When to Take Your Child to the Physical Therapist


child lying on exercise ball

You may only know physical therapy (PT) as a remedy for damaged muscles or other mobility-limiting injuries. While physical therapists indeed help those with injuries get back to their old selves, they also improve the lives of those with lifelong diseases affecting strength and mobility. Children with such conditions can especially benefit from working with a physical therapist early on in life, so that they can maximize strength and mobility while they are young or slow the progress of degenerative disease. If your child has one of the following conditions, physical therapy may be something that can help them reduce pain, increase mobility, and gain independence.

This guide will take you through the following:

  1. Conditions that PTs can help treat, including what their signs are.
  2. How to get your child an appointment with a PT, including your states rules about referrals
  3. Where you can expect PT sessions to occur
  4. How to pay for PT
  5. What your role as a parent is in your child’s success

Note: You should consult with your doctor or physical therapist for treatment recommendations. We are not doctors and the information in this article does not constitute as medical advice. We don’t recommend or endorse any specific tests, procedures or opinions  that may be mentioned on the site and reliance on any information on the site is solely at your own risk.

Pediatric Conditions that Benefit from Physical Therapy

 

Autism

While many people think of autism interventions as being essential for social and language skill development, children with autism also have motor skill and sensory development needs that benefit from physical therapy. Some of the challenges that autistic children face- including delays in large and small-movement skills, poor balance and coordination, walking instability, and difficulty controlling posture- are things that can be improved with the help of a PT. By working with a PT to increase motor skills, your child can gain independence and participate in school and at home at a higher level.

Physical Therapy Helps Children With Autism:

  • Make progress in motor skill development
  • Improve balance
  • Improve coordination

Movement-Related Signs of Autism:

  • Delays in walking, jumping, and other large-movement skills
  • Delays in tying shoes and other small-movement skills
  • Lack of coordination and hand eye coordination
  • Lack of balance
  • Trouble planning movements
  • Walking instability
  • Poor posture control

Further Reading

Cerebral Palsy

Cerebral Palsy can vary in severity but will always affect posture and movement to some degree. Depending on the degree of symptoms, physical therapy can help children with the disorder increase strength, posture, and motor control and expand the range of things they can do. Therapy focuses on helping your child achieve what is within his or her potential through a combination of increasing gross motor ability and finding alternate ways to achieve goals. For someone with milder symptoms, this could mean walking with less assistance. For someone with more severe systems, this could mean operating a wheelchair. PTs meet each patient where they are at and work towards achieving the best outcomes.

Physical Therapy Helps Children With Cerebral Palsy:

  • Improve gross motor skills
  • Increase strength and posture
  • Find alternate ways to complete tasks

Signs of Cerebral Palsy

  • Missing developmental, social, and cognitive milestones
  • Physical and motor skill difficulties
  • Diagnosis often comes at a very young age

Further Reading

Chronic Pain

A child may have chronic pain for a variety of reasons. Injuries, disorders, and diseases can all be causes of chronic pain. Whatever the cause, physical therapy may help reduce or eliminate your child’s chronic pain through movement, stretching, and strengthening. Every instance of chronic pain and its cause is unique- PTs have the skill set to evaluate these cases and use evidence-based practice to come up with a treatment plan for your child.

Physical Therapy Helps Children With Chronic Pain:

  • Reduce or eliminate pain

Signs of Chronic Pain

Persistent pain lasting longer than 6 months.

Down Syndrome

Children with Down Syndrome have looseness of ligaments, low muscle tone, and decreased strength. These physical attributes affect gross motor skill development. Children with down syndrome do the same activities that “typical” children do, but because they have to compensate for low muscle tone and increased flexibility (from loose ligaments), their different path to motor skill development comes with risks such as foot pain. It also leads to inefficiencies in walking and other movements. Physical therapists do not speed up motor development in their Down Syndrome patients- they make sure that when these skills are developing, that movement patterns are efficient and not harsh on the body.

Physical Therapy Helps Children With Down Syndrome:

  • Ensure motor skills develop so that movements are safe and efficient
  • Increase strength

Signs of Down Syndrome

This diagnosis is usually given during pregnancy.

Further Reading

General Developmental Delays

Not every delay in motor skill development can be attributed to a disease or injury. PTs can help any child improve balance, strength, and motor skills. If your child is missing his or her milestones, you should always have them evaluated to see if physical therapy may help.

Physical Therapy Helps Children With Developmental Delays:

  • Improve balance
  • Improve strength
  • Improve motor skills

Milestones and Signs to Look Out For

  • 4 months- holding head up
  • 6 months- sitting
  • 12 months- walking
  • General movement difficulties
  • Low muscle tone

Further Reading

Neuromuscular Disorders

Physical therapy can benefit children with neuromuscular disorders such as muscular dystrophy. Even though these diseases are degenerative, physical therapy can maximize capability and quality of life throughout the course of the disease. PTs work with children to maintain function as long as possible and then to adapt to loss of function. They also work to prevent and manage pain in children with these diseases. If your child has a neuromuscular disorder, PT may be an important part of reducing his or her pain and slowing the progression of disease.

Physical Therapy Helps Children With Neuromuscular Disorders:

  • Slow disease progression/Maintain function as long as possible
  • Adapt to loss of function
  • Manage pain

Signs of Neuromuscular Disorders

  • Stumbling
  • Waddling
  • Trouble climbing stairs
  • Toe walking (heels do not hit floor)
  • Difficulty pushing
  • Trouble getting up after sitting

Further Reading

Spinal Cord Injury 

Spinal cord injuries can greatly affect a child’s life- depending on the type of injury and severity they can cause paralysis, muscle weakness, breathing trouble, and loss of function in the bowels and bladder. Some spinal cord injuries may be the result of an accident, while others such as spina bifida are diagnosed at birth. Depending on your child’s needs and limitations due to the severity of the injury, PTs can help your child gain muscle strength, increase mobility and balance, and improve quality of life.

Physical Therapy Helps Children With Spinal Cord Injuries:

  • Strengthen muscles
  • Increase balance and mobility
  • Find alternative ways to complete tasks
  • Improve quality of life

Signs of Spinal Cord Injury

  • Low strength
  • Loss of motor function or paralysis
  • Breathing difficulties
  • Bladder/bowel function loss
  • Loss of feeling
  • Spasms
  • Pain
  • For spina bifida, a tuft of hair or birthmark may be present above abnormality

Further Reading

Torticollis

For children with congenital muscular torticollis, physical therapy can lengthen the shortened muscle that is causing the tilt in the neck. A PT may recommend a special collar that will help strengthen your child’s neck muscles and straighten the head and will also you specific exercises you can use to strengthen your child’s neck at home

Physical Therapy Helps Children With Torticollis:

  • Strengthen neck muscles to straighten the head

Signs of Torticollis

  • Head tilting to one side
  • Limited range of head/neck motion
  • Facial asymmetry
  • Musculoskeletal issues

Further Reading

Traumatic Brain Injury and Pediatric Stroke

Physical therapists play an important role in the rehabilitative process for those with brain injuries. Stroke and TBI often cause people to forget how to make movements and complete physical tasks that once came second nature. PTs help those with brain injuries relearn the movements and skills they have lost. If your child has had a pediatric stroke or other brain injury, physical therapy will certainly be part of the rehabilitative process.

Physical Therapy Helps Children With TBI:

  • Relearn movements
  • Regain strength

Signs of Pediatric TBI

  • Change in eating habits
  • Irritability
  • Inconsolability, persistent crying
  • Change in attention span
  • Change in sleep habits
  • Seizures
  • Depression
  • Drowsiness
  • Loss of interest in preferred activities

Further Reading

How do I Get My Child Physical Therapy?

Most states allow patients to seek out physical therapy in at least some instances without a referral from a doctor. Depending on the state, there may be some or many instances where a referral is required. Even if a referral is not required, seeing a PT without a referral may jeopardize insurance coverage depending on your plan. Before finding your child a physical therapist, do these two things:

  1. Check your insurance policy to see if you need a referral in order to get coverage
  2. Check this APTA list to see if your state requires that you get a doctor’s referral before your child’s first appointment. Some states may still require PT’s to get approval or refer you back to a primary care provider after a certain amount of time, but you can ask your PT if there are any such requirements on your first visit if you are not already required to have a referral for the initial visit. The PT may also be required to inform your physician of treatment, in which case they will talk to you about whom they should notify.

If you are required to get a referral before seeking treatment, you can get one from a physician, surgeon, podiatrist, or depending on the state, another health professional. It is always good to consult a physician about any symptoms or abnormalities that you observe in your child.

Where Will My Child Receive Physical Therapy?

Physical therapy may take place in a variety of settings. It may be offered through your child’s school as part of an IEP plan. One out of three physical therapists work in an office by themselves or with other therapists such as occupational therapists or speech pathologists, so therapy may be at one of those practices. If your child is hospitalized, PT may take place in the hospital. Some PTs may even treat your child in your own home. No matter the setting, part of therapy will involve the PT educating you on exercises and things you can do to help your child progress at home in between sessions, so some PT will always happen at home.

How Do I Pay for My Child’s Physical Therapy

Most insurance plans will cover at least some portion of medically necessary physical therapy costs. Depending on the plan, it may be required that you get a referral for PT services from your doctor in order for those services to qualify for reimbursement. Make sure you check with your insurance company directly to see what they will cover and ensure you are doing everything you need to do to qualify for reimbursement.

If your insurance does not cover the physical therapy services, you can pay for them directly.

If your child has an IEP plan at school and has physical therapy needs, physical therapy will be part of your child’s education plan free of charge, and may take place during the school day or at a separate facility.

What Role Do Parents Play in the Physical Therapy Process?

After an initial evaluation, your child’s PT will develop a treatment plan which will involve your child attending one to several PT sessions per week. In addition to these sessions, your child’s physical therapist will educate you on how to help your child progress at home. What you do for your child at home is very important to his or her progress. You may be instructed by the PT to do the following:

  • Positioning your child: PTs will instruct you on how to put your child in positions that strengthen them (such as in cases where the child has cerebral palsy) and will also instruct you to prevent your child from positioning themselves in ways that inhibit good posture and movement (such as w-sitting).
  • Toy adaptation: Physical therapists will teach you how to adapt your child’s play things so that they are easier for your child to use or promote strength
  • Expand mobility options: If your child is limited in his or her mobility, PTs will introduce you to technologies or methods that will help expand your child’s mobility.
  • Exercise: The physical therapist will instruct you to perform exercises with your child at home in between sessions.