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Play Today, Better Tomorrow: Benefits of Pediatric Physical Therapy
Corrine Pearl, PT, DPT discusses the benefits of pediatric physical therapy.
Featuring:
Corrine Pearl, PT, DPT
My name is Corrine Pearl. I grew up in small town Ridgecrest, CA and saw first hand the lack of pediatric resources in this town. I attended Burroughs High School where I played softball all four years. In high school I injured my bicep and went to physical therapy, which is where my interest for the profession began. I attended York College in York, Ne for undergrad where I majored in Biology and received my BS. I would come home over summer and winter breaks to shadow at a physical therapy clinic in town, which is when I further realized that pediatric therapy was a much needed service in Ridgecrest. For PT school I had the privilege to attend the University of Nebraska Medical Center and graduate from the first class on the Kearney campus with my DPT. In PT school my love and passion for kids intensified and I knew I wanted to do peds. I chose two different pediatric rotations to gain more experience working with tiny humans in a school setting and in a clinical setting. I learned a lot about kids, but most importantly I learned more about myself. I knew peds was my "calling", and I knew I wanted to bring peds back to my hometown. After passing boards, I returned home to fulfill my dream of starting pediatric PT in Ridgecrest. I have been working for the hospital for a year now (Sept 2019), but I started as the inpatient and SNF therapist. I moved to pediatrics after a colleague relocated about four months ago (June 2020). I am excited that the peds clinic is now officially up and running for the hospital and this service can be provided to a town in desperate need of pediatric therapy. Transcription:
Prakash Chandran (Host): October welcomes the start of physical therapy month. Today we’ll be learning about how physical therapy can help our pediatric population. We’re going to talk about it today with Corrine Pearl, a pediatric physical therapist at Ridgecrest Regional Hospital. This is the Ridgecrest Regional Hospital podcast. I'm Prakash Chandran. So first of all, Corrine, it’s great to have you here today. Just starting with a very basic question. What exactly is pediatric physical therapy?
Corrine Pearl, PT, DPT (Guest): Peds therapy is working with kiddos that have—Most of them have developmental delay. So you're helping them reach those developmental milestones as rolling over as kids or walking when they're infants to either running, jumping, just really big gross motor skills. That’s kind of the bulk of physical therapy, but we also deal with a lot of kids with mental disabilities and kind of help them through that process with what they’ve got going on physically as well.
Host: I see. One of the things that we talked about before we hit record is that it’s also Down syndrome awareness month. Is that something that physical therapy can also help with?
Corrine: Absolutely. Kids with Down syndrome they’ve got a lot of different physical abilities, but there's also a lot of developmental disabilities that come with Down syndrome. Some of them start off not being able to stand up when they're infants. With PT, you can help them kind of accomplish that with different techniques and different tools. Then kind of continuing on all the way up until they're even 21 years old, which that’s something I didn’t mention earlier is that pediatric therapy covers birth until 21 years of age. So anywhere along that timespan in a child’s life, with Down syndrome we can cover that and go over anything that they might accomplish. Another thing with Down syndrome is that they get poor endurance. So kind of giving them some activity tolerance and working on their physical capabilities to do P.E. in school or to climb stairs on road trips with family and stuff like that. Just to give them a better quality of life is something that we really like to focus on.
Host: Absolutely. I didn’t realize that the age range was so vast. That you kind of worked with children up to the point that they're 21 years old. They're kind of young adults at this point. I'm curious as to when this child might need this type of physical therapy and what prompts the parents to bring them in in the first place.
Corrine: So for most babies—I could speak to just the baby population right now with diagnoses such as torticollis, coming in plagiocephaly—having a flat spot on their head—bringing them in and it’s kind of a lot of parent education at that point on handling techniques to help with doing crib positioning and feeding positions and stuff like that to kind of get that head in a different shape with more rounded head shape to it, with strengthening of their neck muscles and stuff. With kids with Down syndrome coming in that early, when they go to their pediatrician with concerns of ability to roll or ability to push up onto their arms when laying on their stomachs for crawling and stuff like that. We have tools that we can use to help those kids meet those milestones and kind of get them moving through play. So pediatric therapy is kind of learning through play. That’s kind of how kids developed those neurological pathways in their brain. So coming in and setting up an environment that’s fun and inviting is going to have them succeed while also doing therapy in a way that they don’t realize that they're doing it.
Host: Learning through play. I like that. One of the things that I wanted to ask you about is as a parent myself, I track all of the milestones that my daughter is doing through or had been going through. That’s lifting their head up, learning how to crawl and learning how to walk. For the parents that are listening to this that are wondering when it might make sense to bring their child in, is it around trying to get them to walk if they're a little late in achieving that milestone? Talk to us a little bit about that.
Corrine: Absolutely. Especially for our late walkers, typically around that 12 months is when they're starting to pull to stand. So that means they're on the floor and they're grabbing on to furniture and pulling up to stand. Then right around that age is when they're cruising along furniture. So they're walking side to side to play with toys along the couch or pushing a push toy kind of down the hallway. So if around that 12 month age your child is not able to do that, that’s definitely kind of like a red flag to say, “Hey I might need to take my child down to the pediatrician and say I've got a late walker here. Hasn’t started standing up. Hasn’t been cruising along furniture.” Then especially if you’ve hit that 18 month mark six months down the road of not walking by him or herself independently, that’s kind of when that concern kicks in and the pediatrician can say, “Absolutely. We’ll send him to PT and kind of see what they can do for him.”
Host: I see. You know, I know just going to physical therapy myself as an adult, there's always exercised and things I have to do outside of the session itself. So I imagine that is no different for children. When the child is at home, are there things that parents can do to help their child’s development as they go through physical therapy?
Corrine: Most definitely. With kids, it’s even more important because they're learning at such a fast rapid rate. Kids are like sponges. They soak up everything you're doing. So the majority of the legwork is done in the home. We’ve got handouts that we provide with parents so that they can learn the proper tools and techniques to kind of help their child succeed with those developmental milestones. Since most of the legwork is done at home, a lot of it is education like I talked about earlier with kids and handling and kid positioning and stuff like that so that the parents can provide that most successful home environment for the kids to learn. It’s all done through play like I said earlier. So setting up toys along the couch in the l-shape sofa and having the kid go from one end of the couch all the way to the other end by putting toys along there just so that the kid is playing through that but also learning to walk at the same time.
Host: You know, I imagine that when parents come to physical therapy, there is kind of an implicit sense of frustration or just a little bit of concern because they're comparing their children with those of their peers. So what advice might you have to help them cope with those feelings when they come in or when they have a child that’s going through physical therapy.
Corrine: Right. Absolutely. So one of the things that I've noticed here recently more so than in the years past is that when I see a kiddo say once every week even, they actually have made progress towards every goal that I've ever put down just because kids do grow up at rapid rate. When parents are home and they see them every day, they're with them 24/7, it’s really hard for the parents to see that change. So what I like to do is say take a video. Take a video of your kid who’s not able to stand up right now, and the first time that he is able to stand up on that sofa take that video. Then the next time two weeks down the road when he’s here at therapy and takes his first step, take another video that way you see the progress being made. It’s just progress maybe two weeks down the road, but you're still making progress because the kids aren’t going to see it on the daily basis. Versus an outsider’s eye seeing it once a week, once every other week you definitely do see that progress. So that’s one thing that I would tell my parents is take videos along the way, take pictures along the way of the progress your child has made and look back at the timeline, see how far they’ve truly come.
Host: Yeah, that’s good. Setting those markers so you can easily see how far they’ve come and how far they’ve progressed. One of the things that I wanted to ask you about was the actual physical therapy session itself. Can you walk us through a typical session?
Corrine: Absolutely. So I’ll start with the evaluation. It’s typically longer. Depending on the diagnosis, it could be half an hour to 45 minutes. With infants and babies, they only last about that 30 to 45 minute marker just because they get fussy, they're tired, they're hungry, they need a diaper change. With kiddos that are a little bit older, typically it’s around an hour. You go through standardized testing. There's a lot of different tests out there as pediatric therapists that we perform that puts kids in a category, per say, for their age equivalence. What they're currently functioning at according to other peers in their age group. So we do a lot of assessment tools that way and with just different gross motor tasks involved in it. We’re always looking at their posture and their alignment, making sure that their muscles and their bones are in correct alignment so that everything can work properly. If it’s not then we can address that through orthotics or braces of some sort of kind of enhance the capability to move with those deficits. That’s kind of the eval and then treatment sessions after that, after making goals and finding out what the parents want to work towards, then it’s just breaking it down and working on it step by step in therapy typically anywhere from that half hour to an hour range depending on the kid’s tolerance therapy.
Host: So just as we close here, I know that you’ve seen so many children and parents throughout your time practicing as a pediatric therapist. If there was one piece of advice that you could leave our listeners with, what might that be?
Corrine: Play. Kids are sponges, like I said earlier. Getting them to play and interact with other people is going to be the biggest thing because they're not only learning from what they're playing with, they're learning from the kids around them. So the child sitting next to them might have a skill that they don’t know yet. When the kid sees that, they're going to say like oh hey, how did you do that? Then they're going to try to figure it out themselves. Then once they figure it out, then they know how to do it for the rest of their lives. It might take them a couple of times to practice, but going through play, getting together play groups with other parents with kids around the same age or even kids that are a little bit older than them to kind of get those milestones in a different age group even. Just getting the kid to see it, hear it, do it himself is beneficial.
Host: Well Corrine I think that is the perfect place to end. Thank you so much for your time today. That’s Corrine Pearl, a pediatric physical therapist at Ridgecrest Regional Hospital. Thanks for checking out this episode of the Ridgecrest Regional Hospital podcast. To learn more, visit rrh.org. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.
Prakash Chandran (Host): October welcomes the start of physical therapy month. Today we’ll be learning about how physical therapy can help our pediatric population. We’re going to talk about it today with Corrine Pearl, a pediatric physical therapist at Ridgecrest Regional Hospital. This is the Ridgecrest Regional Hospital podcast. I'm Prakash Chandran. So first of all, Corrine, it’s great to have you here today. Just starting with a very basic question. What exactly is pediatric physical therapy?
Corrine Pearl, PT, DPT (Guest): Peds therapy is working with kiddos that have—Most of them have developmental delay. So you're helping them reach those developmental milestones as rolling over as kids or walking when they're infants to either running, jumping, just really big gross motor skills. That’s kind of the bulk of physical therapy, but we also deal with a lot of kids with mental disabilities and kind of help them through that process with what they’ve got going on physically as well.
Host: I see. One of the things that we talked about before we hit record is that it’s also Down syndrome awareness month. Is that something that physical therapy can also help with?
Corrine: Absolutely. Kids with Down syndrome they’ve got a lot of different physical abilities, but there's also a lot of developmental disabilities that come with Down syndrome. Some of them start off not being able to stand up when they're infants. With PT, you can help them kind of accomplish that with different techniques and different tools. Then kind of continuing on all the way up until they're even 21 years old, which that’s something I didn’t mention earlier is that pediatric therapy covers birth until 21 years of age. So anywhere along that timespan in a child’s life, with Down syndrome we can cover that and go over anything that they might accomplish. Another thing with Down syndrome is that they get poor endurance. So kind of giving them some activity tolerance and working on their physical capabilities to do P.E. in school or to climb stairs on road trips with family and stuff like that. Just to give them a better quality of life is something that we really like to focus on.
Host: Absolutely. I didn’t realize that the age range was so vast. That you kind of worked with children up to the point that they're 21 years old. They're kind of young adults at this point. I'm curious as to when this child might need this type of physical therapy and what prompts the parents to bring them in in the first place.
Corrine: So for most babies—I could speak to just the baby population right now with diagnoses such as torticollis, coming in plagiocephaly—having a flat spot on their head—bringing them in and it’s kind of a lot of parent education at that point on handling techniques to help with doing crib positioning and feeding positions and stuff like that to kind of get that head in a different shape with more rounded head shape to it, with strengthening of their neck muscles and stuff. With kids with Down syndrome coming in that early, when they go to their pediatrician with concerns of ability to roll or ability to push up onto their arms when laying on their stomachs for crawling and stuff like that. We have tools that we can use to help those kids meet those milestones and kind of get them moving through play. So pediatric therapy is kind of learning through play. That’s kind of how kids developed those neurological pathways in their brain. So coming in and setting up an environment that’s fun and inviting is going to have them succeed while also doing therapy in a way that they don’t realize that they're doing it.
Host: Learning through play. I like that. One of the things that I wanted to ask you about is as a parent myself, I track all of the milestones that my daughter is doing through or had been going through. That’s lifting their head up, learning how to crawl and learning how to walk. For the parents that are listening to this that are wondering when it might make sense to bring their child in, is it around trying to get them to walk if they're a little late in achieving that milestone? Talk to us a little bit about that.
Corrine: Absolutely. Especially for our late walkers, typically around that 12 months is when they're starting to pull to stand. So that means they're on the floor and they're grabbing on to furniture and pulling up to stand. Then right around that age is when they're cruising along furniture. So they're walking side to side to play with toys along the couch or pushing a push toy kind of down the hallway. So if around that 12 month age your child is not able to do that, that’s definitely kind of like a red flag to say, “Hey I might need to take my child down to the pediatrician and say I've got a late walker here. Hasn’t started standing up. Hasn’t been cruising along furniture.” Then especially if you’ve hit that 18 month mark six months down the road of not walking by him or herself independently, that’s kind of when that concern kicks in and the pediatrician can say, “Absolutely. We’ll send him to PT and kind of see what they can do for him.”
Host: I see. You know, I know just going to physical therapy myself as an adult, there's always exercised and things I have to do outside of the session itself. So I imagine that is no different for children. When the child is at home, are there things that parents can do to help their child’s development as they go through physical therapy?
Corrine: Most definitely. With kids, it’s even more important because they're learning at such a fast rapid rate. Kids are like sponges. They soak up everything you're doing. So the majority of the legwork is done in the home. We’ve got handouts that we provide with parents so that they can learn the proper tools and techniques to kind of help their child succeed with those developmental milestones. Since most of the legwork is done at home, a lot of it is education like I talked about earlier with kids and handling and kid positioning and stuff like that so that the parents can provide that most successful home environment for the kids to learn. It’s all done through play like I said earlier. So setting up toys along the couch in the l-shape sofa and having the kid go from one end of the couch all the way to the other end by putting toys along there just so that the kid is playing through that but also learning to walk at the same time.
Host: You know, I imagine that when parents come to physical therapy, there is kind of an implicit sense of frustration or just a little bit of concern because they're comparing their children with those of their peers. So what advice might you have to help them cope with those feelings when they come in or when they have a child that’s going through physical therapy.
Corrine: Right. Absolutely. So one of the things that I've noticed here recently more so than in the years past is that when I see a kiddo say once every week even, they actually have made progress towards every goal that I've ever put down just because kids do grow up at rapid rate. When parents are home and they see them every day, they're with them 24/7, it’s really hard for the parents to see that change. So what I like to do is say take a video. Take a video of your kid who’s not able to stand up right now, and the first time that he is able to stand up on that sofa take that video. Then the next time two weeks down the road when he’s here at therapy and takes his first step, take another video that way you see the progress being made. It’s just progress maybe two weeks down the road, but you're still making progress because the kids aren’t going to see it on the daily basis. Versus an outsider’s eye seeing it once a week, once every other week you definitely do see that progress. So that’s one thing that I would tell my parents is take videos along the way, take pictures along the way of the progress your child has made and look back at the timeline, see how far they’ve truly come.
Host: Yeah, that’s good. Setting those markers so you can easily see how far they’ve come and how far they’ve progressed. One of the things that I wanted to ask you about was the actual physical therapy session itself. Can you walk us through a typical session?
Corrine: Absolutely. So I’ll start with the evaluation. It’s typically longer. Depending on the diagnosis, it could be half an hour to 45 minutes. With infants and babies, they only last about that 30 to 45 minute marker just because they get fussy, they're tired, they're hungry, they need a diaper change. With kiddos that are a little bit older, typically it’s around an hour. You go through standardized testing. There's a lot of different tests out there as pediatric therapists that we perform that puts kids in a category, per say, for their age equivalence. What they're currently functioning at according to other peers in their age group. So we do a lot of assessment tools that way and with just different gross motor tasks involved in it. We’re always looking at their posture and their alignment, making sure that their muscles and their bones are in correct alignment so that everything can work properly. If it’s not then we can address that through orthotics or braces of some sort of kind of enhance the capability to move with those deficits. That’s kind of the eval and then treatment sessions after that, after making goals and finding out what the parents want to work towards, then it’s just breaking it down and working on it step by step in therapy typically anywhere from that half hour to an hour range depending on the kid’s tolerance therapy.
Host: So just as we close here, I know that you’ve seen so many children and parents throughout your time practicing as a pediatric therapist. If there was one piece of advice that you could leave our listeners with, what might that be?
Corrine: Play. Kids are sponges, like I said earlier. Getting them to play and interact with other people is going to be the biggest thing because they're not only learning from what they're playing with, they're learning from the kids around them. So the child sitting next to them might have a skill that they don’t know yet. When the kid sees that, they're going to say like oh hey, how did you do that? Then they're going to try to figure it out themselves. Then once they figure it out, then they know how to do it for the rest of their lives. It might take them a couple of times to practice, but going through play, getting together play groups with other parents with kids around the same age or even kids that are a little bit older than them to kind of get those milestones in a different age group even. Just getting the kid to see it, hear it, do it himself is beneficial.
Host: Well Corrine I think that is the perfect place to end. Thank you so much for your time today. That’s Corrine Pearl, a pediatric physical therapist at Ridgecrest Regional Hospital. Thanks for checking out this episode of the Ridgecrest Regional Hospital podcast. To learn more, visit rrh.org. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. Thanks and we’ll talk next time.