From the first hints of a
smile to their triumphant
first steps, parents
anticipate their children’s
milestones with excitement.
But what if something
feels off with how the
child is developing and
progressing?
CalvertHealth Outpatient Rehabilitation offers pediatric physical and
occupational therapy at their Prince Frederick office. The therapists
are a key part of a parent’s support system for early intervention if
issues are detected in early childhood development. Physical therapy
involves strength, balance and motor skills while occupational therapy
involves components of these same skills but focuses on daily activities.
For children, this means dressing, toileting, and tackling the barriers to
these kinds of life skills.
“It’s hugely important because if we don’t address the small barriers
they’re experiencing in their early childhood, we tend to see issues down
the road,” Emily Phipps, ORT/L, MSOT said. Particularly in the first
year of life, children develop at such a rapid pace and it is crucial to catch
issues early.
“If you feel funny about something, talk to your doctor and keep
bringing it up,” said Kathy Moore, OTR/L, CEAS1, director of
rehabilitation services and wound care at CalvertHealth Medical
Center (CHMC).
A Team Dynamic
“A lot of times when parents are told
their child needs physical therapy,
they start thinking something is really
wrong with their child. But a lot of
times it simply means the child needs
more help or facilitation to achieve the
milestones and developmental goals,”
Sarah Nessel, DPT said.
When a child isn’t hitting
milestones as expected, Nessel can
assess what might be the cause.
For example, by seeing a child in
person who isn’t walking yet, she
can determine if the child has muscle
weakness or tightness in different
areas. It could also include sensory
components.
If a parent has a concern, they
should speak to their pediatrician
and ask to have it monitored by a
therapist. It doesn’t mean treatment
will be needed right away. An
assessment might be all that is
needed, stated Nessel.
Therapists (PT/OT) can help
differentiate between the varying
degrees of normal development. Most
pediatricians give parents a checklist
of skills to mark during well-child
visits. Phipps recommends parents
look at those checklists and see if
they have any concerns. Instead
of simply checking yes or no, think
through the skills to determine if
something may be off and bring those
concerns to the pediatrician. Parents
shouldn’t feel pressure to memorize
what skills their child should have and
when. The PT or OT communicates
with the pediatrician and the parent
regarding treatment, which is tailored
specifically for the child’s needs and
how they are developing.
“We become an advocate between
doctor and family because we can
provide that validation. It becomes a
team dynamic,” Phipps said.
Small Signs, Big Impact
All parts of the body are linked
to one another, Phipps said, so
seemingly small or insignificant
issues or delays could potentially
lead to larger problems later in
life. For example, an infant with
plagiocephaly (flatness on the head)
can also have vision issues stemming
from one eye sitting more forward
than the other. There could also be
asymmetry in the jaw, which can
impact the inner ear.
Nessel cautions parents whose
children seem to skip crawling
to see this as a concern, not a
triumph. Crawling is important
developmentally for many reasons.
It’s the first time a child coordinates
the right and left sides of the body
and puts weight on their hands and
shoulders. This helps with hand/eye
coordination, problem solving and
visual scanning skills. Studies show
later on the skills that result from
crawling promote fine motor skills
later in life such as writing.
Additional signs Phipps and
Nessel recommend bringing up to
the pediatrician are asymmetry in
reach, difficulty lifting head during
tummy time, a floppy feeling baby or
low muscle tone when picked up, an
overly stiff/tight baby, delay in any
major milestones (rolling, sitting,
crawling), abnormal walking
patterns (on toes, feet turned),
tripping and falling more frequently
than normal, and difficulty keeping
up with children their own age on
the playground.
Parents as Advocates
If a parent has a concern about their
child’s development, it can be a scary
thing to notice and to bring it up to the
pediatrician. Could it mean something
is wrong with their child?
“If a parent has a concern they
have already asked their pediatrician
about, we are here to provide
additional insight. Again, it doesn’t
mean treatment is needed, but an
assessment can give parents an
added assurance to their child’s
development,” Nessel said.
Monitoring and assessing can
be a good middle ground before
going straight to treatment and is
still a proactive approach. It’s not
always a straight path directly from
pediatrician referral to treatment.
Physical and occupational
therapists can also gauge between
the degrees of normal childhood
development. It is a delicate balance
between those degrees of normal
and the ranges of when typical
milestones occur. Phipps said she
works to determine whether a delay is
significant or not and to look closely
at what is expected at the child’s
particular age.
“We are there as a support system
to differentiate that,” Phipps said.