor of physical therapy and a scientist, teamed up with his colleague, Dr. Sunil Agrawal, professor of mechanical engineering, with the goal of increasing exploration in children with special needs. They take basic ride-on cars available at toy stores, and adapt them to suit the particular needs of a child with motor disabilities. The result is a specially powered kiddie car that a child is able to ride.

Why is this so wonderful?

The efforts of Drs. Galloway and Agrawal have enabled children with gross motor disabilities to zoom around on these powered cars and play with classmates the same as any non-disabled child. In other words, for part of his day, a child with motor limitations can now play and compete with peers on equal footing.  The result is a child who suddenly sees himself on par with the kids in his class or his neighborhood. He is not “different” when he is in his car. The self-esteem and social connections that develop as a result of his new experiences are profound. Of course, the added fun to his life doesn’t hurt either!

This idea is changing the lives of these kids. Literally. The video (below) describes how these adapted cars enable children to increase their mobility as well as their socialization.

PT on the car

Another cool benefit of this kind of mobile car is that it can augment a child’s specific physical therapy (PT) needs. For example, if a child has trouble keeping his head up due to his disability, powering the car by pushing a button with his head can be a fun way to work on this physical therapy goal. Talk about a motivator!

Do it yourself

The best news yet is that parents can change ordinary ride-on cars into personalized motor cars themselves, by following the instructions Drs. Galloway and Agrawal have created.  They are freely sharing this information and have made it as easy as possible to “do it yourself.”

So, watch this video (with some tissues ready), and then, pass it on (with a pair of pliers) to parents you know with little ones who struggle with motor issues. Thanks to the genius of these professors and their open hearts, kids with special needs can be just “kids.” At least for a little while.

 

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date (just keep scrolling down). As always, we welcome your comments and input – send them to AskUs@marchofdimes.org.

What is dyspraxia?

Wednesday, February 26th, 2014

child using forkDyspraxia is a complex motor skill disorder that interferes with the activities of daily life. It can be mild or severe and affects every child differently. It is also called developmental dyspraxia and developmental coordination disorder.  It affects boys more than twice as often as girls. Dyspraxia is a lifelong disorder that can be managed but not cured.

What are some warning signs?

In babies and toddlers, signs of dyspraxia include delays in reaching developmental milestones, such as not rolling over or crawling, and later having trouble learning to walk. In young children, some of the signs of dyspraxia include being clumsy, having trouble using utensils to eat, being unable to tie shoe laces, ride a bike or catch a ball, having difficulty with speech and not completing tasks.

As you can see, dyspraxia does not have one specific sign or symptom. Having trouble talking is very different from not being able to catch a ball. But, all of these symptoms share the common basis of planning and carrying out a motor task. But, just to muddy the waters a bit, some children with dyspraxia still achieve major developmental milestones. (Are you confused yet? Wait, there’s more.) Yet, other children may have some of the signs or symptoms of dyspraxia but they are due to another diagnosis entirely. (Think of a runny nose…it could be due to a cold, the flu or allergies. The symptom is the same for each diagnosis.)  So…

How can you tell if it is dyspraxia or not, and what should you do?

In order to know if your child’s symptoms are due to dyspraxia, a developmental delay, a vision problem, or a different diagnosis entirely, it is important that a professional evaluate her. First, discuss your concerns with your child’s pediatrician at an office visit. He may recommend an additional evaluation by another expert. In addition, you can have your child evaluated through the early intervention program in your state for babies and toddlers, or through the special education system for children age 3 and older.

How is dyspraxia treated?

The kind of treatment a child receives depends on the type of symptoms and severity she is experiencing. Treatment  should be individualized. For example, if a child has trouble speaking (can’t form words properly, has trouble with the volume of her voice, etc.), then speech therapy would probably be appropriate. If a child has trouble with buttons, zippers, using a fork or knife, brushing teeth, is extra sensitive about hair brushing, or tags on clothing drives her to distraction, then occupational therapy may be helpful. If a child has trouble with moving around (she bumps into things, seems uncoordinated or clumsy, has trouble riding a bike, and generally has a tough time negotiating her space), then physical therapy may be in order.

In many cases, a child needs more than one kind of therapy in order to overcome obstacles. And, as a child grows and develops, the therapy needs to be adjusted to address her current issues and age.

It is worth noting that children with dyspraxia are often challenged by having other disorders at the same time, such as a learning disability, a speech and language disorder and/or attention problems. This is why it is important for a child to be diagnosed accurately and to receive appropriate treatment as early as possible.

Good company

shoelaces undoneDaniel Radclliffe, the actor who plays Harry Potter in the film series, has openly discussed his dyspraxia. He has trouble with handwriting and tying shoes, and admits he struggled in school.  Evidently, he has been able to focus on his gifts and talents to become a world famous actor. (Or perhaps there was just a little bit of magic thrown in?) But seriously, hard work and perseverance are always factors in learning to be successful despite a disability.

Where can you get more info?

You can learn more about dyspraxia and other learning disabilities at the National Center for Learning Disabilities (NCLD).  They have a short video that is helpful in understanding the different facets of dyspraxia. The NIH also has information on dyspraxia.

Bottom line

Although dyspraxia is a lifelong disorder, it can be managed through appropriate treatment. If you are concerned about your child’s development, be sure to speak with her health care provider or ask that your child be evaluated. Intervention at any time, is valuable.

Have questions? Send them to AskUs@marchofdimes.org.

Note:  This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started in January 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the Categories menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

What are hippotherapy and therapeutic riding (THR)?

Wednesday, July 3rd, 2013

horse-1For children with special needs, horseback riding may be very therapeutic. It may help your child improve socially, cognitively, behaviorally, physically and emotionally. And, to top it off, it can be loads of fun!

Hippo is the Greek word for horse. Hippotherapy and therapeutic riding (THR) are terms that are commonly used interchangeably to describe therapy that is provided with the help of a horse. But, there are some differences between the two.

What is hippotherapy?

The motion of the horse as it walks provides sensory input to the child. The horse’s movement is rhythmic and repetitive and closely resembles the normal gait (walk pattern) of a person. This sensory input movement is thought to help your child feel and learn the motion that is needed to learn to walk. Usually a licensed professional therapist provides OT, PT or ST as the child is on the horse. A child may even do certain exercises while lying down on the horse. In essence, it is therapy given while on a horse. The horse handlers are responsible for controlling the horse. Your child is not learning how to independently ride a horse in hippotherapy.

What is therapeutic riding (THR)?

Therapeutic riding is different from hippotherapy because THR focuses on riding skills and therapeutic activities. For instance, special tasks are given to your child to work towards certain goals (such as learning how to steer the horse, learning right from left, communicating with the horse handlers or “side walkers,” etc.). Your child slowly learns specific riding skills. Your child may or may not be in primary control of the horse depending on his level of skill and expertise.

Whatever the differences, the similarities are clear in that the use of a horse is key in working towards achieving functional goals.

What is it like?

When my daughter was younger, I took her to therapeutic riding sessions once a week. She sat on the horse and needed to sit up straight, hold the reins and pull on them to make the horse go in a certain direction. She needed to give walking commands to the horse (“Walk on Toby”) and listen to the instructors by her side. At first I was nervous as my little one sat atop this huge horse – she was speech delayed and often needed more time to process what was said to her. Her muscle tone was relaxed so working on her posture was not an easy task. But, I sat on the sidelines and watched quietly.

In time, I saw my daughter become more confident in her speech and movements as she directed the horse to move ahead, slow down or stop. Her posture improved as the sessions became more complicated – such as reaching for hoops or picking up objects alongside the rink while she kept the horse moving forward. She had conversations with her horse “side walkers” and formed a special bond with the horse, Toby.

My niece, who has autism, absolutely loves her riding sessions. Her ability to understand verbal commands has improved considerably since starting her therapy. She shows a sense of confidence and excitement when she arrives at the stable that she does not show in other environments. It is hugely evident from the smile on her face that she is thoroughly enjoying herself. She also displays a level of patience and control while on the horse that is not seen in other circumstances.

Where can you find hippotherapy or THR?

To learn more about hippotherapy, contact the American Hippotherapy Association. Click on “find a facility” in their drop down menu to locate a stable near you. The AHA maintains hippotherapy standards for programs and professionals.

To learn more about therapeutic riding, contact the Professional Association of Therapeutic Horsemanship International (PATH Int’l). Click on “find a center” to locate a stable near you. PATH establishes the industry standards for program safety as well as instructor training and certification.

Usually, a program accepts children as young as 4 years of age but rules may vary from one organization to another. Likewise, the cost of a program varies widely, although many organizations offer financial assistance. Be prepared to encounter a waitlist as these programs are usually immensely popular.

Is hippotherapy or therapeutic riding medically beneficial?

There aren’t a lot of robust studies, but I took a look at some of the more recent research as it pertains to children with developmental delays, autism and cerebral palsy (CP).

One study found that therapeutic riding may lead to improvement in gross motor function in developmentally delayed children “and that these improvements remain once therapeutic riding ceases.” Another study found that children with autism had improved behaviors (such as social motivation and less inattention, distractibility and sedentary behaviors). A review of 8 studies found that “riding therapy is indicated to improve postural control and balance in children with CP,” while another review found that both hippotherapy and THR have positive effects on gross motor function on children with CP. But, there are also studies that did not show definite results. Some had sample sizes that were too small to draw conclusions, or simply did not find any benefits for kids with CP.

Bottom line

More studies are needed to back up the benefits to which many parents, clinicians and even the patients themselves attest. But, aside from the studies, it may be worth it to look into any therapy that might benefit your special needs child. What works well for one child may not help another, and vice versa. Often you have to try more than one therapy to see what helps your child. And, often it is a combination of therapies that helps a child take off and make progress.

Have you tried any kind of horseback riding therapy for your child? Please tell us about your experiences.

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started on January 16, 2013 and appears every Wednesday. Go to News Moms Need and click on “Help for your child” on the menu on the right side to view all of the blog posts to date. As always, we welcome your comments and input.

What is physical therapy or “PT”?

Wednesday, April 24th, 2013

child-on-tricyclePhysical Therapy, or PT, can help your child increase strength, flexibility or endurance, and improve posture, balance and movement (such as walking). Therapy can help improve overall function and reduce disability. PT generally involves “gross motor” therapy, which means large body parts, such as the legs, but it can involve the entire body.

PT may be provided for your baby, toddler or school age child, depending on her needs. If you have a child with a developmental delay, disability or medical condition, her doctor may recommend PT.  Likewise, if your child is evaluated for early intervention services by the Child Find services or by your local school district, she may qualify for PT services. (See my posts on early intervention for babies and toddlers or intervention for children ages 3 and older to learn how to request an evaluation for free.) PT falls under the umbrella of “Related Services” which is available for children with disabilities, in order for them to benefit from special education.

In most cases, if your child qualifies (based on the results of an evaluation), she will receive the PT services for free. However, every state has slightly different regulations, so you should check with your state to find out more specifics.

Who provides the PT services?

The IDEA (law) says that physical therapy means “services provided by a qualified physical therapist.” Every state requires a physical therapist to be licensed. A physical therapist is highly educated. In fact, according to their credentialing organization, the American Physical Therapy Association (APTA),  “all physical therapists must receive a graduate degree from an accredited physical therapist program before taking the national licensure exam that allows them to practice. Physical therapists have the most specialized education to help people restore and improve motion.”

Where will the PT take place?

If your child qualifies for PT, services will be provided at a place that is appropriate for your child. This may be your home, a PT center, hospital, or your child’s local school. PTs who work with children are usually very creative. They find engaging ways to interact with your child, making the sessions fun while working toward goals. Kids usually enjoy PT sessions and look forward to them.

Remembering back to when my daughter received PT, she “played” with scarves and bean bags, ran obstacle courses, climbed ropes and balanced on huge balls or balance beams. She loved playing games such as Twister with some of her classmates. She even learned to ride a tricycle in her PT sessions!

What will the goals of PT be?

Specific needs and goals will be outlined in your child’s individualized plan. This is called an IFSP – Individualized Family Service Plan (for kids from birth to age 3) and an IEP -Individualized Education Program (for kids ages 3 and older). This document will provide details of the services she will receive, such as the specific goals to be achieved, how often she will see the physical therapist and the place where services will take place. Parents, as team members, have input into the creation of this very important document.

Often a PT will coordinate therapy goals with your child’s other therapists, such as an occupational therapist, to maximize results. And, it is important that a child’s teacher understand the goals and objectives of the PT sessions so that progress can be integrated into the classroom.

Remember, the goals to be achieved are specific to each individual child, and is based on her needs. Every child is unique! There is no one-size-fits-all plan. And, at a minimum, goals need to be reviewed and updated yearly. See my prior post on how to create a good IEP.

Bottom line

Physical therapy has helped many babies, toddlers and children to overcome obstacles. If your child qualifies to receive this service, it may make a huge difference in her life!

Have questions?  Send them to AskUs@marchofdimes.org

Note: This post is part of the weekly series Delays and disabilities – how to get help for your child. It was started on January 16, 2013 and appears every Wednesday. Feel free to go back to look at prior posts as the series builds on itself. As always, we welcome your comments and input.

What are related services?

Wednesday, March 13th, 2013

related-servicesAccording to the IDEA, the federal law which specifies how states provide early intervention services and special education, “Related services means transportation and such developmental, corrective, and other supportive services as are required to assist a child with a disability to benefit from special education.”

Simply put, related services can include, but are not limited to, any of the following:
 speech-language pathology and audiology services
• interpreting services
• psychological services
• physical and occupational therapies
• recreation, including therapeutic recreation
• early identification and assessment of disabilities in children
• counseling services, including rehabilitation counseling
• orientation and mobility services
• medical services for diagnostic or evaluation purposes
• school health services and school nurse services
• social work services in schools
• parent counseling and training

As you can see from the above list, there are many different kinds of services. In other posts I give you more details about some of these related services. In addition, you can view the law  and view the definitions of these services on the CPIR website. For now, it is important for you to know that these categories exist, and that if your child qualifies, he will most likely receive these services at no cost to you (although this may vary from state to state).

How can you get one or more related service for your child?

If you think that your child could benefit from any of the above services, he must be evaluated first. (In other posts, I discussed how to have your baby and toddler or child age 3 and older evaluated for free.) Once your child has been evaluated and you have met with the evaluator or team to discuss the results, they may recommend that your child receive one or more related service.  If so, the team will meet with you to create a document which will specify the services that your child will receive.  In my two prior posts, I explained these documents – the IFSP (for babies and toddlers) and the IEP (for children ages 3 and older). Remember, parents are active members of the team that creates the goals for your child!

How many kinds of related services can your child receive?

There is no cookie cutter formula that dictates what services a child may receive. The law requires that the interventions be individualized based on the child’s developmental delay or qualifying disability. Also, a child can receive related services if he is on a 504 plan (discussed in an upcoming post).

Where can you go for more information?

The CPIR website has a  complete discussion of related services which will answer a great many of your questions, including how related services are funded, how to get them for your child, who delivers the services, where they are held, etc. Also, Wrightslaw, has excellent information on this topic. It is a website created by experts Pam and Pete Wright that explains all of the laws you need to know to help your child. Definitely check it out.

Have questions?  Send them to AskUs@marchofdimes.org.

Note: This post is part of the new weekly series Delays and disabilities – how to get help for your child. It appears every Wednesday, and was started on January 16, 2013. Feel free to go back to look at prior posts as the series builds on itself. As always, we welcome your comments and input.

Early intervention for children ages 3 and older

Wednesday, February 6th, 2013

puzzleIn a prior blog post, I shared how to find early intervention services for babies and toddlers, up to age 3. In this post, I will tell you what to do if your child is between the ages of 3 and 21 years old.

Once your child turns 3, early intervention services are now called Special Education and Related Services, and your local school district becomes the provider of services to your child.

If your child had been receiving services in the babies and toddlers program, then usually the program administrator will help you with the transition to the local school district, if it is recommended that services continue. Each State is responsible for making sure that a smooth transition occurs between the existing program and that of the new preschool program.

If your child was not receiving services up until this point, you have not “missed the boat.” Often problems or issues are not evident until your child reaches school age or later. If you (or your child’s health care provider or teachers) suspect there may be a developmental issue or problem, you can request to have your child evaluated by your school district. The evaluation is free to you – it is paid for by your school district and federal funds.

How to request an evaluation

The request for an evaluation should be made in writing (ideally) but it can also be verbal. It should be sent to the Principal of your local school, or to the Special Education Administrator of your school district. Then, they should contact you and set up an appointment for an evaluation.

Who will test your child?

The evaluation may be done in one or more sessions and with one or more professionals, depending on your child’s needs. For example, the school psychologist may do some testing to determine your child’s educational and cognitive (thinking, memory, and reasoning) levels. Then he may or may not recommend that the speech therapist also screen your child in the area of language and speech. If your child is having trouble with fine motor skills, such as holding a pencil or feeding himself, he may also be evaluated by an occupational therapist. If there are gross motor concerns, such as walking, running or even catching a ball, then a physical therapist may be asked to evaluate your child, too. The school district will coordinate all of the screenings and soon you should be called back to hear the results from the professionals.

Will your child qualify for services?

To be eligible to receive services, your child must be found to be a “child with a disability” as defined by IDEA – the Individuals with Disabilities Education Act (a federal law). Keep in mind that a “developmental delay” is one of the qualifying conditions, at least up until the age of 5 in most states, and up to age 9 in others. So, it is not always necessary to “label” a child with a specific diagnosis, (especially if the testing is not conclusive) in order for him to qualify for services.

As the law stands today, the 14 qualifying conditions or disability categories are:
• Autism
• Deaf-blindness
• Deafness
• Developmental delay (subject to each state’s specific criteria, and usually only up to age 9 and sometimes younger)
• Emotional disturbance
• Hearing impairment
• Intellectual disability
• Multiple disabilities
• Orthopedic impairment
• Other health impairment
• Specific learning disability
• Speech or language impairment
• Traumatic brain injury
• Visual impairment

For more info on whether your child qualifies for services, see this description of the 14 qualifying categories.

Once you have reviewed the evaluation results, if you disagree with the outcome of the evaluation, you may choose to take your child for an independent (private) evaluation. You can request that the school district pay for it. Sometimes they do (but not always).

Once your child qualifies, what happens next?

If the testing shows that your child fits the criteria for receiving services, the professional team will meet with you to develop an Individualized Education Program or IEP. This plan will provide the details of the services your child will receive, including “related services” (speech, OT, PT, etc.) and supplementary aids and services (such as specific supports or changes to the curriculum to meet your child’s individual needs). The IEP will specify details about the services provided. It should include where and when your child will receive services, with whom (such as a therapist, teacher, specialist) and how often (eg. daily, weekly). Most importantly, the IEP’s goals should be clearly defined and measurable. In a later blog post, I will give you a lot more information about IEPs.

For a helpful snapshot of this process, read 10 Steps in the Special Education Process.  This sheet will help you keep track of where you are in the process.

Bottom line

If your child is struggling in a particular area, or if you just have that nagging feeling that something isn’t right, it is better to seek help earlier rather than later. By having an evaluation done, you will learn a great deal about your child. If he needs assistance, the sooner the help begins, the sooner he can improve.

Note: This post is part of the new weekly series Delays and Disabilities – How to get help for your child.

Updated April 2016.