Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232


(615) 936-1000

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Frequency of Therapy

 

The focus of therapy is to provide children and families with the knowledge and skills necessary to manage daily activities after therapy has ended. The goal of therapy is to help each child develop the skills necessary for the job of living.

As the child grows and changes, the need and frequency of therapy services is expected to change. Therapy programs are short-term with clearly identified functional goals. We continually assess progress toward these goals and determine at least every three months whether or not therapy is still necessary.

Frequency of therapy models

An intensive physical therapy program uses a greater frequency than traditional therapy. Clients participate in therapy two to four hours per day at an increased frequency, two to five times per week for six to 12 weeks. We set goals to reach the next developmental milestone in gross motor skills and/or improve functional mobility. A break in therapy usually follows this schedule.

We educate the family in a home program to continue using these new skills. This program can be repeated once every six to 12 months dependent upon the patient’s needs. Programs will typically include activities and exercises needed to reach specific, functional goals set with the child’s primary therapist.

The program may include clinic equipment and modalities as appropriate, including but not limited to: body-weight supported treadmill training, pediatric specific resistance training equipment, functional electrical stimulation, TheraTogs, and other adaptive equipment.

This model of therapy is recommended for children who

  • Continue to make steady progress in skills but need an intensive boost
  • Are in a critical period for skill acquisition or for potential regression related to medical condition
  • Have recently undergone a surgical procedure
  • Are able to follow one- to two-step directions and perform active movements
  • Have immediate and complex needs following a significant or extensive trauma or illness
  • Have had a significant change in medical status
  • Have families that understand the needed commitment and dedication to appointment attendance and home programs

A progressive therapy plan is appropriate for patients who show continuous progress toward functional and measurable goals. We schedule physical therapy visits at frequencies between twice weekly and once every other week. Participation in a home exercise program is required to enhance skills practiced during therapy sessions. The therapist monitors the program and adjusts as necessary.

This model of therapy is recommended for patients who

  • Are making steady changes toward goals and who require frequent modification of home exercise program activities
  • Are recovering skills or function lost due to illness, trauma, or surgery
  • Have complex equipment or home program needs that require frequent modification

A periodic therapy plan is appropriate for patients who show small changes toward established functional goals or are in a period of relative stability. Therapy visits occur every one to three months. Participation in a home exercise program is required to enhance skills practiced during therapy sessions. The therapist will need to modify the program less frequently.

This model of therapy is recommended for patients who

  • Have no potential for skills regression
  • Continue to make progress but at a slow attainment rate
  • Have caregivers who are able to safely carry out a home program with periodic modifications
  • Have equipment needs that require intermittent modification or adaptation
  • Are receiving therapy services from other agencies, such as school or early intervention
  • Cannot cooperate or participate in therapy sessions due to stranger anxiety or behavior problems

A consultative therapy plan is appropriate for patients who may have moved through the other therapy plans, or are making minimal progress toward established therapy goals. We schedule therapy visits as needed. The patient and family should be able to safely complete a therapist-recommended home exercise program. Less monitoring and modification of the home program is needed.

This plan is recommended for patients who

  • Need ongoing care and monitoring
  • Need specific adaptive equipment
  • Have new challenges or issues that require the skilled knowledge of a therapist to assist in problem solving, such as upcoming planned medical intervention, major change in physical environment, or new developmental or life stage
  • Require a skilled therapist’s help for addition or modification of home exercise program activities
  • Have therapeutic needs that are being met through intervention at another agency and/or through community resources

Changing frequencies and ending therapy

Transition from one frequency of therapy to another is to be expected. This occurs when the child moves from one life stage to another, from one functional level to another, and from one environment to another. Discharge from therapy occurs when the child reaches expected goals and results or when therapy services are no longer providing functional gains.


Last Edited: August 29, 2017
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