Pediatric Programs

Our goal at Teton Physical Therapy & Rehabilitation is to connect well with the child, thoroughly assess and identify and functional performance issues and then partner with the parents/caregivers to develop a treatment plan and goals that will enhance the quality of life of the child.

What does a Pediatric Occupational Therapist do?

Our Occupational Therapist who specializes in Pediatrics, Molly McNichol has a doctorate in Occupational Therapy and has 15 years of experience with Pediatrics.  Molly’s expertise and unique connection with children allows her to connect well with kids so she can identify barriers to a child’s occupational performance, teaching new skills and strategies, adapt the child’s environment and expands a child’s occupational performance in order to fully participate in life.

What does a Pediatric Speech Therapist do?

Our Pediatric Speech Language Pathologist, Kate Wienman has a strong skill-set and compassion for children.  She is highly trained to help children learn to communicate with others and also addresses swallow disorders to help improve the child’s quality of life.

Give us a call if you have questions about our pediatric services.

• Asperger Syndrome

  Asperger syndrome is an autism spectrum disorder (ASD), which is considered to be on the higher functioning end of children affected with autism. Many of the children affected by Asperger syndrome have difficulty with social interactions and can have limited interests as well as repetitive behaviors. At times, normal motor development may be delayed, causing clumsiness or uncoordinated motor movements.

  Children with Asperger syndrome often do not have significant delays or difficulties with language or cognitive development.  In fact, they may demonstrate advanced use of vocabulary, concentrated in a specialized area of interest. The below signs and symptoms are common with Asperger syndrome, are not often all present in any one individual and will vary in degree:

  • Limited or awkward social interactions
  • Robotic or repetitive speech
  • Challenges with nonverbal communication (gestures)
  • Lack of eye contact
  • Poor ability to engage in reciprocal conversation
  • Difficulty taking the perspective of others
  • Obsession with specific topics
  • Awkward movements or mannerisms

  How Pediatric Therapy Helps

  Our pediatric therapy focuses on first assessing where your child’s abilities may have limitations, then completing a thorough plan to address them. Often, the focus is on helping your child with social interactions, self-awareness, improved coordination and speech. The earlier the intervention, typically the better the outcome. Our goal is to help your child be more successful in life and their interactions with others.

• Autism

  Autism is a general term for a group of complex disorders of brain development. Autism is thought to stem from very early brain development, and while signs tend to become most obvious between 2 and 3 years of age, children much younger can be identified. According to the Centers for Disease Control and Prevention (CDC), autism is identified in around 1 in 88 American children. In addition, studies show that autism affects boys four to five times as much as girls.

  Research is coming to light that shows autism is caused by not just one factor, but a multitude of factors from genes, to early oxygen deprivation in the brain, to environmental influences and a host of other possible factors. It is important to note that autism is a wide range of symptoms and every person affected with autism is unique.

  Symptoms include:

  • Social interaction difficulties
  • Communication challenges
  • Tendency to engage in repetitive behaviors
  • Language disabilities
  • Aggression
  • Hyperactivity
  • Self Injury
  • Sleep deficits
  • Gastrointestinal disorders
  • Immune dysfunction
  • Seizures
  • Sensory processing problems

  How Pediatric Therapy Helps

  As every child with autism is unique, they need to be treated as such. Our therapists understand that autism is a disorder that affects the whole family. Parents at times can feel frustrated and at a loss with no forward plan. By evaluating your child and working with the family, we can address the main areas to focus on to improve your child’s abilities. In addition, we also focus on family training, teaching effective strategies to use in the home. Pediatric therapy often involves a multi-disciplinary approach to achieve the best results, and we are always eager to work with your child’s entire team of professionals. Our expert understanding of sensory processing and its impact on motor function and behavior builds the foundation to our comprehensive therapeutic approach.

• Developmental Delay

  As we develop from birth, there are common developmental “milestones” that are reached around certain ages. For example, the ability to walk, taking first steps is generally between months 9 and 12. Another is at age 4-7 months, babies typically start babbling and engage, smiling at the parents. When children don’t meet their normal milestones in a reasonable amount of time, a delay in development can start to become evident.

  Often development delay can be seen in babies who seem to stiff or floppy, have difficulty holding their head steady, can’t sit on their own or don’t respond to noises or smiles, after the appropriate ages to do so. In addition, as a child with development delay gets older, they may have difficulty engaging in normal play, seem clumsy, have difficulty with running and other more challenging activities.

  How Pediatric Therapy Helps

  Our therapists work closely with your child to determine the root cause of their developmental delay. After a thorough evaluation, we develop a comprehensive plan, at times involving physical, occupational and speech therapy to assist your child with attaining their developmental milestones. We work closely with your child and the entire family to ensure your child achieves the best outcome possible.

• Down Syndrome

  Down Syndrome occurs when there is a full or partial extra copy of chromosome 21. This additional genetic material alters the course of development and produces common traits for children with Down Syndrome. A few common physical traits that occur are low muscle tone, low strength, difficulty attaining normal development milestones, walking difficulties and looseness of ligaments.

  Children with Down Syndrome most often have cognitive and neurological delays with difficulty processing normal activities. However, this is usually mild to moderate, affecting normal tasks and interactions.

  How Pediatric Therapy Helps

  Pediatric Therapy is very important in helping the child with Down Syndrome reach their full potential. Pediatric physical therapy works to improve muscle motor patterns, so activities can be completed with more skill and accuracy. In addition, any problems with walking, sitting, standing, balance and more are treated. By empowering the child with more physical skills, they become better able to master normal daily activities and attain more independence.

  Pediatric occupational therapy and pediatric speech therapy help the child with Down Syndrome to improve self care skills, fine and gross motor skills, play and leisure activities, speech or feeding difficulties. In addition, pediatric speech therapy addresses issues with speech and language development. The low tone associated with Down Syndrome often affects the muscles of the tongue and throat, affecting speech and feeding. Our therapists work closely with your child to identify limitations and make appropriate treatments to improve those.

• Feeding and Swallowing Difficulties

  There are many actions which have to occur in the mouth and throat in order for us to normally suck, chew and swallow food/drink. Swallowing difficulty can occur at different stages of the swallowing process.  In addition to difficulty swallowing, some children have sensory feeding problems.  These children are often labeled “picky eaters”, but may have a real oral-tactile defensiveness to certain textures and foods which make feeding difficult.

  If you notice your child having some of the following signs, a feeding / swallowing evaluation should be conducted:

  • Irritability or lack of alertness during feeding
  • Refusing food or liquid
  • Failure to accept different textures of food
  • Long feeding times
  • Difficulty chewing
  • Coughing or gagging during meals
  • Excessive drooling or food / liquid coming out of the mouth or nose
  • Difficulty coordinating breathing with eating and drinking
  • Hoarseness, gurgling or poor voice quality
  • Frequent spitting or vomiting
  • Less than normal weight gain or growth

  Our speech and occupational therapists work with your child’s pediatrician to determine the limitations during the swallowing process and develop the appropriate treatment plan to ensure your child can take needed food and liquids. Pediatric therapy helps to improve the strength and coordination of the tongue, mouth and throat to facilitate normal sucking, chewing and swallowing.

• Fine Motor Delay and Handwriting Difficulties

  Fine motor is defined as your child’s ability to manipulate their body in very coordinated ways, especially the hands and fingers. It takes a lot of coordination and skill to manipulate smaller and smaller objects, especially as we grow, eventually learning to write. Children can have delays in their ability to manipulate everyday objects and often appear clumsy. With different neurological disorders a child may not keep up with his / her peers when grasping objects, holding them, bringing them to their mouth, stacking small objects.

  For older children, this delay can cause difficulties in handwriting and doing more complex tasks with fine precision.

  How Pediatric Therapy Helps

  Our specialized therapists work with your child to determine where they are in the normal progression of their fine motor skill development. If there are suspected delays in abilities, a plan is worked out to enhance your child’s fine motor skills on a gradient. We work with your child and the whole family, to engage in activities that can also be done in the home to further improve your child’s coordination.

  For children having difficulty with handwriting, our occupational therapists determine the specific limitations and integrate a skilled plan to help your child improve their writing.

• Language and Speech Delays

  Parents often begin to notice language delays when comparing one child to a sibling who could say words and sentences at certain ages. The parent typically thinks that the child will “catch up”. Many parents hesitate to seek advice feeling a child will just grow into it. Cooing and babbling should occur prior to 12 months. After 12-15 months a child should be using a wide range of speech sounds in their babbling (p, b, m, d or n) and start to mimic sounds from family members. At 18-24 months toddlers should be saying at least 20-50 words by the time they turn 2. From 2-3 years, parents should see big gains in their child’s vocabulary.

  There are different terms for delays in speech and language:

  Receptive language delay – This is when a child has difficulty understanding language. They have trouble comprehending when they listen or read.

  Expressive language delay – This is when a child has difficulty talking or expressing his/her ideas.

  Pragmatic language delay – This is when a child has difficulty understanding the semantics of speech (the meaning of what is being said).

  How Pediatric Speech Therapy Helps

  If you feel your child is not meeting these normal language milestones, an assessment by our skilled pediatric speech and language therapists can easily identify if there is any delay. Then the right therapies can be performed to focus on improving it. Speech therapy involves first identifying what kinds of delays your child may be experiencing. There may difficulties with the neurological processing and possibly muscle function in the tongue and throat.

  Just like muscles of the body need strengthening and coordination, so do the muscles of the tongue and throat to make proper speech. Our speech therapists work on neurological exercises and speech exercises to help children with a wide array of speech/language difficulties. Our pediatric speech therapists work to improve understanding, pronunciation and forming of speech to help your child be more social and communicate effectively.

• Orthopedic Problems and Sports Injuries

  There are a variety of different orthopedic problems and sports injuries that we help. Orthopedic refers to problems with joints or muscles. Children can suffer from many of the same orthopedic problems that adults may encounter.

  Such conditions may be painful movement of:

  • Back and neck
  • Shoulder elbow, arm and hand
  • Hip and knee
  • Ankle and foot

  Pediatric orthopedic conditions can occur for a number of reasons; injury, poor posture, weakness of certain muscle groups, development delays and much more. Our therapists have years of experience, evaluating and treating patients with pediatric orthopedic problems.

  Sports Injuries

  Children are very active and a big part of growing up is participating in sports. However, at times an injury can occur while playing sports. From a mild ankle sprain to severe injuries and fractures, a child may need pediatric therapy afterwards to recover quickly and return to normal play / sport activities. That is where we can help.

  How Pediatric Therapy Helps

  Our pediatric physical and occupational therapists routinely help children with orthopedic problems and also recovery after a sports injury. In addition to regular treatments to relieve pain, improve strength and restore function, we also perform splinting, assistive device fitting and management (crutches, walkers, wheelchairs).

  With experienced hands-on therapy, gentle therapeutic exercises and specialized pediatric therapy care, we help children reduce pain, restore range of motion and get back to normal activities quickly.

• Reading Difficulties

  At times, reading difficulties can be more than just academic. When children have difficulty processing communication, visually tracking and scanning words, it can make it frustrating to perform the act of reading. This may be confused for the child being lazy or not wanting to read, when in fact there may be a neurological or physical issue with reading. A thorough reading and communication assessment can determine if there are issues that can be addressed with therapy.

  How Pediatric Therapy Helps

  A thorough evaluation is performed to determine the quality of comprehension, visual tracking and if there are any difficulties with understanding or processing. Your child can be taught new skills to improve reading comprehension and make any adaptions that may be necessary. Coordination with the family and teachers helps make adaptions and corrections to reading skills easier for your child and to improve overall reading ability.

• Sensory Processing Disorder

  Sensory processing disorder and sensory integration dysfunction occur when children have difficulty processing normal information from their typical senses – sound, sight, smell, taste, touch and hearing, and two hidden senses – proprioceptive (where they are in space) and vestibular (movement). The exact cause is not known, but this is commonly seen in children with autism or Asperger’s disorder as well as other developmental disabilities.

  Children with sensory processing disorder and sensory integration dysfunction cannot properly process sensations from the outside world and therefore, have difficulty with even ordinary tasks.

  Symptoms can include, but not limited to:

  • Withdrawing when touched
  • Oversensitivity to odors
  • Refusal to eat certain foods due to the feel
  • Hypersensitivity to certain fabrics
  • Appearing clumsy
  • Having difficulty calming oneself
  • Being overly sensitive to sound and much more

  How Pediatric Therapy Helps

  If your child is suspected of having sensory processing issues, our therapists first complete a thorough evaluation to determine where your child is having the most difficulties. Our therapists then coordinate fun and interactive activities that engage your child’s sensory inputs to challenge them, and successful organize responses. Over time, this improves your child’s ability to process sensations more normally and engage in a happy, productive lifestyle.

  Click for more information on Sensory Processing Disorder

• Torticollis

  Torticollis is the condition by which the muscles in a child’s neck become tightened affecting his/her ability to turn their head. In some cases, there may be a change in the neck and head posture.  In addition, pediatric therapy will also check for abnormal head shape, misalignment of the hips and spine problems that can occur with Torticollis.

  Typically, Torticollis occurs from difficulties with positioning during birthing or in-utero. Additionally, positioning in the crib or lack of use of muscles in the shoulder/upper back can further lead to Torticollis.

  How Pediatric Therapy Helps

  The goal of pediatric therapy is to help children with Torticollis improve their range of motion, positioning and functioning of their neck. It is important that your child be evaluated and treated as soon as possible to correct for any future deformities, headaches / neck pain and improve overall function. Therapeutic play, hands-on therapy and education can dramatically improve Torticollis in most cases.

• Walking and Balance Difficulties

  There are many different conditions that can cause walking and balance difficulties. Walking is a very complicated sequence of muscles and nerves firing at the right time and the right place. Typically children progress through normal stages of walking development, from standing holding onto objects, to cruising, walking with arms out and up for balance, to smoother walking and finally running. Problems with balance and walking difficulties can often show up with running and playing, especially on unsteady surfaces such as grass. Having a child walk or run backwards, can show just what muscle motor patterns may be affected.

  Children, that start to fall behind often have problems with coordination, balance and strength. This can be slight or quite significant. In addition, conditions such as Cerebral Palsy can create excessive firing of muscles (hypertonia), making normal walking patterns, rigid, spastic and very difficult.

  How Pediatric Therapy Helps

  Our pediatric physical therapists typically work with children having delays or difficulty with walking. However, at times our pediatric occupational therapists will be involved in helping children with improving their muscle motor movements to facilitate improved walking. Our therapists evaluate your child’s posture, joint movement, muscle strength, balance and coordination on a variety of surfaces.

  This paints a picture of what specific sequences or areas may need addressing. A thorough plan is then put together that may involve strengthening, balance and coordination exercises. Additionally, exercises and working with the family on activities to perform at home, help your child practice proper walking for their age and development. The goal in pediatric therapy is to attain great results for your child, while making therapy a fun, playful and engaging activity.