July 7, 2014
When Kids Grow Up

Before I get your hopes up, I need to say that this month’s blog is not about shoes. Although I love shoes, today I actually want to discuss our paediatric clients as they grow up. Generally speaking, there are more children with physical disabilities than there were several decades ago. There are a greater number of children identified with sensory processing disorders. And the latest statistics indicate that one child in 68 is diagnosed with autism in the USA.
We are seeing more research on postural control in children with Cerebral Palsy, Autism, Sensory Processing Disorder, Developmental Coordination Disorder and Anxiety. This research has much to tell us regarding the challenges these children face in terms of how they organize their motor and sensory input for balance. Right now, it is paediatric PTs who have this knowledge.
Our systems have invested money in early intervention, with less funding for school-aged children and almost no funding for teens; families are left to fend for themselves as their children grow older. Presently, I am seeing two teen-aged girls with high functioning autism. I am proud to say they understand how they process sensory information, how alignment impacts their central stability and strength, their balance and functional skills are improving and their pain is gone. Along with their parents, I’ve talked them through the changes in their body’s structure during puberty (and the changes in their brain as well) and they have continued to improve during this time. And I hope that one day, when they go through pregnancy and delivery, they will be able to put their bodies’ back together.
But I know that this is not typical for most of our clients. Most children with challenges will grow up without this knowledge. As they age, they may experience orthopedic/pelvic health/chronic pain issues and seek help in adult clinics, where therapists may not be aware of the postural control research in their populations. So this is my appeal to you as paediatric Physical Therapists – go out and talk to your adult colleagues. Talk to them over coffee, talk to them at conferences, talk to them in their clinics. Pass on your knowledge regarding the children you treat. Help your colleagues to be more informed when these children grow up and need their help. We know our clients have to make many transitions over their lifespan and we’re in a position to help make this one a little smoother.
While this has been a problem for a long time, I think we are getting to a situation of crisis proportions. And it’s not on therapists. At least at our facility, we are constantly talking to and in servicing adult staff. However, there is a dearth of physicians who know and care about our kids as they turn to adults. I just went thru this problem with an adult with CP, finding there was no orthopedic surgeon in Indiana who understands and is willing to see these adults.
Thank you Kay, I am so glad to hear that you interact with your adult staff. Sadly I have had the same problem here with GPs, orthopaedic surgeons and other specialists here. I hope they too begin to learn about the new populations in our communities.