How OT and PT can set your child on a path to success

The limp, motionless form of my three-month-old daughter disappeared into the depths of the MRI machine. Terms like “genetic disorder” and “brain abnormality” floated through my mind as the inexorable noise of the MRI machine filled the room. It all felt like a distorted dream. How did I end up here?

When Rivky was born, none of us noticed anything worrisome. But as the weeks passed, there was a slight sense of unease. Rivky would scream when placed on her stomach, and she seemed to have a hard time lifting her head. Her movements looked slower and less energetic than those of her siblings. Over summer vacation there was little change, and the anxiety grew acute. When I described what was happening to the pediatrician over the phone, he was baffled and recommended some testing at a local hospital.

Rivky was poked, prodded, and examined by what seemed like the entire medical establishment. Subjected to endless blood tests, examined for illnesses I had never heard of, she was finally recommended for a brain scan. It was a draining, three-day process that left us terrified.

And then the hospital physical therapist bustled into the room.

“It looks like Rivky needs physical therapy,” she announced. “This baby has weak muscle tone. Weekly sessions with a PT specializing in infant development should help.”

She was right. The brain scans were normal. There were no genetic disorders. Within a year of beginning physical therapy, Rivky met all her milestones. We endured so much anguish and uncertainty when the issue was relatively simple.

According to Rochel Feinstein PT, DPT, PCS, and Gitty Zelczer M.S., OTR/L, the duo behind OPTimal Care Therapy Center in Lakewood, New Jersey, my story is not as unique as I’d thought it was.

“How often does this happen?” I ask them curiously. “I know our case was atypical, but how often do you encounter basic misdiagnoses, where kids really have an OT or PT issue?”

“Every single day,” comes the swift response.

Every. Single. Day?

Therapy Explained

In the simplest sense, a physical therapist works to improve a person’s ability to move his/her body, while an occupational therapist focuses on improving a person’s ability to do daily activities. But there’s definitely an overlap. Research shows that OT and PT services are often complementary. The physical therapist works on strengthening the musculoskeletal system in various ways, and the occupational therapist focuses on teaching the strengthened patient to implement this into daily activities. Together they can create a pathway to success.

Think of it this way: Sensory pathways travel upward — you touch something soft, and the message gets sent to your brain, so you feel the texture. Motor pathways travel downward — your brain tells your arms to catch a ball. Both pathways need to work together to ensure optimal success.

Gitty, the OT of the OPTimal duo explains: “Occupational therapists help people learn how to process sensory information, which includes understanding whether each system exhibits good function/motor skills. But what you might not realize is that in addition to our five main senses — touch, sight, hearing, taste, and smell — there are the “hidden senses” of proprioception (our sense of body awareness) and vestibular function (our sense of movement and balance).

“So, for example, a person might need OT because their auditory sense is off, like Elisheva*, an adorable three-year-old I treated recently. Elisheva exhibited extreme behaviors. Elisheva was anxious all the time, constantly crying. She seemed to feel overwhelmed by loud noises and lots of people. It was becoming impossible for her mother to take her anywhere, and her morah was having a lot of trouble dealing with her.

“After watching Elisheva’s loud reaction to my clinic (a hysterical tantrum when she heard the noise of some other children shouting), it was clear that her issue was one of sensory integration. Her auditory system was too responsive, magnifying noise and causing a flight-or-fight response. It’s no wonder Elisheva reacted how she did!

“I used several auditory/music programs to help Elisheva slowly accustom herself to different frequencies of sound. This type of treatment helps ‘calm’ the nervous system, stopping it from over-processing information. In a few weeks, Elisheva was thriving.”