Mike Thomas: It's time to ask the expert. Our weekly ask the expert program with our experts from
Barnes-Jewish St. Peters Hospital and
Progress West Hospital. Today we're going to talk with Amanda Wang, she's a physical therapist specializing in pediatrics. She works for Barnes-Jewish St. Peters Hospital outpatient therapy services and has been with the hospital for four years. She works for a variety of diagnoses, including Down Syndrome, cerebral palsy, prematurity, developmental delay... and we're going to find out ways that maybe she can help your child and talk about physical therapy for kids today.
Amanda, good morning welcome!
Amanda Levinson: Good morning
Mike Thomas: Let's I guess first off... why would a child need your services?
Amanda Levinson: There's a wide variety of reasons why a child would come to see us. We see neurological disorders like cerebral palsy, spina bifida, muscular dystrophy. There are a lot of genetic disorders that exist.. the most common being Down Syndrome. We also see a lot of just general developmental delay, prematurity, and torticollis is very common right now, which is when the babies have a tight neck muscle... and also toe walking. In the older children, we see more and more sports related orthopedic injuries these days too.
Mike Thomas: What type of treatments do you guys provide?
Amanda Levinson: The treatment really varies with age and diagnosis. For infants, we work on reaching the developmental milestones which might be age appropriate sitting, or rolling. For babies with torticollis, again that's that tight neck muscle, we work on stretching the head and a lot of parent education. In older children, it's going to be very similar to an adult but much more fun. Instead of having an adult or you walk up a flight of stairs five times, I might have a child do it but with a puzzle at the top and the pieces at the bottom to make it much more fun. It's really a lot of parent education too.
Mike Thomas: That might be what I need for exercise purposes too but uh... I hear the term "tummy time." What is tummy time and when should a baby start tummy time?
Amanda Levinson: As soon as possible. One thing that seems to be missed right now.. parents are very fearful of putting babies on their tummies for fear of SIDS. The push right now being the "back to sleep" thought.. where babies should be put on their backs to sleep. Unfortunately it is slowing babies' development. So, get the babies on their tummy as soon as possible... definitely when they are awake and supervised. It's going to help them get stronger head, neck, shoulder muscles, promote motor skills and it can also prevent that flat spot that I hear people complaining about out on the backs of their babies' head a lot.
Mike Thomas: Interesting, so I'm curious what is the youngest patient you've ever treated?
Amanda Levinson: Well I started out in pediatric home health and I would see premature infants as soon as they came home from the hospital, maybe two weeks old.. sometimes no more than four pounds. So, in outpatient, where you might bring your baby to me here in the clinic, between four and eight weeks. Really, the younger the better... the quicker we can get a jump on things I would say don't hesitate and talk to your doctor.
Mike Thomas: I'm going to assume this may vary but how often in general does a child need to see the physical therapist?
Amanda Levinson: It does vary. Older children with more of the orthopedic problems are going to be more of twice a week or a month or two. Babies are anywhere from once or twice a week to two times a month depending on what they have and how compliant the parents are with their program. They usually last 30 to 45 minutes.
Mike Thomas: Before I get to that point of seeing you, obviously there are a couple of steps in between. Let's talk about that. How do I get my child started with the physical therapy.
Amanda Levinson: Sure. You have to start with a physician prescription. That can be your pediatrician, neurologist, orthopedist, really any doctor is fine. You would just talk to them and get a prescription. Then, give our office a call and make an appointment just like you would any doctor's office you need an appointment with. We do often recommend that you check insurance before coming just to make your life a little bit easier but that's really it.
Mike Thomas: If someone needs to find a physical therapist for their child, how would they go about doing that.
Amanda Levinson: Well, you can always call us. We'll be happy if we're not in your network to guide you to places that are but speak with your doctor usually they have a list of places around the area that will offer pediatric services.
Mike Thomas: Right, I know to go through BJC, all they have to call 636.928.WELL and that will point them in the right direction.