Introduction to Pediatric Physical Therapy

Patient Population: Provides evidence-informed evaluation and treatment for children ages $0-21$ years.
Interdisciplinary Team: Collaboration with Occupational Therapists (OT), Speech Therapists (ST), Physical Therapist Assistants (PTA), Certified Occupational Therapy Assistants (COTA), physicians, nurses, social workers, orthotists, and assistive technology professionals.
Core Responsibilities: * Expertise in movement, motor development, and body systems (strength, endurance). * Assessment and screening for orthotics, assistive technology, and specialized referrals. * Family education regarding health, wellness, and developmental safety.
Common Diagnoses: * Developmental delay, $Cerebral palsy$ , $Spina bifida$ , and $Autism spectrum disorder$ . * Genetic disorders including $Down syndrome$ and $Williams syndrome$ . * $Muscular dystrophy$ , $Congenital muscular torticollis$ , and $Idiopathic toe walking$ .

Organizes pediatric care using the International Classification of Functioning, Disability and Health (ICF) linked to six "F-words" ( $Rosenbaum\, \&\, Gorter,\, 2012$ ): * Body Structure and Function: $Fitness$ (physical and mental health). * Activity: $Functioning$ ("I CAN do things" regardless of method). * Participation: $Friends$ (opportunities for socialization). * Environmental Factors: $Family$ (respecting family as the central experts). * Personal Factors: $Fun$ (engaging in enjoyable activities). * Future: Inclusion and growth within the community.

Clinical Settings: * Outpatient Clinics: Insurance or private pay based on medical necessity; typically seen $1-2\times/week$ for $6$ -month durations. * Hospital-Based: Includes the Neonatal Intensive Care Unit ( $NICU$ ), Acute care (functional maintenance and discharge training), and Inpatient Rehabilitation (intensive recovery following medical issues).
Natural Environments: * Home Health: Skilled services delivered in the home, daycare, or community settings. * School-Based (IDEA Part B): Federal law mandated for ages $3-21$ ; physical therapy is a "related service" governed by an Individual Education Plan ( $IEP$ ) with education-related goals. * Early-Childhood Intervention (ECI/IDEA Part C): Supports children birth to $3$ years; guided by an Individual Family Service Plan ( $IFSP$ ); primarily uses a coaching model in natural environments.

Child- and Family-Centered Care: Philosophy valuing family values and beliefs; treats parents as ultimate experts and involves them in shared decision-making.
Trauma-Informed Care (TIC): Understands the impact of trauma (including illness/injury) on the family system. Follows the Four R's: 1. Realize trauma's impact. 2. Recognize signs and symptoms. 3. Respond by integrating TIC into policies. 4. Resist re-traumatization.
Strengths-Based Approach: Focuses on assets and current capabilities rather than deficits (e.g., "The child can maintain standing balance for $5$ seconds" vs. "The child is unable to walk").

Case Practice: A $6$ -year-old with a complete $L4$ spinal cord injury (injury occurred $5$ months ago) in a school setting. * Patient Status: Requires $Mod\, A$ for chair-to-floor transfers and $Max\, A$ for floor-to-chair. Propels manual wheelchair but fatigues quickly. Needs reminders for pressure relief. * Prompts: 1. Determine strategies for providing family-centered care. 2. Identify trauma-informed care strategies for recent injury survivors. 3. Develop strengths-based language for communicating progress to the family.

Patient Population: Provides evidence-informed evaluation and treatment for children ages $0-21$ years, addressing developmental needs and fostering healthy growth.
Interdisciplinary Team: Collaboration with various professionals enhances comprehensive care, ensuring that all aspects of a child's well-being are considered.
Core Responsibilities: Expertise in movement and body systems aids in effective assessment, guiding families in health and wellness, fulfilling objectives related to physical functioning and overall health.
Common Diagnoses: Recognizing conditions such as developmental delay and autism spectrum disorder aligns with objectives focused on specific health challenges facing children.

This framework facilitates holistic care by linking health and development to fitness, functioning, socialization, familial involvement, enjoyment, and community integration, aligning directly with the objectives of enhancing participation and future growth.

Clinical Settings: Engagement in outpatient, hospital, and natural environments like schools emphasizes the objective of providing targeted interventions based on individual needs.
Child- and Family-Centered Care: The philosophy values family input, central to shared decision-making, fulfilling objectives to involve families in care processes actively.
Strengths-Based Approach: Focusing on capabilities fosters a positive framework for child development, aligning with the objectives of encouraging improvements over perceived limitations.