Gabby Cinnamon (Host): Welcome back to the Well Within Reach podcast brought to you by Riverside Healthcare. I'm your host, Gabby Cinnamon, and today I am very excited to be joined by two special guests, Drew Haverstock, Physical Therapist and Founder Owner of Milestone Therapy, and Katie Doph, a Physical Therapy Assistant and Director of Clinical Services at Milestone Therapy, to talk about pediatric therapy services at Riverside.

Thank you both for coming on the podcast today.

Drew Haverstock, PT: Thanks for having us.

Katie Dolph, PT: Yeah, thanks, Gabby.

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Host: We're back with Drew and Katie. So this is your first time on our show. Can you tell us about yourselves?

Katie Dolph, PT: My name is Katie. I'm a Physical Therapist Assistant. I've worked with Milestone Therapy for 12 years. I have always been a pediatric based therapist and working with Riverside for the past five and a half years at our pediatric clinic. We started in 2018.

Drew Haverstock, PT: And, Drew Haverstock. I started out at Indiana University getting a business degree and realized I really didn't like that. Met my future wife, who is a speech therapist, and she took me down the path of becoming a PT once I met a bunch of her friends and realized I needed to do something else with my life. So fast forward a handful of years, we moved from Florida back up to Chicago where I was born and raised, and I went, got my PT degree, graduating in 2001 and started the company in 2002.

And was very fortunate to meet Katie and a number of others that are on our leadership team, through the years to get us to the point where we are now.

Gabby Cinnamon (Host): Well, thank you both for that, introducing yourselves. So Riverside has partnered with Milestone Therapy to provide pediatric therapy to the community. Can you talk about that relationship and kind of explain to everyone what pediatric therapy is?

Katie Dolph, PT: I'd love to talk about Riverside's relationship with Milestone a little bit because it's been a wonderful one. Riverside has such an amazing view on community and that meets Milestone with one of the things that we love to do. And, to be able to build that has been just amazing. And to look at pediatric therapy, PT, physical therapy, occupational therapy, speech therapy, and take what we can do with kids and just help them where they are, help their families and help them grow. We like to say our biggest passion in life is to unlock life's potential, and I can let Drew talk on that a little bit more.

Drew Haverstock, PT: Yeah, the reason things have worked so well with Riverside through the years is at Milestone to Katie's point, is we like to use the phrase unlock life's potential, and it's not just about the children that we treat, but it has to do with the therapists that are under our employ, with the folks that are working the front desk, the folks in billing.

 Everybody has to pull the rope the same direction to help as many kids be seen and for us to help them in the best ways possible. Riverside seems to have exactly something similar at their core. They may use different words, but our values definitely aligned. So when we started, the dance a number of years ago, it made things really easy to get to a point where we could find something that worked for everyone and we could bring something that was severely lacking to the Kankakee area, and that being pediatric therapy, and really help expand the base that Riverside's able to support.

Gabby Cinnamon (Host): Can you guys talk more about the specialized services that are offered at pediatric therapy location in Bourbonnais?

Katie Dolph, PT: Yeah. We specialize in occupational, speech and physical therapy. The big emphasis on our speech and OT right now, we've got a lot of kids who have sensory needs. They may have been newly diagnosed with autism. And we provide the services for kids age 0 to 22 to start where they're at, meet their families where they are, and see where we need to go to help develop their skills.

Gabby Cinnamon (Host): Yeah, that's amazing that we have all of this right here and part of the reason why I wanted to do this podcast is to raise awareness to that. People fortunately don't have to travel far to get all these great services and we're very happy to be able to provide this to our community. When might pediatric therapy be necessary?

Drew Haverstock, PT: A lot of parents don't always get the proverbial heads up when the child's in utero, when something is one step left of center. They oftentimes are having a very typical pregnancy and then during childbirth they may have something go awry, which is often no one's fault. It's just life and it just happens. And it's our job often to step in and help families understand it's not about what happened, but about what's next.

How can we help them figure out the best way to allow their child to achieve their greatest functional independence. And that's kind of where we start is looking at that parent who oftentimes has been told by, by friends or family about all the things that they should worry about, or all the things their kid might not be able to do.

We're the first ones that walk in and say, here's what your child could possibly do. But we know statistically, if we don't start now, the chances of it occurring drop immensely. So if your game, let's go. And you can almost see all the parents shoulders kind of lift and their chins come up. And I swear once I felt like one was going to open their shirt and have the big red S on their chest and the cape.

And they found a new purpose because their job now was to help their kiddo in any and every way they could. So when is it necessary? It's necessary, and the phrase that I often use is when a parent's spider sense goes off. A lot of times they'll have siblings or cousins that they've seen develop through the years, and they notice that their little one just isn't able to keep up.

Oftentimes we do evaluations, and we find, hey, your kid's doing fine. They're just a little bit behind. There's no reason for us to intervene at this point. And that makes us feel great because we know that parent now can sleep at night and there's nothing quote unquote off or off step with their child's development.

They're just slightly delayed. But other times they come in and with our specialists, we're able to find a handful of things where direct intervention can truly make a difference. And that's where Katie and her crew step in and do a fabulous job.

Gabby Cinnamon (Host): So let's say a parent of a child is listening to this and maybe they've scheduled their first pediatric therapy session or they've been referred over to you guys. What can they expect in that first session?

Katie Dolph, PT: Yeah, in that first session, they're going to come in, and the very first thing that we do is we do an evaluation. And doesn't matter what kind of service they're getting evaluated for, they're going to have a similar experience. They're going to meet with the therapist. That therapist is going to ask them some questions about their concerns. We want to know their history, their concerns, what's bringing them in that day. And then we're going to go ahead and do some different kind of tests. And what I love to make sure the families know is that this isn't doctor type testing. There's no needles involved. Let your kids know that we are here to do fun stuff and we're here to play and work at the same time. So they can expect somebody who is passionate, compassionate about what they do, and who's going to talk to them in a way that, they can understand what's going on. And they can expect to have a team member who is going to work together with them to address a concern that have been probably piling up for a while. And they can expect to have an experience where they can feel those concerns really being addressed and looked at.

Drew Haverstock, PT: If I can jump in, Katie, I think that's a great point. The thing that most people don't recognize when it comes to pediatric therapy is that everything that we do is habilitative in nature. Meaning that we are often the first time a child is learning how to walk, how to talk, how to throw, how to catch, how to tie their shoes or button their shirt. With adults, they've injured something and they're trying to get back to where they were. Rehabilitation.

But with the children we work with, it's habilitative and very different from just doing adult based therapy. So it's not like just taking an adult therapist and putting them in a pediatric environment. There's an entirely different underpinning for how we go about helping these children advance in their functional independence.

So that's number one, number two, and the best part about it is everything we do is play based. So when Katie's talking about what we do in our sessions, it's often a parent will walk in and they'll be like, why are you playing ball with my kid? And what we get to do is explain to them, no, no, no, no. We're not just playing ball, right now they're learning how to turn take, they're learning how to share. But more importantly, as I roll the ball to your child, I'm seeing if their eyes are tracking the ball to them. I'm seeing if they're anticipating that ball. And if they're corralling it when it gets to them, or if their anticipatory reflexes are good enough for them to grab the ball before it gets to them, and then you can take a look at the different ways that one can throw a ball from a chest pass to just throwing it willy nilly to an overhand one arm throw.

There's a million different ways we look at the different difficulty levels of how to throw a ball. And that's what all these specialists do is they break down some of the things that we take for granted into milestones for these children to achieve and then we help redirect the skills that really aren't desirable if they're doing things in a neurological way that isn't appropriate as they develop.

And then we continue to reinforce the positive stuff and get more and more out of them. So Katie and her crew are just amazing at creating those plans. And the third piece and the best piece is that everything is done with a home program behind it, meaning that the families towards the end of every session will be brought back to see what we're doing so they can learn what they can do when we are not working with them because they're the ones and their carryover and their efforts are the ones that really make the longterm difference.

I always like to say, we give a parent a home program and they've been working on these, let's say squat to stand with their kid to develop their thighs and their booty as they're getting taller and stronger. When we get ahold of them, we're able then, because of that newfound strength that they've been working on over the last week or two with this home programming that the parents and siblings and grandparents have been doing, all of a sudden, they take their first step with us.

And the parents are always like, oh, you guys are great. And we're like, no, it's not about us. It's about what you did when we weren't around. And that's how we accelerate progress. And that's how this works, is when we create that full care team. And that's, why this is my favorite part of the business.

I could do adult work. That's fine. But when I get that little kid to take their first step, I love it.

Gabby Cinnamon (Host): Yeah, that's amazing. I think, just hearing how positive you guys are and hearing you describe that with any parent listening, this would put them at ease. I can imagine it's probably overwhelming at first to start that journey. So that was awesome.

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You guys kind of touched on this, with having a home program, beyond just the sessions that you guys do, but how does your team involve families and caregivers in the pediatric therapy process?

Katie Dolph, PT: Yeah, families and caregivers are the most important part of the process. What we do is we support them, we guide them, we help them. They are doing so much hard work every single day and they have their kids all of the time. They come in to us for an hour, maybe two throughout the week and what we do is we try to give them all the best supplemental materials, educate them, cheer them on, validate them and make sure they understand what's going on. And they're a very active team member in what we're trying to accomplish. So, as long as they understand where we're headed, what we're trying to do for their child, the most important part is them.

Drew Haverstock, PT: And I think to build on that, the thing that we do differently than a lot of the other groups that are out there, is we focus on something called episodic care. And what episodic care is means that, if your child has a major diagnosis, whether it be Down syndrome, cerebral palsy, et cetera, et cetera, some places will just say your child has one of these diagnoses and we're going to see them for a very long time. What Katie and her crew do is they say, okay, for this three month period or this six month period for this episode, we're going to focus on A, B, and C.

And everyone understands exactly what's being asked of them. The home programming is centered around that and the measurables are charted over that period of time. So we can make sure that the child is becoming more and more functionally independent over that three, six, nine month period, whatever the therapist deems appropriate.

At the end of that episode, if appropriate, and there's still a delay, we focus on the next set of goals for, and maybe for a shorter period, maybe three months. And we may increase or decrease the frequency or intensity of any given episode, but this makes sure that people don't fall into that trap of, yep, my child has Down syndrome. We're going to therapy once a week, forever and ever. That's not how this works. Just because your child has a diagnosis, doesn't mean they have to be in therapy for their life. The object is to have a life, to get out, to play soccer, to go to the playground, to engage with their siblings and family, not to come to therapy forever and ever.

So Katie and her crew do a wonderful job of describing what discharge looks like when it comes to involving these caregivers at home so they understand the reason you're doing that home program is to ultimately see the light at the end of the tunnel and come out better as a family unit.

Gabby Cinnamon (Host): Yeah. I think, describing it that way makes a lot of sense, even, in your own life, if you are trying to focus on 500 things at once and you have so many tasks, you can't possibly be putting your energy into all of those. So breaking down the care like that makes a lot of sense. And I'm sure it's so helpful to parents too, like you said, seeing the light at the end, I can't imagine how helpful that is. What advice do you guys give parents or caregivers who are seeking pediatric therapy services for their child or, you know, have maybe recently started pediatric therapy.

Katie Dolph, PT: My advice is if you have a question, please ask it. Be very curious. Don't just take anybody's word for it or if you don't agree with something, talk to them about it. You should always feel like you're on the same page with whatever provider you're with, whether that be a therapist, a doctor, a nurse, a teacher, anybody who could be part of that child's life.

It is okay to ask questions and it is imperative that you understand what the goal is too. So don't be afraid to be a team member just because you're not the expert. You know your child. You're the expert on your child. You know them better than anybody, so it's okay to have those standards and questions.

Drew Haverstock, PT: I think that Katie does a really good job of capturing the Ted Lasso, be curious, concept. And that is that a lot of people, because they don't have MD at the end of their name or they're not a DPT or doctor devotee or have their masters, they feel like they're a passive participant in the process. By actively engaging with your therapist, by asking those questions, you are going to be able to sleep at night and also you're going to be able to rule out the things that may not be keeping you up, but you're getting misinformation from. Because right now everybody knows in this world of Jenny McCarthy blogs and all that good stuff.

It's really easy to get bad info. So at Milestone and at Riverside, everyone starts with the evidence. And if you start with the evidence and know the peer reviewed medical journals, this is where we get the basis and the underpinnings of all of our treatment methodologies. That's where we start. That's where we end. And so we can always make sure we can justify and explain to you why we're going about things in a specific fashion. Because the evidence points to it being best practice.

Gabby Cinnamon (Host): Yeah. I think we talk about Dr. Google being a downfall for a lot of people, and that's a great way to describe it. I mean, your Physical Therapist, Physical Therapist Assistant is going to know your child and you're not dumb for asking a question yet it shows that you're engaged in that you care and it's just a part of the journey. So I think that's great. Do you guys have, like, any, success stories or favorite stories that you'd like to share? I think that's always kind of a good way to tie things in and kind of get across to people the amazing things that you guys can do.

Katie Dolph, PT: I have a couple of different ones that come to mind. One of the ones that stands out to me most is, we just talked about our episodic care and the way we can see that care kind of transition from service to service as well. We have had little ones who start with us in this area specifically, we get them when they're itty bitty babies. So, it's been very interesting and so cool to see them start off maybe with me. Maybe I'm seeing them for physical therapy, because there's a little bit of delay, or they're not sitting up, or they're not rolling, or they started with the torticollis.

And then we're able to work with each other and say, actually, there's some other stuff that we can work on with their fine motor skills, now that they're a little bit older, or there's some other things that we could work on for speech, now that they're at this milestone, so they don't need me anymore, but they're able to roll into the next and they're able to get care across all of our settings because we collaborate and we work with each other really well.

The other thing that's great to see is we've got one kiddo who we have seen throughout the years on and off, and to see that kid start when they were newly diagnosed, nonverbal, not really giving anything expressively or receptively. And now that kid runs and talks and has attitude and is sassy and you just would never have known that this was inside this little guy this whole time.

And through the hard work of this parent coming every single week to multiple therapies through many episodes of care to see that transformation and to look back and say I remember what it looked like when you were just this little guy. It's such a special thing to see.

Drew Haverstock, PT: That's pretty cool. I'll give one that's a little closer to home. I am a double agent, meaning that I am a therapist in the system, but I am also a parent with a child in the system, and my oldest, Tommy, had something called apraxia, and I mentioned earlier my wife was a speech therapist, but at the time she worked with adults.

I'm a pediatric specialist, but I'm a Physical Therapist. And with apraxia, basically my son's mouth wasn't wired like yours or mine. I could ask Tommy to go grab a ball and put it in the bucket, come over, sit on his mom's lap and give her a kiss on the cheek. And he'd go, bing, bing, bing. And you'd be great. But if you asked him, what's that? Birds were tsss, trees were crees, fire truck for fava gucks. The only people that could understand him were my wife and myself. And I had to take off my therapist hat and allow the professionals that we were seeing, this is prior to our relationship with Riverside, but listen to those professionals as a parent and follow through on the home exercises that they gave me.

And I had to recognize I don't know it all. I need to be quiet. I need to listen. I typically talk at 5,000 miles an hour and the voice that I'm using for this podcast is the voice that I learned to use with my son. I was actually causing him to have a stutter. Because I was talking so fast and he was trying to keep up once he started to communicate.

So I had to rewire myself to be a better father to my son. And the moment that I will never forget is when we were in the car and Tommy was in the backseat and he's just blah, blah, blah, blah, blah, blah, blah, blah. And I turned around. I was like, Tom, and my wife put her hand on my leg and squeezed it and goes, shh, we paid a lot of money for those words.

And as a parent, I just realized at that very moment, I would never have thought that I'd be turning around to tell my son to be quiet because we couldn't get him to even talk for so long. And seeing things like that for me personally is great, but it helps me better understand the benefits that we're able to bring to those in the Kankakee area.

 It warms the cockles of my heart. I love what we do. Love it.

Gabby Cinnamon (Host): Thank you both so much for sharing that. That's awesome. Before we go, is there anything else you would like to add?

Katie Dolph, PT: The biggest thing I'd like to add is just, if you've got a concern, if you've got a question, if your spider senses are tingling, talk to your doctor, call us, let us help you, and, we can get you started, even if it might take some time to figure out what you need to do or what you're looking for. We will talk to you. We will help you and kind of take that first step along with you. So please contact us.

Drew Haverstock, PT: And on my side of the fence, I'd like to say that we're actually hiring. We had some space actually built out, and we have some new rooms, and we're looking for some new physical, occupational, and speech therapists. So if there are any registered therapists or assistant level therapists, we'd love to have the chance to chat with you because there's a lot of kids waiting at the door that we'd love to be able to see sooner than later.

Gabby Cinnamon (Host): Awesome. Thank you both so much for coming on the podcast today and sharing all this amazing information. It was great to have you both.

Drew Haverstock, PT: Thanks, Gabby.

Katie Dolph, PT: Thank you.

Gabby Cinnamon (Host): And thank you, listeners, for tuning in to Well Within Reach, brought to you by Riverside Healthcare. For more information about pediatric therapy at Riverside, visit riversidehealthcare.org. Also, make sure to rate and leave a review for the Well Within Reach podcast on Apple, Spotify, or wherever you listen to the show.