Susan Effgen, PT, PhD, FAPTA is Professor Emerita and former Director of the Rehabilitation Sciences Doctoral Program at the University of Kentucky. She is an established educator and researcher in pediatric physical therapy and is a Catherine Worthingham Fellow of APTA. As co-chair of the APTA’s then Section on Pediatrics Government Affairs Committee, she was active in the authorization and reauthorization process of the Individuals with Disabilities Education Act (IDEA). The Academy’s Advocacy Award is now given in her name. She has served on several editorial boards, including Physical Therapy, and authored the text Meeting the Physical Therapy Needs of Children. She was co-investigator of a US Department of Education grant: PT COUNTS, studying the Relationship of Student Outcomes to School-based Physical Therapy Services. She is the founding chair of the APTA Academy of Pediatric Physical Therapy, School-based Special Interest Group.
Note: You should consult with your doctor or physical therapist for recommendations on treatment. The views and opinions expressed in this article are those of Dr. Effgen and do not necessarily reflect the official policy or position of OnlinePhysicalTherapyPrograms.com
How did you become interested in researching early intervention physical therapy?
In the 1970s, I worked as a physical therapist on several federal BEH early intervention grants in Atlanta. These grants were required to collect data and so this was my start in data collection, research, and early intervention.
What inspired you to develop the first doctorate in pediatric PT in the US? What is it like starting a program from the ground floor?
When I started my doctoral work there were no PhD programs in physical therapy. You had to embrace another profession. Not that that is bad, but we needed individuals who were fully vested in physical therapy and physical therapy research. So when the opportunity arose at Hahnemann University in Philadelphia, I decided to develop what would be the 4th or 6th (depending on whether you counted joint programs that included PT) PhD physical therapy program in the nation, starting with pediatrics. I can still remember being questioned by the university council about whether there was a “sufficient body of literature” in physical therapy. Well of course, there was not, that was why we needed PhD programs.
What are some of the most important things we have learned about the role of early intervention PT in recent years?
Early intervention should be a team intervention. No one profession has all the knowledge and skills required to meet the individual needs of the child and family. Some children require the advanced expertise of one discipline, but always in combination with the support of other disciplines. The original law, Pl 99-456, recognized this when they said the service coordinator should be from the discipline representing the greatest needs of the child. Unfortunately, I believe that this is no longer followed and the least expensive professional, usually with very general knowledge, tends to lead the team.
Therapists must embrace the coaching model and parent involvement. That includes parent education, demonstrating interventions to parents, observing the parents as they perform the interventions, and collaborating with other disciplines. It should not mean hands off, but parent education is critical. Unfortunately, the main elements of coaching are not being done to the extent recommended as found in a recent study completed by my doctoral student.
What are some of the challenges to getting those in need of EI PT the care that they need?
There needs to be more federal and state support for early intervention so that all needed disciplines can be involved to maximize the child’s development. Parents must also recognize the need for therapy services. Years ago, parents were the biggest advocates for therapists. I do not think they understand our role anymore. They think of us for their grandparents or for athletes, not as the developmental specialists that go back to the roots of our profession.
You have written many articles on the role of school based service delivery. What is the impact of having access to physical therapy through schools?
It is very hard to determine the impact of school-based physical therapy since there are so many variables and little funding for research. The PT COUNTS study found that the majority of children achieve or exceed goals related to physical therapy and improved on the School Function Assessment. Those students were receiving therapy from truly dedicated PTs, working in school systems that allowed research. I wonder about the level of services and student outcomes in school systems without that level of dedication and involvement.
I believe we really help the team help the students achieve their goals and ease the burden on teachers and other staff. Schools are truly the natural environment and the place where participation occurs. It is the best environment for intervention and school systems that welcome therapists appear to have the best student outcomes.
What aspect of your research are you most proud of?
I am really most proud of the PhD students I have worked with and mentored. They have gone on to successful careers as researchers and faculty to meet a critical need in our profession and the children we serve.
What advice do you have for those interested in a career in pediatric physical therapy?
You have to be flexible, accepting of ambiguity, able to change direction, and a life-long learner. Pediatrics is a very diverse area of practice; not only because of the array of diagnoses and service delivery settings, but the children are still developing, and have varying levels of cognitive function. You must welcome the challenge.
A practical piece of advice is to consider rolling stools your friends. So many of my pediatric colleagues have knee issues as they age. Any way you can save those knees while you are young will help you later!