The Children's Therapy Center, Pediatric Physical Therapy Services

BACK TO SCHOOL
Many of our families will have children heading off to school this September. If your child is a high school, middle school, elementary student, or a new pre-schooler, The Children's Therapy Center, PC is here to help make their initial school experience a good one.

During the summer, many of our therapists have begun preparing several of our ambulatory patients with cerebral palsy for the transition to middle school or high school. The physical therapists have been diligently working on balance techniques and protective extension techniques that will indeed come in handy when they are faced with that dreaded hallway experience called "changing classes". There are many strategies that we can implement to make this challenge easier. Ask your physical therapist for assistance.

BACK PACKS
As always, I must begin each September with my back pack lecture. Remember that if your child has trunk weakness, asymmetries such as hemiplegia cerebral palsy, scoliosis, or lordosis, it is very important that he or she is equipped with an appropriate school bag. One recommendation is to make sure that the back pack is not too heavy. Talk to the school about possibly having two sets of books, one for class and one for home, to eliminate the extra load and stress on the musculature. If your child must carry a heavy load of books, make sure that the pack is evenly placed over both shoulders. The fad these days is to carry that backpack very low on the back. If your child has trunk hypotonia or is lordotic (sway back due to weak abdominals) this will exacerbate the malalignment of the spine . If your child has asymmetries due to hemiplegia one sided weaknesses, or scoliosis, make sure that the back pack is not carried over one should (especially the weaker side). This will accentuate the C shaped curve of the back. If possible, rolling back packs are an excellent choice. Ask your physical therapist to help you with specific concerns.

FINE MOTOR ACTIVITIES AT SCHOOL
The Children's Therapy Center's occupational therapists have a variety of pencil grips available for your perusal. If your child has difficulty with handwritng tasks, your OT may have a recommendation.

Also if you are shoe shopping, remember to be aware of your child's capabilities in regard to shoe tying. Velcro straps may be more appropriate than laced shoes. If your child absolutely must have tie shoes, there are laces that allow tightening of the shoe without actually tying them (spyrolaces). Ask your OT for further assistance in this matter.

If fine motor activities such as zipping, buttoning, snapping, cutting are a problem, talk to your OT about such devices like zipper pulls, zipper grips, velcro style button aids, button hooks, adaptive scissors, and other assistive devices.

FEEDING AND ORAL MOTOR ACTIVITIES AT SCHOOL
For those children requiring additional help with feeding and oral motor, there are many varieties of straws, cups, sandwich holders, and adaptive spoons that will allow an easier time in the cafeteria during lunchtime. Your occupational therapist and speech therapist can certainly help you problem-solve specific needs. Also, we can also help you decide which foods may be easy to chew, swallow, etc. during the hurried lunch period. We are here to help.

CHILDREN WHO RECEIVE SCHOOL SERVICES
Many times parents ask us to help them with the IEP process. This may mean reviewing school goals, attending school meetings, or writing specific reports, or observing your child in the classroom. Although we want to be part of your child's team, it is The Children's Therapy Center's policy to not infringe on the school's policy or their provision of therapy services. Please remember that we have the luxury of operating as a private entity, which allows us to work on refining skills that are functionally based, or academically based. We are able to include your goals into our treatment and operate as a MEDICAL MODEL, with frequency and duration of treatment decided by you, and your therapist, (and, unfortunately, your insurance company). The school, on the other hand, must follow their guidelines and work under the auspices of an EDUCATIONAL MODEL. This may mean that direct services may be denied if your child is not exhibiting a 25% delay. The school may also recommend group therapy or consultative services. We will gladly support your family by inviting a therapist to our treatment session, consulting by telephone in order to coordinate services, collaborate on specific equipment, and align with them on behavior strategies. However, we want to remain respectful of their mission and policies and not overstep professional boundaries.