Intensives

P-CIMT

Serial Casting

Spinal Stimulation

DIRFloortime

 

INTENSIVES:

What are Intensives?
Short Term, High Frequency, Big Results!
Research shows that many children benefit from receiving therapy services at a higher frequency over a shorter period of time when focusing on specific goals. 

How Does it Work?
Children who participate in intensive therapy attend each day for anywhere between a week to 3 weeks in order to solidify skills needed for participation in everyday life. Intensives may be a great way to begin your child’s therapy experience or to help your child achieve a goal he or she is close to meeting. It may also simply be a better fit for you and your family’s lifestyle through what we describe as “burst” therapy.

What are the goals of Intensives? 

• Address specific and measurable goals that are likely to be attained through consistency and daily intervention 
•  Jump-start rapport building/relationships for child/therapist for children who are slow to warm to new environments 
•  Incorporate parents into sessions to increase understanding of techniques and interventions used to improve carryover in the child’s natural environment 

​Who may benefit from Intensives?

• A child who may learn better through consistency & daily intervention 
• Families who may have work schedules that accommodate daily intervention for weeks at a time 
• Families who travel from out of town 
• Families who would like to participate in a special program or would benefit from a “booster” or “jumpstart” prior to starting school or hitting a developmental milestone 

 

P-CIMT: 
​PEDIATRIC CONSTRAINT INDUCED MOVEMENT THERAPY 

What is PCIMT?
Pediatric Constraint-Induced Movement Therapy (CIMT), is an innovative, scientifically supported method of upper extremity rehabilitation for children with neuromotor impairments. PCIMT is emerging as a best practice in the treatment of children with hemiplegia or brachial plexus injury. PCIMT involves constraint of the non-affected arm in combination with intensive therapy. 

How Does it Work? 
 The PCIMT program at PTA consists of three weeks of intensive occupational therapy services - four days per week, three hours per day.  The child's non-affected arm is placed in a removable cast.  The therapist will then engage the child in three hours of play, fine motor and self-care activities using their affected arm.  This will be followed up by three hours of wearing the cast at home to encourage more use of the affected arm.    

What are the goals of PCIMT?

• To increase the spontaneous movement of the child’s affected arm 
• To improve quality of movement of the affected arm 
• To increase overall functional use of the affected arm 
• To increase bilateral skills, the use of both arms together 

 
Who may benefit from PCIMT? 

• Children with hemiplegia who have some movement of the affected arm 
• Children who have had a brachial plexus injury such as Erb’s Palsy 
• Children who are able to follow directions and work in intensive therapy 
• Children whose parents/caregivers are able to dedicate time to the program 

 

Serial Casting

What is Serial Casting? 
Serial Casting is a process in which joints are immobilized in well-padded plaster casts in order to improve range of motion and alignment. By wearing cast(s), children are able to walk with improved alignment, allowing the muscles and soft tissue to stretch and elongate to a more functional position.   
 
How does it work? 
Casts are applied at the clinic and removed in succession (usually every week) over a specific period of time. During the procedure, the affected joint(s) are gradually and repeatedly set in improved alignment resulting in an increase in range of motion. Children wear the casts full time in order to allow for prolonged hold in an optimal position. Once casting is complete, children will be assessed for appropriate orthotics to maintain alignment and range of motion.   
​
 What are the goals? 

• To increase range of motion through the ankle(s) and feet 
• To improve gait pattern 
• To improve alignment and muscle function 

Who would benefit? 

• Children who toe walk 
• Children who have a contracture in their ankle(s) 
• Children who will tolerate prolonged cast wear 
• Children who will tolerate cast application 
• Children whose parents who are able to dedicate time to the program 

 

Spinal Stimulation

What is Spinal Stim?
Spinal Stimulation is neuromuscular electrical stimulation that integrates the spine and can be done with a child inactive or active. The benefits of Spinal Stimulation include improved muscle activation and strength, sensation, respiration, bowel and bladder function, and circulation.​

How does it work?
​The evidence is strong for e-stim and exercise to work together to improve outcomes for peripheral nerve injuries such as spina bifida and brachial plexus injury. The stimulation uses an electrical stimulation unit, like a tens unit, to send electrical impulses from the lower back to the affected limb, like nerves would do to activate muscles. The muscles contract in response.

What are the goals of Spinal Stim?

• To increase muscle strength and activation
• To Increase sensation of affected limbs
• To improve respiration, bowel and bladder, and circulation
• Who may benefit from Spinal Stim?
• Children with cerebral palsy
• Children with spina bifida and spinal cord injury
• Children with brachial plexus injury or who need to improve upper extremity function

FAQ:
How many sessions will it take to set up the system?
The set up will take 4-5 PT sessions which can be scheduled outside of currently scheduled PT sessions. However, authorization for PT treatment must already be established at Pediatric Therapy Associates.

What is the recommendation for use of spinal stimulation at home?
The recommendation for home use is 2 times/day for 30 minutes per session.
It can be done passively (ie. on the car ride to and from school or actively (during physical activities at home)

What kind of electrical stimulation machine will be used?
A Chattanooga Continuum is the electrical stimulation machine that will be used and is what will need to be purchased by the family to use at home. The Chattanooga Continuum device costs approximately $300-$400.

What patients should not use spinal stim?​
Electrical stimulation should not be used directly over implanted hardware (rods in the spine, ect). It should also not be used when there are electronic devices already implanted (pacemaker, VNS, or baclofen pump).

 

DIRFloortime
What is DIRFloortime? 
DIRFloortime is a therapeutic approach aimed at promoting a child’s growth through meaningful, interactive play. “DIR” stands for Developmental, Individual Differences, and Relationship-based—the foundational principles of this model. The therapy environment is structured to actively engage the child with the therapist and parent. Floortime is child-led, meaning the therapist follows the child’s interests, focusing on activities the child prefers. 

How Does It Work? 
DIRFloortime sessions take place during regular weekly appointments. Therapists use specific play styles to encourage children to connect, take initiative, and solve problems alongside them. At the end of each session, parents receive guidance and may participate in an Intensive, where the therapist demonstrates DIRFloortime techniques and shows the parent how to use these strategies at home. 

What Are the Goals? 
Floortime emphasizes process over product, meaning it values reciprocal engagement and problem-solving more than simple skill repetition. While it covers skills in areas like language, daily activities, and mobility, it does so in a child-led, interactive manner.

Who May Benefit? 
Though DIRFloortime is well-known for supporting children with Autism Spectrum Disorders, it can benefit any child facing educational, social-emotional, mental health, or developmental challenges. 

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