Pediatric Rehab

We combine family-centric care and kid-friendly rehabilitation methods to help children and adolescents with medical, cognitive and developmental needs reach their maximum potential.

Conditions We Treat

We create custom treatment plans specific to each child, which may include occupational, physical and speech therapy. These plans are designed to promote mobility, cognitive awareness, social skills and independence. 

Our assessments and therapy programs also include consultation and collaboration with patients family members, school and medical professionals as necessary. 

  • Autism spectrum disorders 
  • Brachial plexus injury 
  • Cerebral palsy 
  • Cleft palate 
  • Developmental delay 
  • Down syndrome 
  • Feeding problems 
  • Hydrocephalus 
  • Impairment 
  • Premature birth 
  • Sensory processing disorders 
  • Spina bifida 
  • Torticollis/plagiocephaly 
  • Traumatic brain injury 
  • Vision/hearing 

A referral is required for patients to receive pediatric rehabilitation services. Talk to your child’s pediatrician about receiving a referral.

Therapies We Provide

Pediatric Physical Therapy

Children want and need to move through their world. We help infants and children achieve the mobility that is needed to play, explore and function as easily and independently as possible in their everyday lives. 

We use our expertise of motor development skills and understanding of the nervous system and growing body to help children achieve independent movement or recover from an injury or illness that has made movement less efficient. 

Pediatric Occupational Therapy 

We assist you and your child in the development of skills that lead to independence in self-help, play, academic and social areas: 

  • Fine motor coordination and handwriting skills.
  • Oral-motor development and eating skills. 
  • Age-appropriate independence in daily living skills. 
  • Instruction for caregivers in development, play or physical handling of the infant. 
  • Normal sensory response development (touch, movement, sight, sound). 

Pediatric Speech-Language Therapy 

We assist you in teaching your child to become a successful communicator and to be an independent language learner: 

  • Language & expression
    • Articulation: Pronouncing sounds.
    • Language comprehension: Listening and understanding vocabulary. 
    • Expressive language: Using words, sentences and gestures to convey ideas. 
    • Fluent speech: Minimize stuttering. 
    • Healthy voice: Minimize hoarseness and vocal strain. 
  • Interaction & communication
    • Social communication: Sharing experiences with peers. 
    • Play skills: Exploring and learning about the world.
  • Reading & writing skills
  • Thinking skills
    • Improving attention span and memory.
    • Encouraging problem solving. 
  • Eating & drinking
    • Promote normal chewing. 
    • Learn safe swallowing.

Serial Casting

What is serial casting?

Serial casting is the process of putting a cast onto and taking it off of a leg every week for a period of several weeks. The goal is to stretch muscles to allow for better movement and range of motion over time. Thanks to Dr. Price and our specially-trained pediatric physical therapists, we’re able to offer serial casting at TMH, so families no longer have to travel hundreds of miles away to receive this treatment and care.

Who could benefit from serial casting?

A child who has tightness in their calf muscles, difficulty standing or walking with feet flat on the ground, or has trouble putting shoes and/or orthotics on their feet due to limited flexibility in their ankle.

Children with the following medical diagnoses or conditions may be good candidates for serial casting:

  • Toe Walking
  • Cerebral Palsy
  • Clubfeet
  • Muscular Dystrophy
  • Neuropathies
  • Spinal Cord Injury
  • Traumatic Brain Injury

What does a typical treatment plan look like?

An initial physical therapy evaluation by a physical therapist who has been specifically-trained in serial casting is scheduled. This a 60 minute appointment. At the end of the evaluation, the physical therapist will go over the treatment plan and may recommend a period of time for stretching and desensitization exercises in preparation for serial casting. If there is strong spasticity present, the child may be referred back to their physician for Botulinum Toxin injections prior to casting for optimal outcomes.

Each serial casting session lasts about 60-90 minutes. At the beginning of each session, your therapist will do a skin check, range of motion assessment and observational posture and gait analysis. The child will need to be able to sit on a bench/chair for the casting procedure. Families can bring snacks and/or favorite toys if desired. The child is able to sit and play while casts are applied, often TMH’s Music Therapy department is available as well.

Once the cast(s) are on, the child gets cast shoes and they’re modified as needed to achieve optimal gait and standing posture. The casts are removed by parents at home each week, the night before they return to their physical therapist for a new cast. Casts are changed weekly until the target and/or acceptable range of motion goals are achieved.

There is no guarantee that the child will reach the target goal. If desired range of motion is not achieved, the physical therapist will refer the child back to Dr. Price or their referring physician.

Following serial casting, the child often requires ankle foot orthotics and/or night splints to maintain the achieved range of motion and proper posture and walking pattern. It may be recommended that the child also continue physical therapy for a time for further work on ankle strengthening and gait training. A home program is always critical to follow in order to maintain achieved improvements.

Things to Know

  • Casts are NOT waterproof and should not get wet.
  • Cast shoes must be worn with the casts any time the child is on their feet. The child will be able walk, run and participate in all activities as before, with the exception of water activities.
  • Casts can be removed at home. The casts are a combination of soft cast and fiberglass and do not require a cast saw for removal. If there are any concerns or issues, the parent will have their therapist’s number and can reach out to them directly.

 

 

 

Our Patient's Perspective

Harper - During

Meet Harper! When Harper’s mom, Katya – who also happens to be one of our amazing physical therapists – noticed her 5-year-old daughter’s gait was off, she knew to seek medical care at TMH. After a neurologist diagnosed Harper with mild Cerebral Palsy, she was referred to Dr. Ryan Price, the region’s only pediatric orthopedic surgeon. He recommended a non-surgical treatment option called serial casting.

Serial casting is the process of putting on and taking off a cast on an arm or leg every week for a period of several weeks. The goal is to stretch muscles to allow for better movement and range of motion over time. Before Dr. Price and our specially trained pediatric physical therapists were able to offer serial casting at TMH, families would have to travel hundreds of miles away to receive this treatment and care.

“Even while wearing the casts it never slowed her down. Harper would play with friends, run all over the place, and it did not bother her at all,” said Katya. “And now that the casts are off, she is just thriving.”

Forms and Resources