Today’s Child Health Specialist interview features the very playful Stacy Menz – a paediatric physical therapist and blogger at Starfish Therapies.
Please tell us a little about the work of a Pediatric Physical Therapist
Being a pediatric physical therapist is in many ways is like being a teacher. But instead of the subjects we typically associate with school, pediatric physical therapists teach motor skills and for the kiddos that need us, it starts as soon at they are born. Movement is one of the first ways an infant shows us that they are learning and how they learn. As a teacher of movement, pediatric physical therapists are experts in both how motor skills should develop and how to encourage their development when a child has difficulty learning on their own. To do this, we combine our expertise in motor skills with knowledge of the individual infant/toddler/child we are working with to develop a plan of care that both motivates the child and teaches them the skills they need to develop. In some cases this will be initial acquisition of a skill, while in others it is re-learning a skill because the strategy being used is not successful.
What qualification(s) do you hold?
I originally graduated from Boston University with a Masters of Science in Physical Therapy (MSPT) and then passed the National Physical Therapy Exam and a state licensure exam to obtain my license to practice physical therapy. After practicing for a few years, I decided to further my education and went back to Boston University to obtain my Doctorate of Physical Therapy (DPT). Over time, I grew to love working with kids and found myself practicing in this specialty area regularly which led me to sit for the American Board of Physical Therapy Specialties exam in pediatrics and I am a board certified pediatric clinical specialist (PCS) through the American Physical Therapy Association (APTA).
What sorts of conditions or problems do you help children with?
I have had the opportunity to work with children with a wide variety of conditions and motor based challenges. Work in a private practice setting that contracts with a variety of funding settings (early intervention, school based, private pay/insurance), I have had the opportunity to work newborns all the way up to young adults. Some of the most common conditions I have seen are: developmental delay, Down Syndrome, cerebral palsy, autism, developmental coordination disorder, hypotonia, Rett Syndrome, and Prader Willi Syndrome. We rarely get referrals for straight forward pediatric orthopedic cases (like rehabilitation after a broken arm or leg); however, when we do, it’s usually because there are other factors to consider. For instance, one of our referrals was for physical therapy after a leg surgery to regain strength, function and range of motion, but the child we were working with had undergone a surgery to remove a bone tumor in her leg rather than a full amputation. She needed to be receiving therapy for her leg while undergoing chemotherapy, which required a different approach than a straightforward knee surgery. Most of our referrals start out as early intervention referrals for children not meeting developmental milestones. As we work with these kids we figure out if it’s because there is something going on related to a specific diagnosis or just a kid needing a little extra push.
Could you walk us through a typical workday?
My typical workday is anything but typical! Because I own the practice I also work for, I have transitioned in and out of patient care over the last couple of years depending on the needs and staffing levels at any given time. These days I am seeing children only in the school based settings unless one of my therapists needs coverage while away on vacation. A majority of our therapists usually dedicate mornings to seeing children at home through early intervention or at school through the school districts and then spend afternoons at our clinic seeing those who need to be seen after school. In between sessions we return phone calls, write reports or complete other paperwork (there is always a ton of paperwork). In addition, I typically spend time helping the other therapists, answering questions with the front office and always dreaming of what else we can do/provide through our practice to help the most families.
What do you enjoy most about your work?
The best part of my work is that I get to play all day long. Pediatric physical therapy is highly play based. Even when we are having the kids do specific exercises it is always in a fun way so they think they are playing a game. The challenge is figuring out what will motivate each individual child. I also love the problem solving aspect of my work. When new kiddos come in with a specific challenge, I love to look at the pieces and figure out what specifically I can do with them and their family to have the biggest impact.
While there may be some specialized equipment that we use for therapeutic purposes, the majority of the ‘tools’ we use on a daily basis are toys. We love to use toys that have multiple pieces such as puzzles, shape sorters, or piggy banks as these foster a natural repetition for the kids to practice the skill we want them to work on. Songs are another must have. It’s amazing the things you can get a child to do when you put it to music! We had one boy who was working on getting up from the floor and going up and down stairs. We used a farm puzzle and I adapted ‘The Farmer in the Dell’ to help us work on the tasks. The new version went something like this: ‘There’s a (kiddo’s name) on the ground, there’s a (name) on the ground, hi ho the dairy oh, there’s a (name) on the ground.’ Then the next verse started with ‘(name) takes a sheep (or whatever animal/piece is there)’ next verse ‘There’s a (name) on his knees’ next verse ‘And, (name) stands up’. From there he would go up the stairs to put the animals in their ‘homes’ and then come back down for the next animal and the song would start over.
With kids, it’s about being creative. Often creativity is born of necessity. Its always easy to get the more compliant children to play with the toy you have and use it as motivation to practice the skill you are working on. It’s a bit more challenging when you have one that isn’t quite as compliant. It’s on us as the therapist to find ways to make it fun – whether that’s by creating a game out of toys, or making an obstacle course, or using an old toy in a new way. The more I get into the activity, the more my kids do too!
What advice would you give to someone looking for a Pediatric Physical Therapist for their child?
I would tell them to look for someone who is willing to listen to their concerns and work with them. One of the things we always have to remember is that while we may be the expert in pediatric physical therapy and movement, parents are the experts on their child. Sometimes a little tough love is necessary because we are asking the child to do things that are challenging but we always want to make sure we are working on the things that are meaningful to the child and their family. In addition, look for someone that can connect with your child when you’re getting started but then don’t be afraid to occasionally work with a different therapist at the same facility. A fresh set of eyes, and games, can bring new ideas and can also help your child to generalize their skills. I had one family laugh about the fact that their child would only walk with me and we had to work so that he would start walking with other people. It meant that he had to work with another therapist occasionally.
Can you tell us a little about your website
My website, Starfish Therapies, is meant to be a resource to tell families about our practice as well as to provide links to other potential resources. My blog is a place where I get to write about whatever moves me with regards to kids and therapy. It is a place to provide education to families, hopefully in everyday lingo so that they can understand what they may be seeing with their own children. I try to provide ideas for encouraging mobility and play with kids so that they have a chance to explore their environment and develop skills through play. Every once in a while, it’s also a place where I get on my soapbox and voice my opinion about pediatric issues. Mostly, it’s where I can take the time to write about my passion – kids. You can also keep up with our latest news and blog posts via the Starfish Therapies Facebook page.
Stacy Menz, Starfish Therapies’ founder, is a pediatric physical therapist with both a Masters and a Doctorate in Physical Therapy from Boston University and is a board certified pediatric clinical specialist. She stumbled into this field when she realized she would get to play with kids all day long! In reality, she loves making a difference in the lives of kids and their families. In addition to doing rehabilitative work with kids, she also promotes overall wellness and prevention of developmental delays through education. Stacy is actively involved in her professional organizations and is on the editorial board of Impact, the publication of the Private Practice Section of the APTA, and serves on the education committee of the Pediatric Special Interest Group for the California Physical Therapy Association. Stacy and her colleagues are also actively involved in research and have an article that was published in Pediatric Physical Therapy.
Do you have any questions about the important work of paediatric physical therapists?
See the other interviews in the series;