When you have a child with developmental delays, chances are high that they are going to be seeing therapists. If you are picturing a couch and a nodding psychoanalyst you have the wrong idea. Although that may come into the picture at some point in any person's life, these are not the types of therapists I am talking about. With so many terms floating around, and not knowing much about any of them, I was a little confused and very overwhelmed when first trying to learn about these people who would soon be involved with my daughter. Once we got started, I realized it was not as confusing as I had originally thought. However, in the case that someone reading may still find themselves wondering who we see and why, allow me to explain.
For starters, there is the physical therapist, or PT. One of the main characteristics the extra chromosome can create is low muscle tone. Not to be confused with strength, muscle tone is defined as the muscle's degree of tension at rest or during a stretch. It is described here as "the inherent ability of the muscle to respond to a stretch." Children with hypotonia, or low muscle tone, are often called "floppy" because their muscles remain loose and limber, and, because of this hypotonia, children with Down syndrome are often delayed in motor skills. The physical therapist will work with your child to improve strength, endurance, motor control, and gross motor skills (ie rolling over, sitting up, walking). Children learn from their environment and being mobile exposes them to new environments, so working on these larger movements is important for more than just physical development.
Related, and sometimes overlapping with the physical therapist, is the occupational therapist, or OT. The occupational therapist works to improve a child's ability to participate in the daily routines of life. This could mean working with the child on sensory issues, fine motor skills (ie grasping objects and holding onto objects; things that require the use of smaller muscles, as opposed to the larger movements of gross motor skills), hand-eye coordination, social skills. The OT will help with any number of things ranging from helping a child learn to feed or dress themselves, to improving on food aversions and attention span.
Then there is the speech and language pathologist. Low muscle tone can affect a child's ability to nurse and take a bottle. It can also cause a child to aspirate. This is why you may see children with Down syndrome sporting a feeding tube. (A side note here: Some doctors will tell you that breastfeeding a child with Down syndrome isn't possible. This is a blanket statement that is not always the case. L has pretty much exclusively breastfed since day one. I will talk more about this another day, but don't get discouraged if you have heard this, or are having a hard time breastfeeding. It takes work, but it is possible.) The speech pathologist will help with issues related to feeding and swallowing when the child is young. As they get older, the speech pathologist will help with speech and language development.
Last but not least is the developmental therapist. Depending on what type of early intervention you are using, you may only see one therapist to start. The developmental therapist is knowledgeable in all fields and will help improve on anything you think your child needs to work on. At the Down syndrome clinic, we see the physical, occupational, and speech therapists a few times a year. Through Tennessee Early Intervention and the Susan Gray School, a developmental therapist comes to our home bi-monthly.
These therapists are all very important to a child's development, but the parent is the most important therapist of all. With your own research, and involvement with these professionals, you can learn how to work appropriately with your child on a daily basis in order to help them achieve their potential. I will add, however, that these programs are all voluntary. It is up to the parent to decide whether they want to involve their child in any of them, and how often to do so. It is important to choose those therapies and therapists that work well with your family and your child.
Click here to learn more about physical therapy, occupational therapy, and their differences. Click here to learn more about muscle tone vs muscle strength. Click here to learn more about developmental therapy.