Physical therapists assist in early detection of health problems and use a wide variety of modalities to treat disorders in the pediatric population. They are specialized in the diagnosis, treatment and management of infants, children and adolescents with a variety of congenital, developmental, neuromuscular, skeletal, or acquired disorders/diseases. Treatments focus on improving gross and fine motor skills, balance and coordination, strength and endurance, as well as cognitive and sensory processing/integration.
The minimum education required for Physical Therapists is a masters level degree with most programs transitioning to a doctoral program. The curriculum consists of, but is not limited to, the following courses: Gross Anatomy, Neuroanatmoy, Musculoskeltal Analysis and Treatment, Pharmacology, Development Across the Lifespan, Modalities, Wound Care, Orthopedics, Orthotics and Prosthetics, and Neurodevelopmental Therories and Treatment Across the Lifespan. Physical therapists are required to complete a series of rotations that encompass all the specialties in their field. This provides a global understanding of medical conditions and other health related issues that limit function and ability in individuals of all ages. Pediatric physical therapists specialize in working with children from birth to age 21. Pediatric P.T.'s take additional specialized course work (classes) that focus on pediatric diagnoses and treatment, along with a pediatric rotation prior to graduation. Following graduation from a masters or doctoral program, physical therapists are required to take a state licensing exam prior to practicing in their related field.
Physical Therapists can help with the following diagnoses:
Incoordination and balance
Hypotonia (Developmental Delays)
Musculoskeletal Injuries (back/neck pain, muscle strains, ligamentous sprains)
Brachial Plexus Injuries
Genetic or Metabolic Disorders
Foot dysfunctions (pronation/supination)
Adaptive Equipment Assessments
Occupational therapists are trained to assist children in developing the skills necessary to become functional. These skills include regulation of arousal level in order to attend, refinement of sensory discrimination and processing, continual refinement and development of motor skills, development of communication skills, appropriate social interactions, language and cognitive skills, age appropriate self-care skills, and self-concept.
The American Occupational Therapy Association defines occupational therapy as, "a skilled treatment that helps individuals achieve independence in all facets of life." Occupational therapy is considered an allied health profession. Coursework includes, but is not limited to: Gross Anatomy, Neuroanatomy, and training in Biological, Physical, Medical, and Behavioral sciences. Occupational therapists complete fieldwork that allows them to work hands on with a variety of diagnoses and specialties prior to graduating. O.T.'s specialize in areas of clinical work that include pediatrics, geriatrics, mental health, and orthopedics. Pediatric O.T.'s work specifically with children from birth to age 21 in various settings. O.T.'s are required to take a state licensing exam prior to practicing in their related field.
Occupational Therapists can evaluate and treat the following areas:
Sensory Processing Disorders
Autism Spectrum Disorders
Dyspraxia and motor incoordination
Low muscle tone and weakness
Attention Deficit Disorder / ADHD
Fine motor and visual motor delays
Oral motor delays
Speech Therapy/Feeding Therapy
A master’s degree in speech-language pathology is required and SLPs need state licensure and professional credentialing from the American Speech-Language-Hearing Association in order to practice. SLPs develop an individual plan of care tailored to each client’s needs. A variety of skilled techniques are used to improve expressive and receptive language. They also teach individuals how to strengthen oral musculature for both speech and swallowing. Speech course work includes anatomy, physiology, the development of areas of the body involved in speech, language, and swallowing, and the nature of disorders. Pediatric SLPs take additional specialized course work that focuses on pediatric diagnoses and treatment, along with completing a pediatric rotation prior to graduation. Continuing education is required as part of both state and national licensure.
Speech/language evaluation and treatment may address:
- Apraxia of Speech
- Articulation and Phonology
- Assistive Technology/Augmentative Communication
- Auditory Processing Disorders
- Expressive/Receptive Language
- Fluency or Stuttering
- Pragmatic/Social Skills
- Vocabulary Development
- Voice Quality/Disorders
- Dysphagia: feeding and swallowing disorders
- Oral Motor Delays (including tongue thrust and drooling)
Diagnoses that frequently warrant speech/language therapy include:
Speech Language Milestones
- Autism Spectrum Disorders
- Specific Language Impairment
- Cerebral Palsy
- Sensory Processing Disorder
- Seizure Disorders
- Down Syndrome
- Attention Deficit Disorders
- Learning Disabilities
- Developmental Delays/Disorders
- Cleft Lip/Palate
- Deaf/Hard of Hearing
- Genetic Disorders
Specialty Speech Services Available at Abilitations Include:
1. Neuromuscular Electrical Stimulation for Swallowing (NMES, Vital Stimulation): NMES is provided only by a certified therapist to improve oral (mouth) and/or pharyngeal (throat) swallowing function to patients with dysphagia. Electrical stimulation is provided to target muscle groups based upon a bedside swallow evaluation and instrumental swallow studies including modified barium swallow studies (MBSS) and fiberoptic endoscopic evaluation of swallowing (FEES). NMES is applied to the face and/or throat to address a patient’s individual needs. NMES is utilized in conjunction with traditional swallowing therapy to maximize recovery and therapy effectiveness. Patients who may benefit from NMES commonly have concerns with pocketing food, difficulty swallowing food, coughing/choking while eating or drinking, G-tube dependence, penetration and/or aspiration, oral and/or pharyngeal residuals, and/or drooling.
Link: What is Vital Stim?
2. Comprehensive Pediatric Dysphagia Programs: Several of our SLPs have completed continuing education and certification programs, including NOMAS, and mentorship programs, including an advanced training program with UNC’s multidisciplinary feeding and swallowing team. The Neonatal Oral-Motor Assessment Scale (NOMAS) is a specialized evaluation tool for assessing the sucking patterns in preterm and term infants. It can be completed only by a trained, certified practitioner. Several of our team members have focused on the treatment of infants, toddlers, and school-aged children with feeding and swallowing disorders. At Abilitations, we are fully equipped to address feeding and swallowing concerns across the continuum and lifespan including difficulties with choking while eating or drinking, spoon feeding, gagging with textures, transitioning to table foods, texture aversion, immature chewing, picky eating, and G-tube dependence.
Parent Handouts: Oral Motor Feeding Treatment
3. McNeill Dysphagia Therapy Program (NDTP): NDTP is a systematic, exercise-based rehabilitation framework for the treatment of swallowing based upon research from exercise physiology principles. It has been shown to be a successful treatment for patients with mild to severe oropharyngeal dysphagia, including patients with a lengthy history of G-tube dependence. This program can only be skillfully implemented by a certified therapist.
4. Prompts for Restructuring Oral Muscular Phonetic Targets (PROMPT): PROMPT is a specific evaluation and treatment program provided only by a trained or certified therapist to retrain the motor speech system by utilizing tactile, kinesthetic on-line shaping of target phonemes (sounds) to improve the motor planning and provide the motor input needed to produce intelligible speech at the word, phrase, and sentence level. PROMPT has been shown to be effective at correcting errors with consonants and vowels.
PROMPT parent handout
What is PROMPT?
5. Picture Exchange Communication System (PECS): PECS is a picture-based system for establishing and developing communication exchanges for children with autism spectrum disorders and developmental delays. PECS can only skillfully be implemented by a trained and/or certified therapist due to the specificity of the six phases involved to ensure mastery of the system.
What is PECS?
6. Aural (Re)habilitation: Aural (re)habilitation may include (re)training auditory perception and awareness of sounds in the environment, developing/improving oral speech communication, and expanding the language base for children who are deaf or hard of hearing. One of our SLPs is conversationally fluent in American Sign Language (ASL) and has worked extensively with the deaf and hard of hearing population.
7. Voice Therapy: Pediatric voice therapy is for children who have been seen by an ear, nose, and throat specialist (otolaryngologist) and have a specific prescription for voice therapy. It is critical that they are seen first seen by a specialist, so that the structures of the ear, nose, and throat have been fully assessed by the physician and deemed appropriate for therapy. These are typically disorders of vocal misuse, vocally abusive behaviors, or pre and post voice surgery, as deemed appropriate by the referring physician. The SLP who does voice therapy focuses on good vocal health and hygiene habits, and incorporating them into the child’s daily speaking environment.
In North Carolina, by law, the term "nutritionist" may only be used if someone has met the requirements set forth by the State of North Carolina and is Licensed by the State of North Carolina.