The Role of PT in the Special Needs Child

Working as a Physical Therapist Asst. for many years, I have learned that people give many reasons for not participating in therapy. Among the reasons given is that the patient believes he/she will progress just the same with or without therapy. There may be a little truth to that statement although it is a statement without a full understanding of what physical therapy can accomplish if done consistently. Let me explain.

While we as parents may not have control over who our children will be as I believe that we all have a path in life that we are wired to follow, we do have control over abilities like strength, eye-hand coordination, thinking before we speak, manners, throwing a ball, socialization skills, etc. We have all seen the movies or read the books of what happens to children when we ignore them during their molding period. Often times we expect that our children will learn these things from osmosis and while there are some exceptions, most of these traits/skills are all learned.

It is the same with therapy, especially for a child with special needs. Children with special needs (CP, Ds, Autism, etc.) simply do not progress like children without these diagnoses. The muscles in children with special needs are not as balanced, meaning that some are weaker than others. It is this weakness that sets the child up to learn wrong movement patterns thereby just exacerbating the problem further because the weakness is never strengthened.

A Physical Therapist is trained to spot these bad movement patterns and to help the child learn the correct patterns thereby strengthening the muscles and bringing all the muscles more into balance. A person who is better balanced strength wise is going to have better posture and better coordination. Good balance also plays a role in good health. For example, a person with uneven balance distributes body weight differently over the hips, knees and ankles which can be deforming if not addressed. Also, poor posture can decrease ability to take deep breaths which can lead to other things.

So yes, a child/adult will heal from an injury or learn to walk, etc without the help of a Therapist but the quality of life will probably not be the same as if the person received therapy. So I leave you with this encouraging word - therapy is a much needed service in the life of your special needs child. We all want our children to grow up to lead happy, productive and long lives so it is important to give them the tools that they are going to need. Unfortunately, one of those tools requires learning how to use all of the muscles we have so they can move correctly. Make it a priority to take them to therapy sessions and to set aside time during the day to work with your child (even if it is 15 minutes). Our children are fully dependent upon us to provide everything for them.

It's A Matter Of The Heart

Lately, there has been talk about our Presidents faux pas on the Leno show last week when he used the Special Olympics as the butt of a joke. It was very distasteful and uncalled for by anyone, especially by a sitting President who is highly educated and a very visible personality who you would think would be well versed in topics to avoid in public speaking.

Mr. Obamas unfortunate slip of the tongue has surprised a lot of people, as it was unexpected from such an educated man. But if you stop and think about the number of times that comments like this have been made and by whom, I think one could conclude that education level doesn't have a lot to do with offensive speech; however, the heart attitude of a man does.

For example, a person can be educated to the differences of people and the sensitivities of different groups and that will increase awareness and understanding but may not have a lot of influence over how a person views the world and people. This is because how a person views the world and people around them is not only learned from books, but also by watching, by experiencing and by learning from those around us.

So in our attempt to "change the world" and the habits of offensive speech, education is only part of the answer as Mr. Obama has shown us earlier this week. A change of heart may be in order for us to see a permanent change.

"....for his mouth speaks from that which fill his heart." Luke 6:45b

An Update and a Word On Orthotics

First, an update on John and then on to the answers to your questions. John continues to do well. We are working on sitting unassisted which he is now able to do this for a couple of minutes while reaching in front of him. What usually topples him is when he turns his body to either the right or left, but he will get it with practice. He is able to maintain his balance if we stabilize his legs which is what we did when first starting to sit. We are also working on his standing which John is able to stand with us holding his hands.

The reason that we are working on standing is not that he is ready to walk because he is no where near that point. But I want him to feel what it is like to bear weight through his hips and his ankles. This also gives me an opportunity to see whether or not he distributes his weight evenly over his ankles.

This leads me to the topic of orthotics. Personally, I think that orthotics have their place and can help in warding off musculoskeletal problems. Before using orthotics to correct a postural deviation, one has to look at whether the deviation is skeletal or muscular. This analysis is best done by a PT who is familiar with this type of evaluation.

Weak muscles can and should be strengthened to hopefully improve the issue, whereas skeletal deviations often require more aggressive intervention. To apply orthotics to a child with muscle weakness may serve to weaken the muscle further; however, the use of orthotics can play a role in cases of muscle weakness. Therefore, it is important to get a proper evaluation as to the cause of the deviation.

It is important to remember that children with Down syndrome vary just as much as children without Down syndrome. Although it is important to note that children with Down syndrome do have a tendency to have skeletal deviations in feet and hips that require orthotics.
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As for the SPIO trunk support, I will give my thoughts in the next post.
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As for teaching a child with Down syndrome how to read which was also asked, I will have to pass that question off to a more experienced parent of a child with Down syndrome. I will say that Joy and I have always read to our children from a very early age until they were able to ready independently. While I have no first hand experience with teaching one of these children to read, we have already begun to introduce John to books by reading to him. John has 6 people in this family that love to read to him and we all share in that, so hopefully we will see some fruit from this in a couple of years.

As for the reading program asked about, I have not heard about this program.