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- Dr.Joni Redlich PT,DPT
The past several months I spent every extra moment I had studying. I took an exam on Saturday to obtain the credential Pediatric Certified Specialist. During every patient cancellation, after my daughter went to bed, and another other time I could grab was put towards learning everything I could about the field that I have devoted myself to professionally over the past 11 years. Along the way I learned a lot of new things, sometimes a small detail, sometimes familiarizing myself with a diagnosis I have not see in person (you tube was an awesome resource since I’m a visual learner), and other times a reflection on my personal life and professional practice. I thought I would share some of these things today.
- I am amazed at how much goes right with our amazing bodies. I am amazed that for most of us our bones strengthen when stressed, our bodies take immediate action to heal when we bleed, and we literally move through our lives without much thought. I am even more amazed by those who weren’t born with parts of their anatomy or physiology intact, and despite their challenges, do more than survive- they thrive, they work hard, and they teach us all how to live.
- We as physical therapists need to get out in the community, better communicate with parents, and delve further into the daily lives of the children we treat. Motor learning and motivation are tremendous factors in the attainment of new skills. We need to focus on daily activities and participation. These aspects are challenging to schedules/logistics and traditional rehab, but are necessary to for children to generalize motor skills and have the repetition needed to master these skills.
- I am reminded of the need for better documentation and testing on my kiddos. Sometimes this means video documentation at regular intervals- nothing is better at detecting change than watching a video.
- Back to motor learning again- we are often focused on teaching a child to perform an activity, or working on the components that make-up that task- we need to make sure we are not helping too much– the child needs to learn if they are going to practice it on their own
- Random point of fact that was fascinating to me: visual flow is interpreted as proprioception by the brain
These are just a few thoughts that I have after the fact. Preparing for this exam was an intense experience, but I believe I am a better therapist for it, whatever the outcome.
UPDATE: I did pass the exam and am now a Board-Certified Pediatric Clinical Specialist! It was a challenging test, but I did feel prepared when I took it. Reading and outlining (most, but not all chapters) of Physical Therapy for Children by Campbell was key in my preparation. I would also recommend reviewing electrical stimulation and ADA laws. Definitely be comfortable with the various standardized tests and knowing when to utilize each.
I expect you will do well on the exam, Joni.
I think serial videotaping of children moving is an excellent way to document progress, or the lack thereof.
I love your number 2 point – we need to focus more on function during everyday tasks and teaching parents. At times, I believe that should be our main objective – educate parents and school staff. Also, love your statement on not helping too much. Let the kids teach us too!
Thanks Margaret! I think part of our role has to be getting parents/caregivers/school staff to believe and understand that they are integral parts of the team and that their carryover is more important than anything else. And that carryover can fit into their daily lives with some tweaking, rather than it being a separate thing. Please share any suggestions you have to making that happen!
To start, we need to stop always pulling kids out of the classroom for PT. When school staff observes what we are doing they will be more likely to help the students when we are not there. Offer professional development to staff on the importance of motor development and academics. When staff realize the benefits of motor development on academic success, it will be easier for them to carry out suggested activities. Part of the problem is that we are viewed so much as a service and not as a part of the whole team. We need to do a better job of educating the community (as you stated) on what we can offer. When providing PT in the home, take the time to just observe the family’s routines and environment. We need to make realistic suggestions of what can be carried out daily. Each home environment and dynamic is different therefore we can not apply a cookie cutter methodology. Bottom line is the child and family must come before “PT Theory”.
The school setting can be so complicated. We are more effective integrating our services into the classroom, but on the other hand it is a process to get staff to trust that this is worth the effort and disruption. When it comes to home I think it is essential to realize that our role is not to come in a “fix” the child. Your point to stop and observe is so important- otherwise what we are providing is a drop in the bucket out of the child’s week and nothing is learned or gained.