The Joys of Being a Pediatric PT
By: Jacqueline Grimenstein, PT, C/NDT, CKTP
Happy PT Month! As I look back over my 40+ years as a pediatric PT I marvel at all the advances that have been made in the identification and treatment of children with disabilities. As a young therapist in the 1970’s most children with disabilities did not start receiving education or therapy services until at least age 5 or 6 when they came to school. Up until then the focus was on medical care if needed. We built our own adaptive equipment and if a child needed braces they were made of metal and may have gone all the way to the waist with the ability to be locked at the hip and knees. There were a limited number of identified genetic disorders that were basically classified by either physical characteristics or medical presentations. How things have changed! We now have sophisticated equipment and genetic testing, metabolic testing and the ability to look for areas of change or damage to the brain. But what haven’t changed are the loving, caring, but demanding challenges of treating a child with a disability.
When I went to PT school I knew I wanted to work in pediatrics, but the number of jobs was very limited. After 6 months of treating in adult acute care I found a job in a school for children with disabilities and never looked back. Working in the field of pediatrics requires a unique skill set of being able to facilitate the children we treat to work hard on the skills needed to make changes in function while at the same time having fun. Given the choice, even as adults, we often choose to work in fun environments. Many of us choose to go the exercise classes with friends to get a workout where we could achieve those same results by just going to the gym or working out in our homes. The job of children is to play, so why not learn through play. It is a lot more fun for the children I treat to learn to take steps by stepping on brightly color shapes or making a game of stomping on squeaky toys that it is to just practice the task of walking. When looking at goals for the children I treat I like to keep in mind 2 things: If it is not fun, it is not functional and we only learn what is meaningful. So my challenge is to find what is meaningful for that child and make it fun, while at the same time developing the components of movement that I need to achieve the functional goal.
In order to know what is meaningful to the child I need to know what they like to do and what are their interests. This may mean keeping up with the current cartoon shows and movies, or if treating in the teen population, knowing the latest pop and rock stars and what is popular on TV. I have designed treatment sessions around Disney movie themes or playing board games by place piece all over the treatment space and having to gather the pieces in order to play. I have developed over the years a very large repertoire of songs that can easily be incorporated into a session. I can add sound effects for just about any movement I want the child to perform. Having a fun treatment session is the best remedy for a stressful day at work.
But being a pediatric therapist is also a lot of work; not just physical work, but adjusting to the emotional needs and personality of each child so I am relating to him/her in a meaningful way. I need to be analyzing their body movements to figure out what components need to change in order to reach my functional outcome. Each child is a puzzle who brings their unique challenges to the session. So over the years not only has the availability of equipment and diagnostics changes, but so has our understanding of how the body works and learn. Having the advances in the study of neuroplasticity verify for us that changes can be made across the lifespan has helped us encourage our clients to continue treatment though adulthood. For a person with a disability the work of improving and maintaining function is a lifelong journey. Many of us who work in pediatrics stay in touch with the children we treated throughout their lifespan. You often develop a unique bond with the children we treat so that they know they can reach back out to us once they have aged out of a pediatric setting.
As I have advanced in my years of being a pediatric therapist I still love providing hands on treatment, but have also developed a love of teaching continuing education to help therapists put more “toys” in their toy box to use when treating in this wonderful population.
To learn more about Jacqueline Grimenstein’s course, “Motor Control and Movement Dysfunction,” click here!