Pediatric Physical Therapy

Pediatric Physical Therapy

Pediatric Physical Therapy:

Focusing on the Whole Child

by Gail A. Hatch

Editor's Note: Many blind children today have

additional disabilities. It is not uncommon for a blind baby, toddler, preschooler, or

older child to work with many different specialists, such as an occupational therapist, a

speech therapist, and a physical therapist. The physical disabilities which create the

need for these services may vary from mild and eventually correctable, to profound and

life-long. The following article was submitted by Carol Castellano, a frequent contributer

to this magazine and a national and state leader in the National Organization of Parents

of Blind Children. Her daughter, who currently has no other disability besides blindness,

needed physical therapy for several years. Carol found the following approach and

information helpful and wanted to share it with other parents and professionals. Here it

is:

As a pediatric physical therapist, my goal is to

facilitate functional and efficient movement in a child and to promote motor development.

During my training and education, however, I realized the need for a more holistic

approach to physical therapy. A child is more than just a group of muscles. A child is an

individual with a set of interacting emotions, physical and mental capabilities. In

addition, a child is an integral part of a large system of relationships which strongly

influence the child's development.

In order for a child to move, suggests Esther

Thelen, psychologist and author of many research articles, the child's perception,

motivation, and sense of well being interact with the system of bones and muscles. Since

the child's relationships affect his or her motivation and self-esteem, the therapist must

be sensitive to them. As a pediatric therapist, I interact with parents, siblings, and

peers, as well as with the child. Families have different cultural and religious beliefs,

structures, and expectations, all of which have an impact on the child and all of which

must be respected.

I am a professional coming into the life of the

family to help mold motor development. I need to gain the parents' trust. The reaction of

parents is very important because it will be directly reflected to the child, who must

also have a trusting relationship with me, in order for therapy to be effective.

As a professional working with children and

parents, therefore, I must respect the family's needs, priorities, and goals. I can help

parents focus on their child's abilities, not limitations, in an effort to support their

bond with each other and to set expectations and goals. Depending on the needs of a parent

or child during a particular session, motor goals may become secondary. Work on motor

skills at a time of great stress for the family may not be of greatest benefit.

I have utmost respect for parents of children

with special needs. I try to bolster their strength, support their efforts, and empathize

in their moments of grief. Many parents have questions about their child's abilities which

they need to have answered in order to set goals. Many times, I share a family's stress

when they hear a diagnosis or when they have one more overwhelming doctor's appointments

to attend. In the midst of all this, parents are trying to develop a bond with their

child, a child who may not be able to respond easily. I have felt helpless during times of

great difficulty for a family and have wished that I could predict success for the child.

I wish that I always knew the right things to say and that I could do more than just

listen and offer support.

Parents are the most competent people in their

child's life. Much of the success the child demonstrates is attributable to the parents'

work, since the parents are with the child so much of the time. The other part of success

is attributable to the child's hard work. Every child has abilities and these need to be

emphasized and built upon. Parents and children have their own needs, priorities, and

goals, and as a professional dealing with the whole child, I must respect these. For it is

only then that I can truly say that I have done the best I can for the child.