Natalie: 0:00

On today's podcast. I chat with Abby Ogleby, a pediatric physical therapist about what PT can look like from both the therapist perspective, as well as the parent perspective. I'm Natalie. And you're listening to the resource doula podcast, a place where we provide information to help you make informed healthcare decisions for yourself and your family. Hello and welcome I'm Natalie. And I'm looking forward to talking with Abby Ogleby today about milestones, pediatric physical therapy and strategies for parents who want to help their kids thrive in development and movement. So Abby is a physical. With specialties in pediatrics and aquatic therapy prior to physical therapy school, Abby taught Pilates and indoor spinning, where she found a joy in helping others become healthy and enjoy exercise. She met her husband, also a physical therapist in graduate school. They have three children, two boys, and a girl ages, seven, five, and three. Their youngest, Elsa was born with Prader-Willi syndrome. Her family moved to Wartsila Alaska last year to be closer to medical care for their daughter. So welcome Abby, Thanks so much for taking the time to chat with me today.

Abbie: 1:14

Thanks Natalie.

Natalie: 1:15

Absolutely. So let's just dive right into it. Can you talk about what aspect of your career you're most passionate about?

Abbie: 1:25

Well, I love kids and I have my own, so I love working with them. They're so much fun. Uh, they love to play. And so I absolutely love incorporating play into therapy, but I really like working with the whole family as well. So whenever. Uh, therapist is treating a child. You're not just treating the child and the problems that are arising, but you're really taking in the whole family aspect. And I, um, I really enjoy working with the parents and even incorporating siblings into therapy sessions and bring therapy into the home. So that's my most fun part about my.

Natalie: 2:09

That's cool. I didn't even think about the sibling aspect or the holistic perspective on the family. Yeah, that's really. So, can you tell us, like, if someone were to sign up for physical therapy today and they have an eval scheduled, what is typically involved? How does that look? And then are there like specific exercises that you give them right away? Or how does that whole process.

Abbie: 2:38

Yeah. So I guess that depends on what setting the therapy is involved in. So with kiddos, there's a couple of different settings. Most people think of like an outpatient clinic because that's where adults will go for physical therapy. But for kids like zero to three, sometimes there'll be referred to the early intervention program within their state. That's a federally funded program. So that will look different than an outpatient. Um, then you can also have therapies within the school districts and, uh, because you want to have therapy where kids are at their most natural, uh, school setting at certain ages might be that setting. And so therapy will take place there. So if we're kind of talking about an outpatient clinic, uh, The first thing that we do is do an evaluation and that's typically a longer visit, uh, same with early intervention and the school setting. And that's where the parents will come in with the child or the baby. And, um, a lot of questions will be asked, so it could range anywhere from how did you deliver the baby? Were there any complications with that? How was the mom's health? Um, a lot about. How they typically met milestones at a very early age. So at three months, did they learn to lift their head at six months? Were they starting to get up on all fours to crawl or, um, even going down further, if they're older kiddos, we want to know, when did you walk? Um, what are you struggling with right now? And where parents would like to see their kids too. So we really want to get a full picture of the kiddos development from birth to wherever they are and really get the parents' sense of what the goals are for them. So, um, it looks really different with whatever problems that are arising, but we really want to incorporate the family into that and see what parents are expecting from therapy. Cause I think there can be a lot of different expectations. And then from. Um, from there after an evaluation, then a therapist would decide the best course of care. So if an outpatient clinic that would be okay, we want to see your kiddo one time a week or whatever the therapist deems appropriate. Um, for early intervention, that looks a little different. Uh that's where most therapists will come into your home to do therapy because that's the. Uh, natural setting and best way to play is inside a home from zero to three or in the school district, they will come into the classroom. They sometimes will pull a kiddo out for therapy, or sometimes they'll even do therapy with the child in the class. So that can be really beneficial.

Natalie: 5:27

Yeah, I didn't know either of those things, the in-home that ma that just makes a lot of sense to me.

Abbie: 5:33

Absolutely. Right. So like a kiddo, zero to three, they spend a lot of time at home with mom and dad. And so you're probably going to get the most bang for your buck being with a kid at home.

Natalie: 5:45

and that helps you probably come up with strategies right then and there, what they can use, what they have as far as like toys and, and objects in the home. for therapy as well.

Abbie: 5:58

Yes. And we get to see how the parents are handling their kids. Right. So like, how do they play with the baby and how do they, um, even like feed the child, right? Like where are they sitting to feed? Um, it really allows you to see organically how things are happening because every position and every play area. Can help or harm a child in there in their development.

Natalie: 6:27

Hm. Okay. Can you talk a little bit more about that? So what, what positions or things may be. Harmful to the child and in development.

Abbie: 6:39

Yeah. So, um, believe it or not, sometimes parents don't know how to play with their kids. And so that's something that as an early interventionists, um, we can really help parents. Figure out ways to engage their babies. They're not talking yet. So sometimes that can be really hard for parents to understand how the baby is even communicating with them so we can help with play. And the best way to play is on the floor. Um, you know, tummy time is great when they're laying on their stomach. Or even just underneath a mobile I'm on the floor, playing with toys, overhead, trying to reach their arms up. Um, sometimes, you know, baby wearing is a big thing lately. And so going for a walk with baby really close can be fun and engaging or, um, taking them even on a, for a walk in the stroller is a really big experience for an infant because they're getting us whole new. Of smells and textures and the feeling of the sun. And there's so much going on, even if the baby's not talking or seems like they're just closing their eyes. There's a lot happening for that baby. So we try to help parents understand what the baby is going through and feeling and experiencing through all of their senses.

Natalie: 8:01

Okay. I like that. So how much floor time or free movement time do kids generally need?

Abbie: 8:10

As much as possible. I like to say,

Natalie: 8:14

that. I like that. I say that for adults as well.

Abbie: 8:17

yeah, we all want to move right. Move. It is the best thing for us. Um, but for babies that looks really different because. They only have so much energy to expend, but you know, typically after a feeding, um, they have some energy, so you want to go play with them. Um, free time I would say is on the floor with just toys around them. So. Toys, they can pick up and shake and watch a move. Um, any kind of that movement where they're free to roll or learn to sit up on their own something that's not, um, containing them in one area is best.

Natalie: 8:59

So speaking of containment, the term. Baby syndrome. I'm doing air quotes here gets thrown a lot around a lot. So can you explain what that is and why it might happen and what parents should maybe look out for? So it doesn't happen to their child.

Abbie: 9:20

Yes. So that is kind of a newer phenomenon, I guess, that's happening with, you know, just general industries, making more things for babies. Um, So there's like a Bumbo seat, which is pretty common, or those toys like saucers, where they have like this ring of toys where you just sit the baby down and they can have all these toys right in front of them, easily accessible. Um, there's even like baby walkers where you, again, sit them in something and then their feet can push on the ground. Um, there's a jumper that you can put in the middle of your door frame, and the babies can learn to jump off their legs. And there's a time and place for these. I would say, um, some therapists are a hard, like no hard pass on all of those. And some people will say, yeah, that's fine. I'm somewhere in the middle. I guess a container baby syndrome is really just a saying to say, The baby is really placed in these toys where they don't have freedom of movement. So that last question that you asked Natalie was great. Like how much time do we want them to have free movement? We really want that all the time. They really should be able to learn how to roll and sit up on their own and crawl on their own time. And there have that freedom of movement and exploration in a spontaneous manner. So that it happens naturally. If we're always sitting a baby in a saucer or in a Bumbo seat as their free play, they really don't know how to get up from the floor, laying on their back, up into a sitting position. They just expect someone to come over and sit them up. So we're missing transitional milestones. We're missing, um, opportunity. To learn basically. And babies adapt really well. And so they know, oh, mom's just going to come and pick me up anyway. So they're just going to lay there and cry and wait for you to pick them up. It's a learned of process and they learn quickly too. So it's hard to say don't use those at all because there's a time and place, right? Like if a mom is home by herself and. There is no one to watch that baby. And she just needs to take a shower by all means. Bring that baby into the shower with you, put them in a Bumbo seat and take a 10 minute shower, but then get the baby out again after that and let them roll around and get into the cupboards and, and play. Right. So we're not saying never use a high chair while you're cooking dinner, saying more of like use it in the appropriate. Time and appropriate amount of free play involved with that too. There has to be a combination

Natalie: 12:11

Right, right. That makes sense. So limiting the amount of time that they're sitting in those containers and oftentimes they are sitting, right?

Abbie: 12:22

Or laying down in a car seat. Right. So, yeah, I mean, there's a lot of driving involved in the U S so. Yeah. Yeah. They have to be in a car seat while they're driving, but they don't need to stay in that car seat to take a nap and they don't need to stay in it once they're inside the house, which is actually pretty common. Um, those babies will just stay in that car seat and they really don't know how to spontaneously move their body. So.

Natalie: 12:52

It's really interesting. It's something that I've been doing a little bit more research on recently, and it seems as though, like, you know, marketing. Marketing these days, they'll try to sell you anything. And a lot of the creators of these containers almost tell you that they'll teach your baby how to sit or teach your baby how to walk or teach your baby how to jump. Now, what you're saying is that they don't need those items to learn those movements. Those are innate. Is that correct?

Abbie: 13:25

That is correct. The babies babies will learn how to sit all on their own. Um, they don't need a tool or a, a gadget to, to figure that out. And same thing with walking or gaining leg strength with jumping. Um, if they are moving. Naturally on the ground, they will figure it out. They will kick their legs. They will roll over to a wall and start kicking a wall. You know, that any of those kinds of movements are going to give the baby strength. They don't need a jumper. To gain leg strength. Is it fun? And they might find enjoyment out of it for five minutes out of a day. Sure. And that could be what a parent wants, but again, I'm leaving a child in a jumper or a saucer for a half an hour is probably too long of a time during the day, especially in one stint.

Natalie: 14:20

Okay. Okay. Thanks for that. And actual practical numbers. I think parents will be curious about that as well.

Abbie: 14:27

Yeah. And you know, it's not like they're, I wouldn't have any like parent guilds if you've used these in the past. Or you're like, oh, well, my baby really enjoyed the saucer and they love to like spin the little toy. And that is totally okay too. Don't want to have like any mom guilt here for that. Um, for a typical child, it's not going to harm them to keep them in a little saucer for, uh, you know, 30 minutes out of their day. Um, as long as we're coupling it with lots of natural movement on the ground.

Natalie: 15:01

Yeah.

Abbie: 15:02

Um, I think that's also a big one is like the mom guilt stuff. It's okay. If you use them every once in a while, they're going to be all right.

Natalie: 15:10

Yeah. Yeah, my, um, I'm going to quote my mom here. Who's quoting my pediatrician from when I was a baby. always used to say there's more than one right. way to raise a child. So it doesn't have to look exactly the same for every single person. Um, and every single parent, because you may be a single mom with three kids and a baby who's getting into cupboards and needing to take that shower. So, yeah, as long as, as long as there's education, I think, and, you know, availability of that free movement then yeah. That's, that's what we're going for. Okay. So you mentioned Tommy time, you mentioned kids rolling around on the ground. What if babies Absolutely. despise being on their tummies? What are some strategies that you have for improving this experience?

Abbie: 16:09

Good question. And I always have to kind of ask parents cause I get this a lot. Do they really hate tummy time? Because sometimes babies just cry. Um, and maybe we're just not queuing into why they're crying. So it's okay for them to cry and fuss a little bit in tummy time. Um, and moms will know the differences between cries. So it's okay. If they're a little fussy, um, I wouldn't go and save them right away. That being said, there's a lot of reasons why a child might not enjoy tummy time. They could have acid reflux and we don't know yet their tummies really might be too full from a feeding and they might start, um, regurgitating some of that during tummy time. Other things. Um, it could be some musculoskeletal problems going on, why they don't like tummy time is because tummy time makes them work really hard on those muscles. Um, the whole back to sleep movement. Um, I don't even know it was probably 20 years ago or something I'm you can't quote me on that, but, um, it was the whole. Uh, reducing SIDS, sudden infant death syndrome and placing babies on their backs while they sleep versus on their tummies. And it was a great movement because it did save lives, but we're also seeing babies really not enjoy tummy time during the day to play. And, um, so the best way to gauge that is in small doses. You can start your, your baby off, um, on tummy time for two minutes and watch them and play with them on their tummy. Give them something to look at, engage them. So they're not just staring at the floor. You really want to have them play while they're in this position. So having them try to look up at pictures, try to look up at mom, try to look up at a dog or siblings while they're looking around on their stomachs. You have to make it really fun for them. That's one way you can help. The other way is to have like a, a pillow underneath them to lift them up a little bit off the ground. So they're not completely on their stomachs that also help in some acid reflux. If they're having those kinds of problems, that don't let them enjoy tummy time, that will help them look around a little bit more too. And the other way is to do this while they're. Um, a parent so that they are laying on your chest and they're facing you. And then you decline a little bit. So you're lounging on the couch. And you're at an inclined, well, the baby's also at an incline and then you can gradually move yourself down to the floor. So you're laying on the floor and baby's laying on top of you. And that way they feel a little bit more secure. They have your face to look at and for you to talk to, and they can really start to enjoy this position and then gradually move them down to the floor.

Natalie: 19:20

That's awesome. That makes a lot of sense too. It's almost like babies and moms just know what to do.

Abbie: 19:27

Yeah. They do they really do.

Natalie: 19:31

If we, if we just kind of get out of our heads, I think in a lot of, like, when I talk to people who are getting ready to have a baby, like getting ready to give birth for the first time and their bodies have done a great job at growing the human. So they just have to kind of get out of their heads and trusted that their body will give birth. Just fine to that same human. Yeah.

Abbie: 19:54

you know, once they're out, just trust that you know, your baby best and you're going to do a great job.

Natalie: 20:02

That's such good advice. Um, Okay I asked my Instagram audience if they had any questions for you and several of them did. So I have one of those here. Um, they asked what is the most common problem that you see that might be really concerning to parents, but like easily solved from a PT perspective.

Abbie: 20:30

So I think one of the most there's a lot of common problems. To be honest, I don't know about the one most concerning to parents, but easily solved. Um, because to be honest, I don't think most parents are super concerned.

Natalie: 20:49

Oh, okay.

Abbie: 20:51

I know. Um, I honestly get a lot of parents who are not very concerned, but there is a glaring problem.

Natalie: 21:01

And that was another question that someone asked, they asked, like, what is the most overlooked, but concerning problem that you see. So talk about those issues, although a little bit.

Abbie: 21:12

Yeah. So. You know, I feel like parents are with their babies all the time. Right. But a pediatrician might see something they're like, oh, this is a little concerning. Why don't we try some physical therapy? And parents are really like, well, I don't see it. I don't know why we have to do this. Or why is that a problem? One of those is head shape. Um, if a baby is starting to have a flat spot on their head, sometimes this is not a proper. Other times it's a big problem. Um, so parents might not be super concerned. They're like, oh, that's just a little flat SOPs flat spot. That'll be fine. It'll all leave it out. Sometimes it does. And that is fantastic. Other times it really does not. And that flat spot will continue to be a flat spot. And, um, there can be other complications that are associated with that. And so seeing a physical therapist is crucial. And then also seeing your pediatric. To continue head growth measurements to make sure the head is continuing to grow, not staying stagnant, um, that can lead to some other problems down the road. And so, and that can be coupled with some torticollis too, which is, um, uh, tightening or restriction of one side of the neck muscles compared to the other side. And so we have some asymmetries and muscle strength. And, uh, when that happens, the baby's head will be turned to one side more than the other. So they might favor looking to the left versus the right. Uh, and that can be another significant musculoskeletal problem and that sometimes that can be associated with a Flathead. Um, and sometimes it's not.

Natalie: 23:00

Okay. Is the container baby syndrome related to the flat head.

Abbie: 23:08

It can be. Yes. So again, if babies are left in the car seat for an extended period of time, other than just in the car, that can be part of it. Or if they're in like a reclined, um, baby sleep. Versus their bed.

Natalie: 23:27

Yeah.

Abbie: 23:27

Um, that can be part of it too. And, and sometimes it's just positioning, right? Sometimes parents just don't understand, oh, I'm only feeding the baby on my left side. Or, um, oh, when I put them down into the crib, I'm only facing them in one direction. So their head is always turning to the right. And that can lead to some of that MIS um, Michigan. Skull. And there are lots of positional strategies that our therapists can teach the family to do other times it's because of the baby just being super squished inside mom. So if their moms carrying multiples, um, one or both babies could have, um, uh, Ms. Shapened school as they start to grow. And so there could be a couple of different reasons why that happens.

Natalie: 24:21

That's interesting to think about the in utero causes. I feel like that's something maybe that we oftentimes don't think about

Abbie: 24:32

No. And you know, parents, aren't going to think about that until babies are here, right. There's only so many things you can think about at once. And that's why you go to those regular routine pediatrician. Check-ups right. You want to make sure everything has just flowing around normal as can be. And if a pediatrician is seeing something that's, um, definitely something parents should cue into and not ignore, um, like I've seen before.

Natalie: 24:58

So when parents are home with their kids, what would you encourage them to look for? I know like milestones. That's a big conversation, especially with the new, the new CDC updates. Um, but, but are there any specifics that you really encourage parents to look for when they're observing their children?

Abbie: 25:24

Yes. So there's a couple of like big ones that we just want to make sure kids are hitting. One of those. And one of the first ones is that your kiddo is starting to roll over. So between, you know, zero to five months, babies learn to roll both tummy to back and back to tummy. We want to make sure it goes both ways. Um, and then, because we can get, I guess, one, another one of those. Um, concerns is that we get happy sitters.

Natalie: 25:58

Yeah.

Abbie: 25:58

So, uh, this can go along with that container baby syndrome too, is that babies just want to sit and it is a developmental milestone in that babies do want to be up right at a certain age because they want to see what's going on around them. So they will cry out to mom or dad to just come sit them up, where they have lost the. Natural ability to move themselves up into sitting on their own, um, and that, you know, comes in time, but we want to make sure baby's rolling first before they're sitting.

Natalie: 26:34

Okay. Interesting.

Abbie: 26:36

Yeah. Um, the other one, which I still think is really crucial for development is crawling. Um, babies learn so much when they are on all fours on their hands and knees, they get reciprocal movement for their arms and legs. They get coordination, they get trunk control. Um, they have a new way to move around their home and their environment. It's a big. Um, movement pattern and growth in their brain to crawl. It also develops a lot of hand strength when they're using their hands on the ground and putting body weight through their hands. Um, they develop those little muscles for fingers and grip strength. Um, so that's one to look out for is to look to see when your child is crawling. Um, and then we also want to see and make sure that walking is happening. Preferably before 15 months

Natalie: 27:36

Okay. Okay. So go back to sitting for a second. Um, w sitting is something that a lot of people talk about. I was a w sitter as a kid, and I think I have subsequent hip issues because of it, but what does that look like? And when. If ever should parents correct it. And how should they correct it?

Abbie: 28:02

Yeah, w sitting, um, is a lot of hip internal rotation. Uh, kids will double use it as they start to move and transition and learn those transitions from laying on the ground to sitting up and then sitting up to. Pulling to stand. They will occasionally move into a double you sit, but most of them will transition right out of it into a, a long set or a side set or something of that sort, w sitting, um, can be a natural thing for kiddos, and then it can be something that we want to look out for. So I don't think, I would say it's like, oh, super bad. You can't let kids ever, um, it could mean, and I want to say, could mean that a kiddo might have some decreased core strength and they just need extra base of support. So they're pushing their legs out to the side so they can sit easily. Um, it could mean that a kiddo might be more pigeon toed in their walking. And so because they have more internal rotation in their hips and it could mean again that, uh, they have some looser joints, so their ligaments are just held at a looser state than others, which again is. Uh, problem, um, yet, you know, I don't, I wouldn't say it's like, we can never let a kid w sit there's a time and place for it again, but in certain populations, we want to make sure that they're not w sitting

Natalie: 29:36

okay. Okay.

Abbie: 29:38

that's a hard one. It can go really deep into that one.

Natalie: 29:41

Yeah. I think like blanket statements where parents here w sitting is the worst don't ever let them do that, that can feel scary. So it's good to have some clarification, you know, maybe some, some options in there. Um, so if a kid has looser connective tissue, looser ligaments, what are some other signs of that? How would a parent know that.

Abbie: 30:09

Yeah. So one would be some of that w. The other one could be that if, um, if they're an infant, like six months, maybe a year, if they can bring their baby's leg, if they're laying on their back, if they can bring their toe, like all the way up to their head on the side of their body, um, I don't know how to say this without a visual.

Natalie: 30:33

folding folding them in half, essentially.

Abbie: 30:37

Um, babies should be able to fold in half actually. Um, but I'm talking about like the leg going up and out to the side, like towards their ear

Natalie: 30:44

Okay. Okay.

Abbie: 30:45

and just their hip is moving and nothing else,

Natalie: 30:49

Um,

Abbie: 30:51

like their torso is not going to the side at all. That could be a sign of like, oh, your hips are very loose,

Natalie: 30:58

that reminds me of like a baby doll, like the baby doll set slide. Their legs are in like on a

Abbie: 31:05

Yes. And babies are super flexible, right? They're super flexible. They should be able to fold in half and then bounce right back. Um, another one is like a really loose shoulder sockets. Um, and this is something a pediatrician would look out for and they will do this on their own. They'll move their baby, your baby, your ground, and all these different positions because, um, they're checking for that already. So a pediatrician would cue into that.

Natalie: 31:34

That's good to know. So

Abbie: 31:36

there's such a big variation between a super floppy baby and a high toned tents, baby. There's a big range.

Natalie: 31:46

could there be issues with the higher tone? Like too much tone?

Abbie: 31:51

Yes. There could be.

Natalie: 31:52

Okay. Hm.

Abbie: 31:54

a pediatrician would definitely let you know, so go to your pediatrician appointments.

Natalie: 31:58

I'm seeing a theme here.

Abbie: 32:00

Yes.

Natalie: 32:03

Okay. So, um, I have another Instagram follower question. Um, someone asked what are the best stretches and exercises for babies or toddlers who walk on their tiptoes?

Abbie: 32:19

So I think that's a hard one to give out blanket statement wise because there could be a lot of things going into a TOA. Um, this could be multifaceted. And so I don't think I can give you any specific stretches or exercises. It is, could be sensory related to a kid. They might not want to feel things on the bottom of their feet. Um, we have to look at the whole. Person, right. The whole little person that's in front of us, not just their feet or how they're walking on their feet, but what's going on in their hips. What's going on in their cores is core strength that they're missing. Um, is it sensory related? Like, are they not liking to touch anything on their feet or their feet super sensitive? And what other sensory systems are they maybe avoiding at that point? So, um, or what other things are going on in their little. Because this could be a sign of something else. Um, so there's a lot that goes into toe walking.

Natalie: 33:25

Okay. Okay. That gives a good basis though.

Abbie: 33:28

We could do a whole podcast on toe walking.

Natalie: 33:31

I'm down, I'm down.

Abbie: 33:36

I would recommend talking to the pediatrician about it and seeing how often their toe walking. Is this a daily occurrence? Is it only when they're outside? Is it when they're wearing their shoes? Um, is it only happening when they're running or how often are they actually walking? Flat-footed uh, are there things also that they're avoiding to touch or feel, is there a texture they avoid? Um, are they picky eaters? I mean, there's so many different things that can go into that, but asking and starting with your pediatrician is probably. The first thing I would do. And then going from there, if this is a constant, they're always on their toes, it is hard to get them down on their heels. They're doing it in all of their shoes. Um, then I would ask a pediatrician, Hey, what are you think about going to a physical therapist to address this?

Natalie: 34:29

Okay, good advice. I like it. Um, so it sounds like every child could benefit from a PT eval. Um, let's you agree with that? Or what would you say? Like their hard and fast rules, so to speak of who should see a PT who might benefit from OT maybe or something else? Is there like a line that you can draw there at all?

Abbie: 35:01

Sometimes, I don't think everyone needs to have a kiddo looked out from a PT. I think if a kid is meeting all of their milestones and milestones happen in a range of months, it's not like six months, they must be crawling. And at a year they must be walking. There's always a range of where a milestone should develop. Do you know, as long as a kid is meeting those milestones within that appropriate range, and there are no other sensory concerns going on or big glaring, like, wow, that's a really funky walk. I don't know why they're doing that. I don't feel like a kid needs to go in for a PT evaluation. Um, And if there is a concern, if a parent is like, I really don't know why they're moving this way. If there's any movement, patterns or movement concerns, then talking to the pediatrician first and then getting a PT referral is, is definitely appropriate. Um, I like how you brought up OT because sensory concerns are a big one for kiddos, and we're seeing that a lot more. I feel like, um, With sensory processing disorders and a PT can treat some of this. We have some training in processing, sensory processing, uh, but an OT is definitely well-versed in this. And so, like we mentioned, the toe walking could be a sensory issue. It can be addressed by an OT in sensory processing, but the movement pattern can be addressed from a physical therapy.

Natalie: 36:40

So it might be more of a collaborative team effort to get that child where you want them to do.

Abbie: 36:47

Yes. And that happens a lot, uh, especially with younger kids, PTs and OTs will do a lot of co treatment.

Natalie: 36:55

Oh, nice. Okay. That's something I didn't necessarily know.

Abbie: 37:00

Yeah. And if there are issues that's concerning like a PT and an OT going to an outpatient clinic that has both of those services at the same location can be really beneficial for parents because you're going to know that both the OT and PT are talking about that person. Together. So they're always going to be on the same page. It's not going to be this paper trail that has to be forwarded over here. And then it has to come over here and have all these papers signed, just to get a one sentence line into the other professional. Um, it's nice when they're in the same house and they can talk with each other and figure out treatment strategies for the.

Natalie: 37:43

Yeah, that seems like it would, can I cut out a lot of frustration for parents?

Abbie: 37:50

it's good to know that all the professionals are supporting the parent and they're all on the same page.

Natalie: 37:55

yes, that needs to happen in every area of healthcare.

Abbie: 38:02

I wish it was always that way. I leave.

Natalie: 38:05

Hey, that's my goal in life so we can dream big, right? So, um, speaking of parent frustrations, can you talk a little bit about what it's been like navigating through having your daughter and being on the receiving end of therapies and PT and OT, and maybe you could give some advice to parents who might find themselves in a similar situation.

Abbie: 38:36

Yeah. Uh, it has definitely opened my eyes to what parents are feeling. Right. So even though I'm a professional, I'm looking at the problems that are in front of me for the child and then for the family. But when I'm on the other side as the family, And I'm nervous or I'm scared that I'm going to hear something that's bad about my kiddo or, um, or if my kid just like, had a really rough day in therapy and they just refuse to do things because we all have our days, um, it's really an emotional toll. I feel like on the parents. Um, we always want our kids to succeed. That's just not always going to happen. So I feel like I have a better insight on what parents are going through emotionally throughout the process of taking their kid to therapy. Um, I do feel like there's a little bit of a stigma of like, oh, my kid needs physical therapy or my kid needs to go to OT. And because I'm a therapist, I don't feel that as much. I just, it's like a normal thing for us to have a kid in therapy. I guess my kid's been in therapy since she was a month old. So, and she's had all three services, PT, OT, and speech since she was a month old. Um, so it's just like a normal part of our lives at this point, but I know that it can be really hard for parents to understand that. Their kid just might need a little extra help. It's not that they aren't going to be like this forever or that they're going to be in therapies for the rest of their lives. Um, I mean maybe because my child has a rare genetic disorder, she will be in therapy for a very, very long time, but it's really to benefit them. Right. it's it's not something to say, oh, there's something wrong with your kid. It's to say, Hey, we've identified a struggle that they're having. Let's come alongside them and help them be the best that they can be. And I'm giving that as like a positive reinforcement instead of this negative, that there's something wrong. Um, if that makes sense,

Natalie: 41:01

Yeah, totally. And I think it also takes away some of the parent guilt that you were talking about before and like, takes that, oh my gosh, my kid needs therapy. It's probably my fault. I did something wrong. All of that too. Let's just help this kid achieve their greatest potential in life.

Abbie: 41:22

Right. And you know, even if your baby was in a container forever and now they have to have therapy or something, it's going to be okay. Just because we did something in the past, doesn't mean that their future is going to be a disaster. We are, we can change, we can change. What's going to happen in the sense that we've turned from what we used to do. And now we're receiving some supports and we can make it better.

Natalie: 41:54

I like that. It's kind of a reframe. So to speak.

Abbie: 41:58

exactly. And trust me. The therapists are really there to help. They are not there to judge or say, you've done the wrong thing. You shouldn't have done that. We're really there to say, Hey, we have some suggestions for you. How does this work into what you're experiencing in your home? So we really want to make suggestions that are going to be functional for the family and functional for the.

Natalie: 42:29

I think that anybody who works with kids, like you guys are all heroes in my book, because I know that you G you got into this world because you care just so much. And to help other people through the obstacles are having with their children is yeah. It's, it's amazing. So thank you for doing what you do.

Abbie: 42:51

Oh, thanks. I love it. I love to help families. Through those difficult moments because our family has had those difficult moments.

Natalie: 43:00

Yeah. Um, Okay. This kind of leads into another Instagram question that I got, Um, more about like the specialty of pediatric therapy. So the question was, what would you say are the biggest misconceptions about your specialty, which I thought

Abbie: 43:19

Um, as a pediatric physical therapy,

Natalie: 43:23

Yeah.

Abbie: 43:25

Um, I think the biggest misconception is that we only work with kids that are severely disabled.

Natalie: 43:32

Okay.

Abbie: 43:33

we only work with kiddos that have, you know, severe cerebral palsy or, um, or like my daughter who has a genetic disorder or, um, has a prosthetic or, you know, That is, has a severe movement disorder, but that is not what we do. Um, we will see kiddos, like I said, with very mild problems. Like they're just not meeting their milestone. Like, I don't know why, but my baby is just not rolling over and they're six months old so we can work with that kid. Um, we also work with kids that. You know, maybe they're in grade school and they're just not running the typical way a kid would run and we can help problem solve that and figure out what is going on in that running pattern. Um, even up into like middle school, high school of athletes, like, uh, I have a kid that wants to be on the swim team, but has some shoulder pain. Um, that's, uh, that can be a pediatric physical therapist. So we don't have to necessarily work with the severely disabled individual we can work with everyday kids. Um, and therapy does not have to happen for years and years and years. It can be six months. It can be less than that too.

Natalie: 44:55

That was going to be my next question. Like how long typically, if someone doesn't have, you know, maybe severe disability, how long does It typically take for them to achieve their goal?

Abbie: 45:07

It depends on the goal. I think it depends on the age of the individual as well. I think, like I said, for that individual and for like a swim team and has some back pain or shoulder pain, uh, you know, that might be a six month stint of therapy. Um, For a baby. We typically want to see certain milestones before we want to say, okay, we're done. Um, so that might be a little bit longer. Um, it just depends on what age the child is at and if we're meeting those goals and if the family is meeting the goals that they want to see as well, I always want to include the family on Goldman.

Natalie: 45:48

Yeah. Yeah, it's really, uh, it's really a family endeavor

Abbie: 45:52

Yes. And just because you stopped therapy doesn't mean you can't go back. Right. So just because the therapist says, oh yeah, we're done. We met our goals. You're graduated. Don't need to come back. Well, if you're having more of those problems later on, take that swimmer. For example, if they continue to have back pain, when the swim season starts, they can always come back to physical therapy. Okay.

Natalie: 46:14

That's a great reminder. You're not dismissed forever. You can come back. So this is a question that I really love to ask everyone I have on the show. What is your. One piece of advice for our listeners. What do you want everyone to know?

Abbie: 46:35

I guess for the parents out there. Don't feel guilty. Don't feel like it's all your fault. And if you're seeing a delay, then you should check it out. Don't let it go. Don't just say, oh, they'll catch on. Or, oh, I'll just give them a little bit more time. If you're seeing a delay, bring it up with a pediatrician. Don't wait and wait and wait. Um, the longer you wait for things to happen, that don't happen. Sometimes the harder it is to treat them when they get older. So if you're seeing something, trust your gut as a parent, and go ask, go ask your doctors for some help and guidance and where to go.

Natalie: 47:19

That's so good. I think every single person I've had on this show had said something to the effect of advocate for yourself and your family. And that falls right in line with what you said. So maybe I need to change the name, health, advocacy, podcasts, or something.

Abbie: 47:38

Yes. Always trust your gut and advocate for what you think is best. Um, I know personally we've had to do that, um, for our daughter of, no, I really just don't think this is right. And so we've gotten those referrals and they have made a massive difference in her outcomes. So me.

Natalie: 47:57

that's awesome.

Abbie: 47:58

If you're also in therapy services with a child or for yourself, As an adult. Um, if you're not clicking with that therapist and your kid is not enjoying therapy with that specific therapist, it is okay to switch therapy services or to switch to a different clinic. Um, I wouldn't say discontinue altogether because you probably still need therapy services, but it is okay to say, you know, we just aren't clicking personality wise. We're just going to go somewhere else. Uh, It is not going to hurt the therapist's feelings. If you just say, we're, we're going to be done for now and move on to a different therapist. I think if a therapist is really professional, they're going to understand, and they might have even felt the same way of like, I'm just not clicking, but this kid he's just not getting what I'm throwing down.

Natalie: 48:54

Yeah.

Abbie: 48:54

It's okay. To part your separate ways and go try some, another place. So. Um, that's the beauty of having lots of different therapists. They work with kids in a slightly different way. Each person is going to be different. So, um, definitely be your advocate in that as well.

Natalie: 49:13

That's such a good point. I've totally done that with my own care as well.

Abbie: 49:18

Yes, me too.

Natalie: 49:20

It's necessary a lot of times. Um, okay. So tell me, what is your favorite wellness habit that you incorporate into your own daily life?

Abbie: 49:34

Uh, movement, I guess I could just say it plain. I just, any kind of movement, you know, some days I don't feel like doing much of anything, but I will do something. We all are just, we're made to move we're bodies and movement. So if that's a quick walk, um, if that's rough housing with the kids in the living room, that's also a movement that will count

Natalie: 50:01

Oh yeah, that will make you sweaty.

Abbie: 50:04

Yes. It's, you know, we just need to get up and move our bodies. Um, and so I, I, and I personally love to exercise, so, um, yeah. I have too much of a problem with that. I definitely have my lazy days, but if I can get around, move my body stretch a bit, um, it always makes me feel better physically and mentally. So I would definitely advocate for everybody to just get a little bit more movement in their day.

Natalie: 50:32

A woman after my own heart. I like it. Okay. So where can listeners find you? Um, you're in west Villa. And so how would someone book with you?

Abbie: 50:46

Yeah. So I am working, uh, as an early interventionist over in Eagle river, actually. And I only do evaluations. So. Early intervention is a federally funded program. It's different state to state and also in the areas, the programs are run a little differently, but evaluations for babies zero to three are free to anyone that wants an evaluation for meeting milestones, anywhere from PT, OT, or speech, any of those areas, um, Even social and behavioral, um, evaluations are available. So I am in Eagle river doing early intervention, and I am also in the outpatient setting as a pediatric physical therapist in west CELA. Um, but it's. Very sparse. I work very little because I also have my three children at home. So, um, most of my time at this point is dedicated to my own children. Um, but I do see some in the outpatient setting.

Natalie: 51:54

Awesome. So if someone can't get in with you or they don't live in the state of Alaska, um, where should they look for, you know, choosing a pediatric PT that can. be daunting if you're first setting out.

Abbie: 52:12

So the, a PTA website is the, uh, American pediatric physical therapy board. So. American physical therapy association for physical therapist in general. And you can look up, uh, pediatric specialty certified physical therapists. There are not a lot of them, so you can start there. If you want someone who is very certified in that most pediatric physical therapists, don't get that certification. There just have lots of experience in the field. I honestly would say, if they're not in Alaska to just go from word of mouth, a lot of parents will know the good place to go. And so you can ask your friends, ask your mom, friends, ask your social media groups, who they prefer and like, and why they like them. You can also just look up, um, physical therapy locations and see, they are usually a staff drop-down menu on all of those. And then you can get. Pick out the therapist, that's, you know, their bio that clicks with you the most. Um, if they specialize in a certain thing for a kid, like if they really specialize in torticollis treatment, that might be a great person. If your kid is struggling with torticollis or maybe they really specialize in sensory integration, that might be a person that you want to go to. So you can look on their website. You can always call outpatient clinics and ask to speak with someone on how they treat kids. What's their methodology. Uh, what's their specialty certifications. Do they have any other continuing education courses that you might be think beneficial for your child? You can ask all those questions. If you just call the offices. Usually they're really good about wanting to see. Uh, a client. So they're going to answer your questions if they don't probably don't go there.

Natalie: 54:21

Some good advice. Well, Abby, thank you so much for being here today and talking through all these things with me, it was, I learned a lot, it was enlightening for me, and I hope that our, our listeners found this here.

Abbie: 54:37

Yeah. Thanks, Natalie. Thanks for having me.

Natalie: 54:40

Any time, come back for it, uh, to walking episode.

Abbie: 54:43

Absolutely.

Natalie: 54:46

I loved hearing Abby's balanced perspective on pediatric physical therapy. Hopefully you learned as much as I did from this episode. My top takeaway is that, you know, your child best and pediatric PT can be that little boost, your child needs in their development, but isn't an indicator of how you're doing as well. Don't wait, if you're seeing things you're concerned about trust your gut and find a qualified profession. Just a reminder that what you hear on this podcast is not medical advice. Please remember to always do your own research and talk to your provider before making important decisions about your healthcare. If you found this podcast helpful, please consider leaving a five-star review in your favorite podcast app. It helps others to find the show. Thanks so much for this.