Pediatric Physical Therapy | Occupational Therapy | MaineHealth Pen Bay Hospital

Prior to the evaluation

Parents complete a questionnaire regarding their concerns and the child's medical, developmental and educational history. We will request medical information from the child's pediatrician, and may also request information from other medical or educational professionals who have evaluated the child.

During the evaluation 

Your child's medical, developmental, and educational history is carefully reviewed. Parents are interviewed regarding their concerns and the child's history. This information helps the speech-language pathologists identify areas to evaluate more closely. A variety of methods, including formal and informal tests, observation, parent/caregiver interview, and play-based activities will be used to evaluate your child's speech, language, cognition and voice. Selection of testing methods is based on your child's individual needs. Parents are encouraged to observe during the evaluation.

Following the evaluation 

Initial results of the evaluation and recommendations are reviewed with you (and your child if age appropriate). A written report detailing evaluation results will be mailed to your home and to your child's physician (if requested).

What is a treatment plan? 

A treatment plan is an individualized plan created by the speech-language pathologists to address your child's speech, language, cognitive, and/or voice needs. The plan may include:

• Recommendations for therapy or re-screening/re-evaluation at a later time
• Initial goals to address during therapy 
• Referrals to other professionals (i.e., audiologist, medical specialist, occupational/physical therapist, etc.)
• Referral to other community services, such as an early intervention program
• Suggestions for parents/caregivers and educators

Children with feeding and swallowing disorders may present with a variety of symptoms including:

• Refusal of different textured foods
• Prolonged feeding times
• Excess drooling or spilling of food and liquids from the mouth
• Frequent spitting up
• Wet, gurgly voice or breathing
• Coughing or gagging during meals
• Recurrent pneumonia or respiratory infections
• Slow weight gain
• Younger children may demonstrate stiffening of body, irritability and/or lack of alertness during feeding

Prior to the evaluation 

Parents complete a questionnaire regarding their concerns and the child's medical, developmental and educational history. We may request medical information from your child's pediatrician, and may also request information from other medical or educational professionals who have evaluated your child. You may be asked to keep a food diary for several days and bring this on the day of the evaluation.

During the evaluation 

Your child's medical, developmental, and feeding history is carefully reviewed. Parents are interviewed regarding their concerns and the child's history. This information helps the Speech-Language Pathologist identify areas to evaluate more closely.

Your child will be provided with an age-appropriate snack (you may be asked to bring in favorite foods and feeding utensils from home). The Speech-Language Pathologist will assess your child's oral structures and movements, sensory responses to food and touch, posture and positioning, oral movements during eating and drinking, swallowing and behavioral responses.

Parents are encouraged to observe during the evaluation.

Following the evaluation 

Initial results of the evaluation and recommendations are reviewed with you (and your child if age appropriate). A written report detailing evaluation results will be mailed to your home and to your child's physician (if requested). The report will include a detailed analysis of your child's feeding-swallowing behaviors.

If your child has indications of a feeding-swallowing disorder, an individualized plan of care will be developed with you, your child, and the physician. The plan may include recommendations for special instrumental diagnostic tests to further evaluate your child's feeding-swallowing. Treatment varies greatly depending on the causes and symptoms of the feeding-swallowing problem.

Speech and language disorders can affect the way children talk, understand, analyze or process information. Speech disorders include the clarity, voice quality, and fluency of a child's spoken words. Language disorders include a child's ability to hold meaningful conversations, understand others, problem solve, read and comprehend, and express thoughts through spoken or written words.

Our speech-language pathologists work with children from infancy to adolescence. If you are concerned about your child's communication skills, please call to find out if your child should be seen for a communication evaluation and/or consultation. Services include:

• Treatment for speech and language delays and disorders
• Augmentative communication (both high- and low-tech)
• Pediatric feeding and swallowing
• Autism – with a focus on language for "relational development" as well as functional communication
• Cerebral palsy and other neurogenic disorders
• Traumatic head injury
• Voice disorders
• Hearing loss/audiology

Pediatric physical therapy promotes independence, increases participation, facilitates motor development and function, improves strength, enhances learning opportunities and eases care giving.   

Pediatric physical therapists work to help children reach their maximum potential for functional independence through examination, evaluation, promotion of health and wellness and implementation of a wide variety of interventions and supports. Pediatric PTs support children from infancy through adolescence and collaborate with their families and other medical, educational, developmental and rehabilitation specialists. They promote the participation of children in daily activities and routines in the home, school and community. 

Parents and families have the primary role in their child’s development. The pediatric physical therapist collaborates with the family to implement an individualized program for the child. Families are supported through coordination of services, advocacy and assistance to enhance the development of their child through: 

• Positioning during daily routines and activities
• Adapting toys for play 
• Expanding mobility options 
• Using equipment effectively 
• Teaching safety for the home and community  
• Providing information on the child’s physical and health care needs
• Easing transitions from early childhood to school and into adult life 

The process of supporting children and families begins with an interview to identify the child’s needs and continues with an examination and evaluation of the child in the context of their daily routines and activities. This evaluation may include, but not be limited to, muscle and joint function, mobility, strength and endurance, cardiopulmonary status, posture and balance, oral motor skills and feeding, sensory and neuromotor development, and use of assistive technology.  

The process of providing pediatric physical therapy continues with collaboration, coaching, and interventions in natural learning environments, including home, child care centers, preschools, schools, job sites, and other community settings. Children and families also may have contact with pediatric physical therapists in hospitals and clinics when receiving care for related medical conditions or during episodes of acute care. 

Occupational therapists help children gain the skills they need to play, learn and socialize. Occupational therapy (OT) can help children overcome cognitive, physical, behavioral and environmental barriers such as:

• Difficulty or avoidance of coloring, writing or small toy play
• Fatigues easily, appears weak, is sedentary or has poor posture
• Difficulty holding a pencil, staying in the lines, tracing, copying or coloring
• Easily distracted or overwhelmed
• Struggles with self control, easily overwhelmed, bites, kicks or fights with others
• Feeling bad about him/herself, social skill issues, appearing anxious or frequent crying
• Difficulty bringing food to mouth, limited diet, gags trying new textures or refuses textures
• Difficulty tolerating clothing textures, challenges with self care or toilet training issues
• Difficulty with purposeful play
• Problem solving concerns, poor memory, organization issues or difficulty following directions
• Limited movement, rigidity or pain
• Difficulty processing sounds, touch, textures or smells
• Over/under responds to pain or difficulty calming self
• Difficulty with copying from chalkboard, letter recognition or finding items

A variety of treatments are used including:

• Working on fine motor skills
• Strength/endurance training
• Handwriting activities
• Activities addressing attention issues and behavioral concerns
• Eating/feeding activities
• Dressing/bathing activities
• Cognitive processing training
• Concussion management
• Reflex integration

We offer aquatic therapy in the therapy pool at the Penobscot Bay YMCA

• Physical therapists use the properties of water, combined with activities and exercises specifically catered to the patient to offer strengthening with minimal impact, a safe sensory environment and restoration to assist children in maintaining their functional mobility and ability.
• We treat children with acute, transient or chronic conditions.

Benefits of aquatic therapy include:

• improved muscle strength and tone,
• increased cardiovascular health and function,
• reduced stress,
• decreased swelling,
• improved circulation, and
• increased endurance and flexibility

What is a speech-language pathologist?

Speech-language pathologists diagnose and provide treatment for children and adults with a variety of speech-language, cognitive, voice and feeding-swallowing problems.

What kinds of speech and language disorders affect children?

Speech and language disorders can affect the way children talk, understand, analyze or process information. Speech disorders include the clarity, voice quality, and fluency of a child's spoken words. Language disorders include a child's ability to hold meaningful conversations, understand others, problem solve, read and comprehend and express thoughts through spoken or written words.

At what age should I seek out help for my child?

Our Speech-language pathologists work with children from infancy to adolescence. If you are concerned about your child's communication skills, please call to find out if your child should be seen for a communication evaluation and/or consultation. The early months of your baby's life are of great importance for good social skills, emotional growth and intelligence.

Is my child developing speech and language at a normal rate?

There are differences in the age at which an individual child understands or uses specific language skills. The following list provides information about general speech and language development. If your child is not doing 1 -2 of the skills in a particular age range, your child may have delayed hearing, speech, and language development. If your child is not doing 3 or more of the skills listed in a particular age range, please take action and contact a speech-language pathologist or audiologist to find out if an evaluation or consultation is necessary.

What is an expressive language disorder? 

Expressive language includes the skills involved in communicating one's thoughts and feelings to others. An expressive language disorder concerns difficultly with verbal expression.

What is a Social Pragmatic Language Disorder? 

Children with social pragmatic difficulties demonstrate deficits in social cognitive functioning. Diagnostic terms include: Asperger Syndrome, hyperlexia, High Functioning Autism, Semantic-Pragmatic Disorder, pervasive developmental disorders-not otherwise specified and non-verbal learning disabilities. Persons with social-pragmatic deficits have significant difficulties in their ability to effectively communicate and problem solve.

Is my child's "stuttering" normal? 

Non-fluent speech is typical between the ages of two and six years. It is typical for non-fluent speech to last up to six months, improve then return. A speech-language evaluation may be in order if your child exhibits any other speech and language difficulties or was a late talker. Any child who is demonstrating any "struggle behaviors" (e.g., facial/bodily tension, breathing disruptions, blocks, grimacing) should be referred to a speech-language pathologist immediately.

What can I do to help my child's disfluencies at home? 

Slow down your own speech to a slow normal rate; slow down own actions and adopt a more relaxed, non-hurried atmosphere for your child. Build in more time for getting ready for activities and changing activities. 

What is a phonological disorder? 

Phonology refers to the speech sound system of language. A phonological disorder is when a child is not using speech sound patterns appropriately. A child whose sound structures are different from the speech typical for their stage of development, or who produce unusual simplifications of sound combinations may be demonstrating a phonological disorder.