Balance Training
Children may have difficulty with their ability to balance while sitting, standing, walking, running, or going up and down steps. This may be due to differences in their strength, stability, or how their nervous system responds to obstacles in their environment. Your physical therapist may incorporate activities to improve your child’s balance by using unstable surfaces, obstacle courses, core strengthening, and other techniques during treatment.
Durable Medical Equipment (DME)
This includes assistive devices used by your child to move and function in their day-to-day life. Examples of common DME include wheelchairs, gait trainers, walkers, crutches, canes, standing devices, etc. Physical therapists can assess your child’s need for DME, ensure its appropriate fit, and teach you and your child how to use it appropriately.
Dynamic Movement Intervention (DMI)
DMI is a therapeutic technique aimed at making changes in the nervous system through dynamic exercises that improve your child’s postural responses and stability. Your child’s therapist may incorporate this technique by utilizing the effects of gravity and providing more specific hands-on support during exercises. DMI is often used to help children progress through the next developmental skill and can be an effective form of treatment for children with various conditions.
Facilitation/Inhibition
If a child has difficulty using the correct muscle groups at the appropriate times, the physical therapist will use a variety of hands-on ways to help them learn how to coordinate this better. The therapist may try to help the child activate (or facilitate) certain muscles or movements or try to relax (or inhibit) muscles that are overactive.
Functional Training
One of the main goals of physical therapy is to teach your child how to move as independently as possible in a way that is most appropriate for their age. Training infants in functional mobility often includes working on gross motor skills such as rolling, crawling, pulling to stand, and walking, while for older children functional training is more related to walking outside or going up and down the stairs. Your therapist may incorporate toys, games, and specialized equipment into your child’s functional training.
Gait Training
This refers to teaching your child how to walk as independently, safely, and pain-free as possible. Gait training includes not only helping infants/toddlers to take their first steps, but also improving children’s walking patterns and posture, helping them to be less prone to falls by improving their balance and endurance, and in some cases, training children to use devices like walkers if appropriate.
Infant Massage
Your physical therapist may incorporate infant massage, which refers to a variety of specialized strokes, to your infant during treatment and/or teach you how you can perform them at home. Infant massage can help with calming your infant, improving body awareness, decreasing sensitivity and, in some cases, reduce constipation. Infant massage strokes can be used on older children with modifications depending on the child’s activity level.
Orthotics
This refers to various devices that provide support or correction to a specific part of the body. Examples of common orthotics include corrective helmets (or cranial orthoses) for head shape, insoles for the feet, leg braces such as Ankle-Foot-Orthoses (AFOs), Supramalleolar Orthoses (SMOs), etc. Physical therapists can assess your child’s need for orthotics, evaluate if they are the right fit, and teach you and your child how to wear them correctly.
Proprioceptive Awareness
Many children with delayed motor skills have difficulty understanding where their body is in space. This is called their body awareness, or proprioceptive awareness. Some activities that address these issues include the use of weights, compression vests, taping, or other deep pressure strategies to give the body more input.
Range of Motion (ROM)
ROM refers to the flexibility of muscles and joints. These can sometimes be tight (hypomobile) or loose (hypermobile) due to differences in each individual’s posture, muscle tone, and movement patterns. Your child’s physical therapist may incorporate stretching exercises to help loosen tight joints, or strengthening exercises to help stabilize joints, especially if it is creating pain or difficulties during your child’s day-to-day life.
Reps
Reps are short for “repetitions,” which means the number of times an exercise should be done in a row. Your therapist may use this term when describing how intensely to practice exercises such as squats, stretches, or lifting weights.
Sensory Integration
This refers to how our brains receive, process, and organize sensory information from our bodies and the environment. Sensory input includes not only what we hear, see, touch, smell, and taste, but also information about our internal emotions and our body’s position and movement in space. If your child has differences in their sensory processing that impact the way he/she moves, the therapist may incorporate certain modalities or environmental modifications to help him/her be more successful during therapy.
Standardized Assessment
At your child’s evaluation, and sometimes at subsequent treatment sessions, the physical therapist may utilize a standardized assessment tool in order to determine your child’s skill level in a specific area. For example, your child’s gross motor skills may be evaluated and compared with children of his/her age, or the test could also look like a questionnaire or timed activity. The scores of these tests can provide more information about what your child may need the most help with as well as measure change from one period to the next.
Strengthening
Many children with motor skill delay, pain, or injuries, have weakness in certain muscle groups. In physical therapy, strengthening can be provided through both exercise and developmental skills. One example is encouraging squatting to pick up toys to strengthen hip and thigh muscles. Another example is placing an infant in tummy time on a ball to strengthen his/her neck and back muscles.
Stretching
The therapist will incorporate stretching into treatment when a child has limited Range of Motion (ROM), which means that muscles or joints are tight. Using play helps the children tolerate the stretches. One example is having a child play, sitting, reaching forward for toys to stretch the backs of the legs. We also use equipment to aid in stretches, such as walking up and down an incline to stretch the ankles.
Taping
Various types of tape may be used during physical therapy depending on the goals for your child. Taping is a modality that can be used to help activate muscles, inhibit or relax muscles, improve posture/alignment, and reduce swelling and pain in a specific body region.
Transfer Training
Children who use adaptive equipment such as wheelchairs, walkers, and bath chairs, may have varying levels of ability to move between these pieces of equipment on their own. Your physical therapist can help you and your child learn how to transfer from one equipment to another safely and efficiently. The therapist might also be able to help build your child’s strength and balance to perform these transfers more independently.