Pediatric Physical Therapy at Home in New York City

What is Pediatric Physical Therapy?

Movement is important at all stages of life; and individuals may have challenges with this at any of these different stages. However, newborns, infants, children and teenagers are not just little adults. Their body’s structure, and how their body responds to interventions are different, and treating a child similarly to an adult can result in injury. When a newborn, infant, child or teenager has challenges with posture, alignment, developmental skills, balance, coordination, strength and stability, flexibility, pain, or performing functional/ play/ sports related skills, a pediatric physical therapist can help.

Palmer Concierge Physical Therapy has therapists that specialize in various areas of pediatric physical therapy including: Developmental PT, Vestibular PT, and Sports Performance, Sports Injury Prevention and Sports Injury Rehabilitation; as well as Pediatric Rehabilitation due to injury or illness. This differs from clinic, hospital, school based and Early Intervention physical therapy in that it is provided at a time and place of your choice, focuses on more than just minimal functional standards, is able to be initiated in a timely manner (rather than waiting on a wait list, or in terms of early intervention – until your child is 2 standard deviations behind their same aged peers to then begin therapy). In addition, babies who are medically fragile, might not yet be fully vaccinated, are possibly immunocompromised due to prematurity or other reasons, or are at higher risk of illness during “respiratory season” can have this risk decreased by not having to navigate crowded areas like public transit and waiting rooms.”

Could Pediatric Physical Therapy At Home Benefit Your Child?

Our physical therapists provide developmental therapy and specialized support for preemies or infants with extended NICU stays, serving patients from newborns to teenagers, including:

Infants with:

• Torticollis
• Club Feet
• Calcaneovalgus
• Cranial malformations
• Chronic lung disease or heart disease affecting your baby’s posture and/or function
• Gastrointestinal dysfunction (sometimes requiring abdominal surgeries, and
• delaying tummy time as well as resulting in bound down abdominal scarring)

Infants who experienced the following at birth or before birth:

• Exposure to toxins (at times prescribed medications that pose challenges to newborns, or accidental non-prescribed substances)
• Loss of oxygen
• Shoulder dystocia

Infants, toddlers, children and teenagers with:

• Developmental Delays
• Challenges of balance, stability and coordination
• Congenital or Genetic Disorders
• Autism Spectrum Disorder
• Cerebral Palsy
• Altered muscle tone – low, high, ataxic, athetoid
• Sensory Challenges
• Deficits resulting from accidental or non-accidental trauma
• Deficits resulting from prolonged illness, surgeries or hospitalization

Especially when working with young clients, PT Krissy finds it most beneficial to work with the client, but also spend time teaching the client’s caregivers how to carry over what is done within the session, between sessions. (This may be the parent, grandparent, daycare provider, nanny or other individual designated by the client’s caregiver.)

Pediatric Physical Therapy At Home: What Parents Can Expect in their First Session? 

The first step in the pediatric physical therapy journey is a thorough baseline evaluation: observation of any positioning or mobility equipment that your baby or child is using.

The evaluation is a time for the parent to voice questions and concerns about pediatric physical therapy.  We review all information and then collaborate with parents, where appropriate the child, and in some cases other professionals involved to determine objectives, aligned to and targeting the child’s functional deficits, delays, injuries or recovery goals.

Your child’s physical therapy treatment plan may include different therapeutic modalities, including:

• Positioning and handling (that the PT will perform and also teach you) to help facilitate developmental milestone progression.
• Education regarding barriers to progression, and different activities and toys to help progress toward the next stages; or in the case of premature babies, identifying and limiting stimulation that may be too much for them.
• Scar massage to help loosen bound down surgical scars that may be limiting movement.
• Strategies for helping babies who can’t regulate their state (are either asleep or awake and crying) improve their transitions and ‘quiet and active alert periods’ so that they can be awake, happy, exploring their environment and playing.
• For children with ASD, sensory and movement strategies that can be integrated into your child’s day to help them function more easily and comfortably throughout the day.
• Activities for increasing: strength, balance, stability, coordination, motor planning, body awareness, muscular length, endurance and postural alignment.
• Play that incorporates breath work, calming the nervous system, and grounding.

Our objective is that through working with your child and yourself; that we can help make movement, play, and exploration easier, safer and more enjoyable; so your child can grow, develop and more easily participate in activities they enjoy, including those with their peers.

Key Benefits of Pediatric Physical Therapy for Babies & Toddlers

• Helps in the transition between a prolonged NICU stay and independent care of a preemie or medically fragile baby.

• Improves asymmetries, so that equipment such as helmets can be avoided, alignment is improved to preserve joint development, and developmental milestones can more easily be achieved.

• Addresses developmental challenges and delays early so that they have less of a chance of progressing as far, can be addressed more easily, and decreases frustration of a baby who wants to play, but motorically is challenged to.

• Increases your child’s sense of confidence and independence.

• Increases a child’s ability to participate with their peers and in a larger variety of activities, both through improving their skills, and helping to modify equipment needed to do so.

Signs Your Baby Might Need Physical Therapy

• Your baby is either asleep, or awake and crying; without any intermediate states.
• Your baby demonstrates a neck preference and/ or has flattening on part of their head that makes it hard for them to keep their head in the middle.
• Your baby doesn’t tolerate tummy time and/ or can’t lift and turn their head when on their belly by 3 months.
• Your baby keeps their thumb(s) in the palm of their hand, unable to bring them out (as is needed for grasping), past __ months.
• Your baby isn’t bringing their hands to their mouth or together by 3 months.
• Your baby isn’t accepting weight through their legs when supported by 6 months.
• Your baby can’t sit unsupported by 8 months.
• Your baby isn’t pulling to stand, standing at a support surface and starting to cruise by 12 months.
• Your baby is showing a hand, arm or leg preference before 3 – 4 years old.

Signs Your Child Might Need Physical Therapy

• Your child trips and falls a lot, bumps into others when walking, or tends to walk with one side of the body touching a wall.
• Your child tends to slouch or lean to one side.
• Your child repeatedly gets picked last for teams, or can’t keep up with his peers.
• Your child wears out the toes of their shoes before the rest of the shoes are worn in; or walks on their toes/ forefeet.
• Your child tires out before their peers walking through the halls, going up stairs, or playing outside.
• Your child isn’t able to sit still in class, at the table for meals or for any activity long enough to finish; needing to get up and move, fidget, or demonstrating challenging behaviors

Pediatric Physical Therapy for Sports Injuries

Participating in sports is an excellent way for children and teens to enjoy regular exercise while learning all about teamwork, perseverance, and leadership.  Unfortunately a side effect of youth sports is the occasional injury that requires pediatric physical therapy to properly heal. 

The bones, muscles and joints of children and teens require special care. Growth plates—tissues at the ends of bones in children and teens that influence the future shape and length of the bone once mature —are still open and vulnerable to damage.  Should growth plates become injured, and not diagnosed or treated correctly, it can lead to long term debilitation leaving children and teens permanently sidelined from the activities they enjoy.  

Some of the most common sports injuries that children and teens experience are due to impact (with other players or objects like balls) and repetitive motions or overuse and include:

• Ankle injuries
• Pulled muscles
• Shin splints
• Knee injuries
• Tennis elbow (tendinitis)
• Hip flexor injuries

While children and teens do recover faster than adults from injury, they should still be treated and as soon as possible once suffering an injury.  Beginning therapy early enables the young athlete to benefit from joint mobilization and manual soft tissue massage to decrease any inflammation and initial pain resulting from an injury. Treating sports injuries purely with rest and medication does not target the movements,  skills, and strength demands for your child to safely return to a sport with a reduced risk of re-injury.   In rehabilitating your child, we will have them safely perform exercises that mimic the specific motions and stressors they will experience when they return to their sport.   Upon completion of a tailored treatment both you and your child should feel confident that they can return to their sport without fear of injury.