For the physical therapist

How can pediatric physical therapy help?

The aim of pediatric physical therapy is to help children reach their maximum developmental dynamics and be more effective in their everyday activities. Pediatric physical therapy helps to improve fine and gross motor skills, balance, muscle strengthening and scope of movement. Through the improvement of motor skills, children are able to participate in various activities with their peers and become more socially involved, thus gaining. The pediatric physical therapist cooperates closely with the family and show them how important is their role in their child’s rehabilitation process. Through continuous training and advising, he family members become active participants in the therapeutic process, by learning special manipulations that will help them overcome other related problems such as feeding and communication.

What is early intervention?

Early intervention applies to infants and children from birth until the age of 3 and is  collective process that involves the engagement of physical therapists, occupational therapists and speech therapists depending on the needs of he baby. It is important for early intervention to be exercised inside a fully equipped centre in order for the therapists to be able to communicate and cooperate with each other. The aim of early intervention is to cure the symptoms or, at least, to improve their manifestation. The plasticity of the brain and the adaptability of the baby’s body help facilitate the work of early intervention.

What is prematurity? 

Premature is a baby born before the 37th week of gestation. Full-term is a baby born between the 38th and 40th weeks of gestation. The more premature a baby is, the higher the risk of suffering from various health problems, such as cerebral palsy, autism or mental disability. The weight at birth is another important factor that may increase the possibilities of a baby exhibiting health problems.

How will my baby need physical therapy?

It depends on the nature of the baby’s problem. The necessary rehabilitation period is decided by the doctor who records the baby’s progress after consultation with the therapist. A general answer might me until the child acquires quality gait and is able to communicate verbally or non-verbally at a level appropriate for their age.

What is cerebral palsy?

Cerebral palsy is a condition that was caused during gestation or at birth. The damaged caused to the brain may affect movement, balance and posture and may also be accompanied by a variety of other problems, e.g. vision, hearing, speech and perception.

What is hypotonia?

Hypotonia is a state of low muscle tone, often involving reduced muscle strength. Hypotonia may be caused by numerous causes. Recognizing hypotonia, even in early infancy is usually relatively straightforward, but diagnosing the underlying cause can be difficult and often unsuccessful. The diagnosis is made by the neurologist. The long-term effects of hypotonia on a child’s development and later life depend primarily on the severity of the muscle weakness and the nature of the cause. The principal treatment of hypotonia is physical therapy.

What is hypertonia?

Hypertonia is a condition marked by an abnormal increase in muscle tension and a reduced ability of a muscle to stretch. The increase in muscle tension decreases the muscle’s ability to stretch thus reducing the scope of the movement. The excessive increase in muscle tension may cause spasticity. The principal treatment for hypertonia is physical therapy. Injections of botulinum toxin are a recent treatment for acute hypertonia and are administered by the doctor or surgically. Long-term hypertonia may cause deformations to the spinal cord and therefore, early diagnosis is very important.

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For the occupational therapist

Why is my child not paying attention to me (is disobedient) and does not sit still?

The most common cause for that is that your child suffers from some type of dysfunction that prevents them from limiting their reaction to the sensory stimuli within the normal limits, that is, to control themselves in order to respond according to the expectations of any given social environment (sensory regulation). The sensory experiences include touch, movement, body awareness, vision, hearing, taste, smell and gravity. The process followed by the brain in order to organize and interpret these experiences is called sensory integration (S.I.). Sensory integration provides the basis for future learning and behavior. For most children, sensory integration develops within the framework of pre-school children’s activities. This procedure results naturally in the ability of motor programming and in the ability to adapt to the incoming stimuli. For some children, however, sensory integration does not develop to a satisfactory level. When this process is disturbed, children exhibit various developmental, learning and behavioral problems.

Why is my child clumsy, prone to accidents, often injuring himself or destroying objects?

Children do not use their brains the same way as the adults. The lower brain centers that are responsible for motivation, movement, emotions, smell and experience collection are “too busy” in their search for stimuli so as to organize in order to perceive their surrounding (the environment). The images, as perceived by the children, are not completed, since their brain is not sensory integrated, thus tending to seek stimuli that will help them adapt. During this search for stimuli, they are attracted by experiences that they can are more “tactile”, that they can experience in a rather physical way.  During this process, they collect and feed their kinesthetic awareness, i.e. the sense that encompasses the body’s abilities to coordinate motion and respond to gravity and their proprioception awareness, i.e. the sense that receives information from the muscles and the tendons. These systems are responsible for the functioning of the ocular movements, posture, balance, muscular tone, stability against gravity and, when matured properly, in coordination with touch they are responsible for: body awareness, motor synchronization, activity levels, attention length and emotional stability. The final “product” of this integration process is focus, organization, self-esteem, self-containment, metal skills and the specialization of the brain hemispheres and the sides of the body. It is therefore common for children who act like your child, suffer from some type of dysfunction of the kinesthetic-poprioception awareness.

Why does my child only eat specific types of food, wears specific clothes or screams during bathing, nail or hair cutting?

Probably your child is expressing his negative reaction to certain types of tactile stimuli due to his inability/difficulty to process the information that is received. People who suffer from this type of deficiency exhibit inability to “translate” the emotional meaning of these tactile experiences in a manner appropriate for themselves and their environment.

They avoid touching certain types of fabric, participating in activities that involve touching other people, they prefer to stand at the end of the queue, they avoid and react negatively to hugging or other expressions of affection, they avoid certain everyday activities (washing their hair or face, brush their teeth) and avoid construction materials such as paint or sand. They exhibit atypical emotional reactions to some tactile stimuli, such as soft touching of the hands or face, high stress when they are close to other people, denial, withdrawal.

Why does my child show obstinacy, avoids playing with his peers, is irritable, avoids new experiences or exhibits manipulative behavior?

Most likely, the child has difficulty in programming and executing correctly skilful and unknown activities or he may be suffering from some type of developmental coordination deficiency (dyspraxia). Some of the elements that that may alert you are the following: clumsiness, poor tactile discrimination, underdeveloped body imaging, slow learning of everyday activities, gross motor problems, difficulties with sports, constructive or exploratory games or difficulties with fine motor skills during the manipulation of objects, difficulties in writing, spelling and speaking and learning disabilities. Children who present such problems also exhibit low self-esteem, irritability, they tend to avoid new experiences, they show manipulative behavior, they prefer talking rather than acting, they tend to act at a slower rate, they forget and, in general, they are quite disorganized.

What can be done?

The occupational therapist or physical therapist can evaluate any child suspected to suffer from any type of sensory integration problems. Such process involves the application of a valid evaluation test and monitoring the child’s reaction towards sensory stimulations, his posture, movement, balance, coordination, ocular-motor skills etc. The therapists will then suggest the appropriate therapeutic program after careful evaluation of the test results and after consultation with other experts and the parents. The program will direct the child towards direct the child towards specific activities that will challenge his ability to appropriately respond to the various sensory stimuli in order to produce (create) a successful and organized answer.

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For the speech therapist

What is the right age for a child to attend speech therapy sessions?

Any child suffering from speech problems (speech delay) may attend a speech therapy program from the age of 2.5-3 years. It is however useful for the child to attend a speech therapy program at an earlier age if they show trouble feeding or swallowing.

What are the most common phonetic and articulation errors? How long does it take to correct the?

The most common phonetic and articulation errors are:

bullet black  phoneme omission (simplification of complex phonemes), e.g. “chool” instead of “school”

bullet black  phoneme replacement, e.g. “faver” instead of “{father”

bullet black  etter interchanging, e.g.” olny” instead of “only”

bullet black  stuttering (a speech disorder in which sounds, syllables, or words are repeated or prolonged, disrupting the normal flow of speech) e.g. “fafafather” instead of “father”

bullet black  Tachylalia (extremely rapid speech)

These dysfunctions inhibit school performance and adaptation and may be corrected with special and systematic speech therapy sessions two or three times a week. It is not easy to predict the time needed to cure such dysfunctions, since that varies from child to child and their level of coordination during the speech therapy sessions.

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