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Chapter 16. Pediatric Physical Therapy

Physical therapy is a profession that focuses on the diagnosis and management of dysfunctional human movement throughout the life span. Pediatric physical therapy relates to the period (0-21 years) during which an individual ages, changes, evolves, and matures. Federal laws in the United States have been particularly supportive of pediatric practice:

  • The Individuals with Disabilities Education Act (IDEA): under the requirements of this federal law, all children who have special needs must be supported in access to free and appropriate public education. This provision is based on an individualized plan. The plan for children who receive services at home (usually through age 3 years) under Part C of IDEA is called an Individual Family Service Plan (IFSP). For all children receiving services at school (usually after age 3 years to 21) under Part B of IDEA, the plan is called an Individualized Educational Plan (IEP).
    • Individual Family Service Plan (IFSP): designed to meet the needs of the family as they relate to their child's development, as well as meet the needs of the child.
    • Individual Educational Plan (IEP): identifies the student's specific learning expectations and outlines how the school will address these expectations through appropriate special education programs and services.
      • Identifies the methods by which the student's progress will be reviewed.
      • Covers all deficit areas, including communication, behavior, socialization, self-help, academics, perceptual-motor and gross-motor skills, vocational skills, and transition services, related services, and needed accommodations in both general (regular and vocational) and special education.

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Debates on whether changes in motor behavior result from external influences such as physical therapy, or to maturational influences remain unresolved.

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  • A motor plan, which is made up of component motor programs, is an idea or plan for purposeful movement.2
  • A motor program is an abstract representation that, when initiated, results in the production of a coordinated sequence of movements.3 A motor program should be thought of as a prestructured plan in the memory that is prepared in advance of the movement, which when executed, results in a controlled contraction and relaxation of muscles causing a specific movement to occur without the involvement of feedback leading to corrections for errors in selection.

The field of motor control is directed at studying the nature of movement and how the movement is controlled. Motor control refers to processes of the brain and spinal cord that preside over the mechanisms essential to regulate or direct posture and movement using both perception and cognition.1 Infants attain gross and fine motor control along a predetermined and sequential path. The integral elements of motor control are listed in Table 16-1.

Table 16-1. Integral Elements of Motor Control
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Table 16-1. Integral Elements of Motor Control

The integral elements of motor control include

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