Similarities between Treating Adults and Kids
Hello friends! As some of you may know, I am currently in my last physical therapy clinical rotation in an outpatient pediatric therapy clinic, and I just finished my first month! I will be trying to document more of my experiences in this setting throughout my time here. While there are obvious differences, I’ve found some significant similarities after I compared my experience in this clinic and my time working primarily with the geriatric population during my last internship. It may be intimidating to some due to the glaring differences between working with different age groups, but I hope that recognizing these similarities between treating adults and kids help to build your confidence in working in pediatrics!
The treatment session can be heavily influenced by their mood!
Regardless of whether you’re working with kids or adults, their mood before and during treatment will greatly affect what they take away from the session.
For kids, if they’re tired or not in their usual playful mood, this can really change the course of your session. You may have to adjust your plan to what they will be able to participate in or what they’re willing to do. Similar to kids, adults can also have bad days! Some days may consist of symptom flare ups that can make them cautious with certain aspects of your treatment plan. This can also change your original plan for the day.
Adults can have bad days too! There will be times where your patient’s mood or feelings about their dysfunction will affect your treatment. Because of the unpredictability of your patient’s mood regardless of age, it is so important to be flexible and try your best to make the treatment session worthwhile. Everyone has those days, and as physical therapists (or students), it’s our job to be mindful of their feelings while preventing regression of their rehab progress.
You may not know the true cause of their impairments or know what exactly is going on in their heads!
When I asked one of CI’s how we would know if nonverbal kids can actually understand what we’re saying, she said “the thing is… we can’t know for sure.”
Nonverbal kids or kids with communication impairments may not know how to tell us when they’re in pain, when they’re happy, or when they’re tired. While we may catch some movement patterns that indicate different feelings, there’s no way of truly knowing how they feel.
In regards to adults, there’s no way of knowing all about a person’s true feelings and thoughts. Adult life comes with its fair share of social, occupational, and mental stresses that can affect physical health and wellbeing. Even though the physical exam may point to no clear cause for the patient’s dysfunction, other psychosocial factors that you may not know about could be the main contributor to their symptoms.
Physical therapy interventions should be functional!
One of the biggest components in pediatric treatments is working on improving the child’s function, which is similar to PT goals for adults as well.
Most of the kids who need physical therapy demonstrate some gross motor delay and are not hitting the appropriate motor milestones. As a result, our interventions usually include functional tasks like sit to stand, upper extremity reaching, and walking. We aim to improve the child’s motor function and planning instead of isolating individual muscles for strengthening or endurance. However, we do usually add a toy or two in there to assist with motivation to participate in these activities.
Similarly, creating interventions that are functional and related to the adults’ goals are very important. While adults are better able to perform isolated exercises than kids, creating a treatment plan that improves the patient’s function and ability to perform certain tasks will be the most beneficial. Complex, task-specific exercises like deadlifts, D2 flexion, and step ups will help patients achieve their functional goals.
Patient/family education is so important!
Something I’ve really liked about this clinical is how involved the parents are in their kids’ future and rehab progress – seeing my CIs educate them on a variety of things is so cool to experience, especially when they use this advice and see the positive results afterwards.
For smaller kids, parent education can include ways to facilitate different movements/activities, education on specific diagnoses, and their child’s rehab progress/prognosis. However, no matter what age, patient education will always be a significant piece in the plan of care. Whether its teaching kids to make safe choices with their bodies (like not crashing into things), talking to them about how well they complete a task (even if they’re nonverbal), or giving them the courage to try things they are not confident in, a physical therapist is always providing the proper patient education in order for the patient to improve long term.
When working with adults, patient education is still an essential aspect that will help them understand the problem and solution. As something that is ingrained in our heads throughout PT school, this part of the rehab process should be done constantly. We teach our patients to heal their injuries and prevent new ones.
While I’m writing this post, I’ve actually learned a lot from just reflecting on my first month of this last clinical rotation. Because it is quite intimidating to work with kids (even though I love kids, I was definitely scared at first), I hope this post about the similarities between treating adults and kids can boost your confidence at least a little bit when working in pediatrics!
Here are some resources if you’re preparing to work in pediatric physical therapy:
- Gross Motor Milestones and Pediatric Reflexes Charts (scroll down to pediatrics)
- Dinosaur PT
- Kinesio Kids
- Starfish Therapies
- Peds Activities – Pinterest
- Pediatric Physical Therapy Exercises – Youtube
I’ll see you guys in my next post!
