What is Pediatric Physical Therapy?

What Do Pediatric Physical Therapists Do?

Physical therapists (PTs) are strength and movement experts. They can help children

• Achieve movement milestones such as sitting up alone or crawling
• Learn to walk or climb stairs
• Navigate around their classrooms safely
• Develop and improve muscle strength
• Manage pain related to muscle and joint issues
• Improve balance and coordination
• Learn to use prosthetics and orthotics
• Learn to use mobility devices such as walkers or wheelchairs
• Improve their cardiovascular endurance

PTs help kids become as independent as possible with movement as they grow. And they can teach parents strategies to help their kids overcome movement challenges at home or in school.

Many of the children that PTs treat have a history of

• Birth defects
• Genetic conditions like Down Syndrome
• Traumatic brain injuries, spinal cord injuries or sports injuries
• Prematurity
• Developmental disabilities like autism
• Muscle weakness or spasticity
• Sports injuries
• Hypertonia or hypotonia (high or low muscle tone)
• Neuromuscular disorders like cerebral palsy
• Pain related to muscle or bone injuries
• Burns
• Orthopedic surgery such as back surgery for scoliosis
• Torticollis, head flatness or other issues related to movement and positioning

But your child does not need to have a diagnosis in order to benefit from PT. PTs are excellent problem solvers and can help get to the bottom of your child’s movement and pain issues even if they don’t have a formal diagnosis.

Physical therapists also prescribe adaptive equipment and mobility devices. Some examples are

• Leg braces
• Orthotic inserts for shoes
• Wheelchairs, canes, or walkers
• Seating systems for eating, riding in a car, or sitting at a desk
• Equipment to help make dressing easier
• Equipment for better positioning during sleep or while sitting up in a chair

How Are Pediatric Physical Therapists Trained?

Most PT programs require students to get a bachelor’s degree before applying. Some programs are combined undergraduate and graduate programs which allow students to earn both types of degrees.

Future PTs must earn a Doctor of Physical Therapy degree (DPT) from an accredited graduate program.

DPT programs usually take about 3 years to complete. PT students take classes related to anatomy, physiology, exercise physiology, biomechanics, kinesiology, neuroscience, psychology, and musculoskeletal disorders, among other subjects.

While in school, PT students complete several hands-on, full-time internships where they take on increasing responsibilities. This allows them to learn to evaluate and treat real patients in a variety of environments before they ever apply for their first job.

After graduating from school, PTs must pass a national board exam before beginning their professional practice. Then they must apply for state licensure.

PT credentials

PTs sign their names using abbreviations that signify their profession, their highest degree, and any specialties that they have.

For instance, a physical therapist who has a doctorate would have a signature similar to Jane Doe, PT, DPT.

A physical therapist who is a board-certified clinical specialist in pediatrics might sign their name Jane Doe, PT, DPT, PCS.

Continuing education and specialization

While continuing education is required to maintain state licensure, most pediatric PTs would prioritize continuing education even if it wasn’t required.

Many pediatric PTs specialize in areas such as Neurodevelopmental Treatment, aquatic therapy, NICU therapy, and sports medicine.

They focus their continuing education on these areas and become experts over the course of their careers.

Some therapists take it a step further and get advanced certifications. However, the lack of certification credentials does not mean a lack of specialized knowledge.

Most pediatric PTs take continuing education courses in a variety of specialty areas without pursuing certification.

If you are wondering if your child’s PT specializes in a specific therapy approach or diagnosis, just ask. If the answer is no, she will most likely be able to refer you to a therapist who does.

Is Pediatric Physical Therapy Supported by Research?

Yes, evidence-based practice is the cornerstone of physical therapy.

Evidence-based practice in pediatric physical therapy combines scientific studies, established care guidelines, and the therapist's hands-on experience.

In addition to using ideas from physical therapy research studies, pediatric PTs pull insights from research and practice approaches from other fields such as

• Child development
• Education
• Psychology
• Occupational Therapy
• Sports Medicine
• Mental Health
• Neuroscience
• Sociology
• Orthopedic Medicine

This well-rounded approach ensures that your child's treatment covers every aspect of their development and overall health.

What Age Groups Do Pediatric Physical Therapists Treat?

Pediatric PTs treat all ages and tailor their approaches to meet the unique developmental needs of each age group.

• Newborns (0 - 1 month): When treating newborns, PTs focus on positioning and teaching parents strategies to support emerging head control. They help parents learn to motivate their babies to move and explore their environments during waking hours.
• Infants (2 months - 1 year): PTs help babies develop the strength and coordination necessary to achieve motor milestones such as rolling, sitting, and standing. They teach parents strategies for helping their children overcome movement challenges.
• Toddlers (1 year - 3 years): Therapists use playful activities to engage toddlers in activities that promote strength and coordination for improving skills like standing, walking, and climbing stairs. They can prescribe orthotics, prosthetics, and mobility devices for toddlers who need them. They can teach parents how to use specialized equipment and help with transfers (such as from a car to a wheelchair).
• Preschoolers (4 years - 5 years): Physical therapists help preschoolers by improving their motor skills through fun activities. They address issues like balance and coordination. PTs work closely with families and teachers to promote independence with movement.
• School-Aged Children (6 years - 11 years): PTs can prescribe exercises and activities to help school-aged children recover from sports injuries. They can train kids to use mobility equipment and braces at home and in school independently. They also work with children with more intense motor needs to achieve movement milestones they may have missed.
• Adolescents (12 years - 18 years): PTs can help teenagers recover from sports injuries so they can safely participate in sports again. They can help children with pain management due to spasticity or surgeries. They can work with children in school to improve their independence in navigating their classrooms.
• Young Adults (18 - 24 years): PTs can help older teenagers become more independent with the transition to college or work. PTs continue to work with parents to identify strategies that can help their children become more self-sufficient during this transitional period.

Where Do Pediatric Physical Therapists Work?

You’ll find pediatric PTs throughout your community. The most common places they work are

• Hospitals: PTs focus on recovery from illnesses like cancer, as well as rehabilitation from traumatic brain and spinal cord injuries. They also assist in rehab after surgery, such as following back surgery for scoliosis. Some hospitals have outpatient pediatric clinics, as well.
• Outpatient Clinics: PT clinics have specialized equipment for treating more intense motor needs. Outpatient PT clinics look more like indoor playgrounds than regular doctor’s offices.
• Schools: PTs provide individual or group therapy either in the child's classroom or in a dedicated PT space. They work on skills that help children succeed with the movement demands of school.
• Preschools and Daycares: PTs help children in preschool adapt to movement challenges at school, participate in simple routines, and develop physical play skills.
• Home-Based (Mobile) Therapy: Many PTs provide therapy in children’s homes. Government-subsidized early intervention therapy is always provided in a child’s natural environment (home or daycare) unless there is a significant reason to see the child in a clinic setting. Home-based PTs can see children of all ages at home.
• Outdoor Therapy: Some PTs offer group or individual services provided entirely in nature. Being outside gives kids the freedom to test their motor skills by negotiating unpredictable obstacles found only in nature.
• Virtual or Online Therapy: PTs can work with your child through online teletherapy platforms. They can also consult with parents and teachers online.
• Consultation: PTs can consult directly with parents and teachers in person or virtually. They can help problem-solve movement issues and provide support strategies for home and school. PTs are often asked to consult with schools and community organizations about building accessible classrooms and playgrounds.

What Types of Issues do Pediatric Physical Therapists Treat?

Pediatric PTs are trained to handle a wide range of issues that children might experience, making it easier for them to navigate daily life. Here's a look at some common areas they focus on.

• Motor Skills: PTs help kids learn to navigate playground equipment and use assistive devices like wheelchairs in order to become independent with movement.
• Pain Management: PTs can help identify activities and positions that limit pain after an injury or surgery. They can provide specific exercises that improve pain related to a variety of conditions.
• Daily Living Skills: Physical therapists can help your child be more independent with basic life skills like dressing and packing a backpack.
• Adaptive Equipment: PTs can recommend specialized tools and equipment such as braces, orthotics, and walkers. They can also teach kids how to use their equipment independently.
• Strengthening: PTs can prescribe exercises to improve a child’s strength after an illness or injury. They can also help children with hypotonia improve their baseline muscle strength.
• Endurance: PTs can help your child improve their cardiovascular endurance for sports or just for life in general.
• Obesity Management: Physical therapists can prescribe exercise and activity programs for home and school to help children with obesity stay active.

Could My Child Benefit From Physical Therapy?

PT could be beneficial for your child if they are experiencing any of the following issues.

• Struggling with Daily Tasks: If your child has difficulty performing basic activities like getting dressed, walking independently, or having enough endurance to get through the day, a PT may be able to help.
• Pain: If your child has pain related to an injury, surgery, or spasticity, a PT evaluation may be beneficial.
• Difficulty with Mobility At School: A PT can help your child if he is having trouble navigating his classroom, school hallways, or bathrooms independently.
• Motor Skill Delays: If your child is weak, struggles with coordination, or is just having difficulty meeting their movement milestones like walking or crawling, PT can help them improve.
• Poor Coordination: PTs can help kids improve their strength and body awareness for better motor coordination.
• Vision or Hearing Challenges: Children with vision and/or hearing deficits often have difficulty with balance and coordination. Physical therapy can help them navigate their environment better even without the full use of their visual or auditory systems.
• Sports Injuries: A PT can be your child’s greatest resource when recovering from an injury that impacts their ability to participate in sports. Physical therapists can also teach your child strategies for preventing injuries while practicing and playing.
• Limited Range of Motion: If your child has difficulty moving a part of their body or has a condition like torticollis or flatness on one side of their head, a PT can help.
• COVID Learning Loss: If your child has strength or coordination deficits related to the life disruptions that happened during the COVID-19 pandemic, PT may be beneficial.

If you think your child is struggling, trust your instincts. You know your child best.

Most pediatric PTs offer free 15-minute phone consultations, so feel free to reach out to one about your child’s issues. They can help you figure out if an evaluation is necessary and help you determine the next steps.

Talk to your child’s pediatrician as well. They can provide advice and guidance about therapy. You’ll likely need a prescription from the pediatrician before you begin therapy, especially if you are using insurance.

If your child has an Individualized Education Plan (IEP) at school, you may be able to request a PT evaluation from his special education team.

How Do I Pay for PT for My Child?

PTs accept the same payment methods as any other healthcare professional. Some examples are

• Insurance: Most PTs accept some form of insurance, whether it's commercial insurance like Blue Cross Blue Shield or public insurance like Medicaid.
• State Programs: Some states offer grant programs or waivers that can subsidize or completely cover the cost of therapy for children with specific diagnoses, such as autism.
• School Districts: If your child has an Individualized Education Plan (IEP), your school district may provide physical therapy as part of their educational program.
• Fee-for-Service Therapists: Some PTs operate on a cash basis, meaning they don't accept insurance. These therapists won't file insurance claims for you, but they offer the flexibility of paying out-of-pocket.

Always ask your child's therapist about payment options, as many therapists offer sliding-scale payment plans for families who qualify.

How Do I Find the Right Physical Therapist for My Child?

Start with A prescription

In many places, pediatric physical therapy requires a prescription from your child's doctor, especially if you plan to use insurance to pay for treatment. Your pediatrician can often point you to trusted therapists they've collaborated with in the past.

Early intervention services

For children aged 0 to 3, check out early intervention programs available in your state. These services include physical therapy and can help you get it set up for your child.

Word-of-mouth and personal recommendations

Talk to other parents whose kids have had physical therapy. Their firsthand experiences can give you valuable insights into a therapist's approach, specialties, and personality.

Ask a teacher

If you know a teacher or trust your child’s teacher, ask them for PT recommendations. There’s a good chance that a teacher you know has heard about a good physical therapist who could help your child.

Ask a coach

Your child’s coach or athletic trainer may be a great resource for helping you find a good physical therapist for your child. Chances are they have worked with several over the course of their career.

Search online

General online search results can be disappointing, but a specialized pediatric therapy directory can give you fast access to qualified therapists in your area. This is especially useful if you're new to therapy and don't have personal recommendations to rely on.

It's important to find a therapist who can build a strong rapport with your child. Most PTs offer free 15-minute phone consultations. Take advantage of that and talk to several before you commit to one.