Pediatric Physical Therapy Through a Child's Eyes

By TLC Physical Therapist Candice Cartiaux, PT, DPT

"I am a kiddo and I have some special needs.  Every day starts with my mom showing me my daily schedule.  My schedule is made of labeled pictures that show me doing the different activities I will do today.  My mom puts them in the order we will do them, and sometimes I help choose what we will do first. What a sweet time each morning for my mom and me! I find freedom to relax and trust someone else to make my decisions when I am given instructions and shown what my day will be like.  I know what to expect, and I like that. 

A photo schedule by Milk Allergy Mom

Today is Thursday.  My mom shows me a picture of myself and my physical therapist as she tells me that I will have therapy this afternoon.  Every week on Thursdays, I have a friend who comes to my home to spend an hour with me.  Even though Mom calls it physical therapy, I really feel like it’s just my special play-time.  When my friend comes over, she always asks if I am ready to play, and even though I can’t tell her yes, my mouth smiles and lets her know that I am ready.  My friend prefers to play on the floor.  I enjoy this because I spend a lot of time sitting in my wheelchair at school during the day.  It feels good to stretch my body and have some space to move.  Though I cannot do much movement on my own, it is great to have the freedom to try. 

A child plays out of his wheelchair during a therapy appointment

My friend likes to take her shoes off and get on my gym mat with me.  My mom puts my favorite songs on the CD player while we play, and I like that my friend sings along to them.  Sweet music puts my body and heart at ease.  Even though we work through some of the same activities and tasks each week, my friend always tells me what she is about to do or help me do before she does it.  I don’t like to be surprised by touch or sound, so this gives me the chance to be mentally prepared and engaged.  

A kiddo plays with two therapists in his backyard at home

One of the biggest things my friend is helping me learn to do is roll over on my mat.  I am pretty good with using my neck to turn my head each direction, especially if there is a toy I like to see and hear.  I swear she can read my mind!  When I turn my head to look at my jingle bells, she says “bells” and shakes them.  I love being able to have a conversation with my eyes because it is very hard for me to form words with my mouth.  I know if I keep looking at the bells out of my reach, my friend knows that I really want to play with them.  She then uses the simple words, “Let’s Roll!”  I appreciate how she gives me more time to process what these words mean, because it takes a little longer for her message to move from my brain to my body.  Because I am already looking over, I can feel my body ready to roll, and we roll.  My body adjusts once I have rolled over, and from the praise I received from my friend, you would have thought I won an Olympic gold medal! It sure feels like it. 

My friend is not only helping me get stronger but also feel stronger.  The stronger I get, the more time I can have to play with my family.  And honestly, that is my favorite thing to do."

Physical therapy can be a fun part of a child's week, in addition to an important part, that helps them grow stronger and more independent. TLC therapists invite kids to PLAY with them during sessions! If you would like to learn more at pediatric physical therapy for children birth - 12, or about pediatric therapy integrated into a preschool setting, contact TLC at (303)776-7417

Early Intervention & Occupational Therapy


By Shari Karmen, TLC Therapeutic Services Manager & Occupational Therapist

I believe in Early Intervention; I don’t believe in the motto “wait and see what happens in a year." Parents should trust their gut feeling when worried about their child’s development because parents know their children best. Early Intervention and screening for developmental delays and disabilities can make all the difference in setting a child on course for healthy growth.

Helping kids and their families screen for delays and address areas of concern to build strong, happy kids is what I love to do. I want all parents to know what Early Intervention is, and how it can benefit their child.

 My son, K, as a baby

When I think of the successes of Early Intervention in children I've worked with, so many faces come to mind. I remember when a little girl with a serious heart condition ate her first cheerio without choking, a huge feat for a toddler with a history of feeding difficulties and poor weight gain. I remember another little girl who was sent home from her long hospital stay with bottles and nipples from the hospital that were not available to the public. Her mom was panicked, but we worked together to find the right combination and a comfortable feeding position. Together, we were able to help the little girl move to a commercially available bottle and nipple. Her mom was overjoyed, and the little girl was able to eat a healthy amount and gain weight at a healthy pace, and that made me smile. I have so many stories like these.

I also have a personal story. My son, K, was delayed. I was probably the nightmare mom – the one who knew just enough to drive the doctors nuts. I brought my son in to the doctor's at four days old and said he had low muscle tone. Of course at the time he was crying his eyes out and stiff as a board, making the process of observing him more difficult. But my pediatrician believed me when I voiced my concerns, and referred me to the Early Intervention program in Tucson.

K is truly an Early Intervention success story. We started Physical Therapy for his low muscle tone at six months, followed by Occupational Therapy, and then Speech Therapy. With help building his strength and muscle tone, K was able to sit upright, as well as crawl a crooked path at nine months. He walked at 18 months. He did not use verbal language, but learned some sign language between 12-18 months. He was very sensitive to movement, noises, and touch, which made car rides, going to the grocery store, and getting dressed a challenge. Our therapists worked with K and us on each of these difficulties.

My husband and I followed through with every recommendation and exercise demonstrated by our therapists, working with K at home following appointments. My son graduated from Physical Therapy, then Speech Therapy (speaking in full sentences), and lastly, Occupational Therapy within three years. I am happy to report that today he is a talented, soft spoken, and loving 18 year old, getting ready to leave the nest to pursue degrees in classical piano performance and music education. We couldn't be prouder parents.

I know not everybody’s story is the same, but in all of my years working, I can honestly say that I always see positive changes with Early Intervention services. I was friends with my son’s therapists, and now I have made friends with my client’s families, and I love seeing the progress their children make long after they've graduated from Early Intervention therapies.

So, what is Early Intervention?

Commonly referred to as EI, Early Intervention is a nationwide system that helps identify, and then helps treat babies and toddlers with developmental delays or disabilities. EI focuses on five areas of development:

  • Physical (rolling, crawling, using hands to play with blocks)
  • Cognitive (problem solving how to get to a toy, playing peek-a-boo, figuring out a toy)
  • Communication (babbling, talking, following directions)
  • Social/Emotional (feeling secure, smiling, playing with other children)
  • Adaptive (eating, dressing, sensory processing)

Eligibility for EI services is determined by an evaluating team. If eligible, EI services can be put in place from birth up to a child’s third birthday.

Anyone can refer a child to EI. If you as a parent have a concern about your child’s development, you can call a center like TLC (a pediatric therapy office specializing in EI services and physical, occupational, and speech therapies for children up to 12), the local Child Find office through your school district, or the Part C agency in your county. Physicians and daycare providers are also great referral sources.

Early Intervention services include:

  • Physical Therapy – to address gross motor skills such as rolling, crawling, and walking, issues with balance, strength, and coordination.
  • Occupational Therapy – to address fine motor skills, sensory processing, self help skills (feeding, dressing), and play skills.
  • Speech and Language Therapy – to address understanding of language, expression, social communication, and speech intelligibility.

EI is based on routines. That means that we, the therapists, help you, the parent, to provide therapeutic activities during your child’s daily routine. EI therapists can see children in the hospital, in homes, in childcare settings, and out and about in the community.

If you have any concerns about the development of your child, don't hesitate to have your child screened. It's easy, and can make a world of difference in helping your child be the happiest and healthiest baby it can be. I'm proud to say, Early Intervention works!