New Therapy for Age Old Issue: Pelvic Floor Therapy

colorful graphic that says pelvic floor therapy

MetroEHS introduced Pelvic Floor Therapy last month and this new therapy will change the lives of countless children because of it. Pelvic floor therapy is a specialized field of physical therapy that focuses on treating conditions and symptoms related to the pelvic floor muscles in children.  Pelvic Floor Therapy involves training your child on how to contract and relax the pelvic floor muscles and with retraining and regular exercises, your child can learn how to better control and gain sensory awareness of these muscles, which play a crucial role in urination and stooling.

Who Could Benefit from Pelvic Floor Therapy?

Pelvic floor therapy can be beneficial for children who struggle with or are unable to gain control over their bowel and bladder. This therapy is often recommended for children who are diagnosed with one or multiple of the following conditions:

  • Enuresis/Bedwetting
  • Constipation
  • Incontinence
  • Overactive bladder
  • Urinary frequency/retention
  • Urinary incontinence
  • Urinary urgency
  • Frequent UTIs

What to Expect with Pelvic Floor Therapy?

The success of pelvic floor therapy often depends on the involvement and commitment of parents or caregivers. Adherence to recommended diet modifications and daily routines can greatly improve the outcomes of this therapy. At MetroEHS, our physical therapists take into account the family history and any life-changing events to tailor the therapy according to the specific needs of each child.

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June 30, 2019

How do I Know if My Child has a Feeding Disorder?

Feeding disorders are very common. Though it is hard to quantify, “[a]pproximately 20-50% of normally developing children, and 70-89% of children with developmental disabilities” (1) have a feeding disorder. How does this happen so frequently?!

According to Dr. Kay Toomey’s research and reviews of other studies, of children who have feeding disorders, between 65-95% of cases are caused by both behavioral and natural, organic causes (2017) (2). In other words, more often than not, a feeding disorder is not just behavioral! For example, a child that has undiagnosed reflux or allergies has learned to refuse food, because they have learned that food causes them to have an upset stomach. They may continue to refuse food even after receiving treatment for the initial physiological problem. A child that has choked on some solids because of undiagnosed oral dysphagia will begin to only eat liquid and purees to avoid choking. A child that is refusing crunchy foods could have sensory processing disorder and benefit from desensitization. A child that is having a hard time breathing will refuse food in order to get enough oxygen to survive. The examples could go on and on. Every child is different, and needs to be diagnosed and treated holistically.

Some signs that may indicate your child could have a feeding disorder include:

  • If your child eats less than 20 foods
  • If mealtimes take more than 30 minutes
  • If they refuse all of food of a certain texture or color, or are they having difficulty transitioning to solids
  • If they are choking, coughing, or gagging while eating
  • If they are demonstrating a lot of negative behaviors during meal times
  • If they have difficulty with mealtime routines or have a hard time sitting at the table
  • If they have difficulty chewing or swallowing (example: food left in their mouth after they’ve finished eating)

If you think your child could have a feeding disorder, or you feel that you’ve exhausted your options at home and don’t know where else to go, your child could likely benefit from a feeding evaluation and possibly feeding therapy. A pediatric feeding specialist can help you determine the cause, if a cause is present, make appropriate referrals, and plan the best course of treatment. Slowly, your child will become an adventurous and independent eater!

Sources:

  1. 2013. June 13. Banchaun Benjasuwantep, Suthida Chaithirayanon, and  Monchutha Eiamudomkan. Feeding Problems in Healthy Young Children: Prevalence, Related Factors and Feeding Practices. Published online 2013 Jun 13. doi: 10.4081/pr.2013.e10
  2. Toomey, Kay (2017). Top Ten Myths of Mealtime in America. SOS Approach to Feeding. https://sosapproach-conferences.com/resources/top-ten-myths-of-mealtime-in-america/

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June 17, 2022

What Is the TheraSuit Method and How Does It Help Children Build Motor Skills?

History of TheraSuit

Richard and Izabela Koscielny are physical therapists, who have a daughter diagnosed with cerebral palsy and tried out suit therapy with her. After significant improvements with the suit, they modified and created their own suit specialized for therapeutic benefits, called TheraSuit™.

How Does TheraSuit Work?

  • TheraSuit worn over a prolonged time will correct proprioception and accelerate progress with functional strengthening
  • Skills practiced become more fluent when TheraSuit is worn
  • TheraSuit facilitates the development of new gross and fine motor skills faster than typical therapy approaches

Benefits Seen with TheraSuit

  • Retraining the central nervous system
  • Restores ontogenetic development
  • Provides external stabilization
  • Normalizes muscle tone
  • Aligns the body to as close to “normal” as possible
  • Provides dynamic correction
  • Normalizes gait patterns
  • Provides tactile stimulation
  • Influences the vestibular system
  • Improves balance
  • Improves coordination
  • Supports weak muscles
  • Decreases uncontrolled movements in ataxia and athetosis
  • Improves body and spatial awareness
  • Provides resistance to muscles to further enhance strengthening
  • Improves speech production and fluency through head control and trunk support
  • Promotes gross and fine motor development
  • Helps decrease contractures
  • Helps improve hip alignment through vertical loading
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Patient Populations

  • Most major neurological diseases/diagnoses:
    • Autism
    • Down Syndrome
    • Cerebral Palsy
    • Cerebral Vascular Acciden
    • Traumatic Brain Injury
    • Spinal Cord Injury
  • Posture/alignment asymmetries
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Intensive Physical Therapy Schedule

  • Intensive physical therapy is meant to be done 3 hours/day, for 5 days/week for 3-5 weeks
  • Recommended to complete 3-4 intensive bouts of therapy throughout the year
  • Breaks between the bouts have been shown to be more beneficial for the patient vs continuously pushing for months on end
  • Recommended to complete HEP 1-hour/day to compliment exercises done in intensive, allowing the patient to not only maintain, but improve their functional abilities
  • The schedule of 4  weeks was created specifically in order to change the neuro-pathways, and allow for increased improvements

In General

  • Week 1 works on correct muscle activation and beginning to complete basic concentric exercises
  • Week 2 works on solidifying concentric movements and working into eccentric movements
  • Week 3 solidifies the eccentric movements and introduces isometric holds
  • Week 4 focuses all on isometric holds, working into more complex exercises, as well as creating POC and HEP for time off between bouts of intensive

Work to decrease primitive reflexes and general movements that are present → goal-directed movements → selective effective strategies → refining skills → maintaining through practice

April 14, 2026

When Should Physicians Refer a Child for Integrated Pediatric Therapy?

Why Integrated Therapy Models Can Improve Functional Outcomes in Pediatric Patients

Pediatric patients with developmental, neurological, behavioral, and sensory conditions rarely present with isolated deficits. In clinical practice, delays in motor function, communication, regulation, feeding, and adaptive behavior frequently overlap, influencing one another in ways that can complicate both diagnosis and treatment planning. Yet despite this reality, many children still enter care through fragmented referral pathways, receiving services across separate disciplines without a unified plan of care.

For physicians, this can create a familiar challenge: a child may be referred for speech concerns, but underlying sensory processing difficulties, motor impairments, or behavioral barriers may be limiting progress. Another patient may be receiving occupational therapy while untreated communication deficits continue to interfere with participation, safety, and family routines. When care is siloed, treatment goals may be addressed in isolation rather than in the context of the child’s overall functional development.

An integrated therapy model offers a more clinically aligned approach. By coordinating services such as Applied Behavior Analysis (ABA), Occupational Therapy (OT), Speech-Language Pathology (SLP), and Physical Therapy (PT) under one interdisciplinary framework, integrated care supports shared functional outcomes rather than disconnected discipline-specific objectives.

The Clinical Problem With Fragmented Pediatric Therapy

Children with autism spectrum disorder, global developmental delays, neurological diagnoses, genetic syndromes, feeding disorders, and sensory-behavioral challenges often require support in multiple developmental domains at the same time. Traditional referral patterns, however, can delay this process. Families may be referred sequentially, moving from one specialty to another over the course of weeks or months. In the meantime, opportunities for early, coordinated intervention may be missed.

This fragmented model can contribute to delayed progress, duplication of effort, inconsistent treatment strategies, and increased caregiver burden. Parents may be left trying to reconcile different home programs, communication methods, and therapeutic priorities across providers. Physicians, in turn, may receive updates from multiple sources without a single cohesive picture of the child’s functional status or trajectory.

What Is an Integrated Therapy Model?

An integrated therapy model brings multiple pediatric disciplines together within a coordinated plan of care. Rather than treating communication, mobility, sensory regulation, and behavior as separate issues to be addressed in parallel but independent tracks, the interdisciplinary team collaborates around shared goals tied to everyday function.

These goals may include functional communication, feeding independence, improved transitions, school readiness, social participation, gross motor mobility, or greater independence with activities of daily living. The emphasis is not simply on increasing therapy volume, but on aligning interventions so that each discipline reinforces the others.

For the referring physician, this model can improve both clinical clarity and continuity of care. Instead of scattered recommendations, the result is a more streamlined treatment course centered on measurable, meaningful progress.

Why Integrated Care Can Produce Faster Functional Gains

One of the primary advantages of integrated pediatric therapy is simultaneous skill development. A child is not required to “complete” one form of therapy before another begins. Instead, deficits across domains can be addressed concurrently, which is often more reflective of how development actually occurs.

For example, a child working on expressive language in speech therapy may also need occupational therapy support for sensory modulation and motor planning, while ABA helps reinforce communication attempts across routines and environments. In a coordinated model, those interventions are not separate—they are mutually reinforcing. This kind of overlap can accelerate the acquisition and generalization of functional skills.

Integrated care also improves goal setting. When therapists across disciplines are aligned around outcomes such as feeding, social participation, transitions, mobility, or independence, treatment tends to be more efficient. This reduces contradictory strategies, minimizes duplication, and makes progress easier for both families and physicians to follow.

Another important factor is treatment intensity without fragmentation. Children with complex needs often benefit from more frequent intervention, but high therapy intensity can become burdensome when services are spread across unrelated systems, schedules, and locations. Integrated models can increase intensity while preserving continuity, making it easier for children to receive comprehensive care without overwhelming families.

Reinforcement Across Disciplines Improves Generalization

Generalization remains one of the most important markers of meaningful pediatric progress. A skill demonstrated in a single therapy session has limited value if it does not transfer into the home, school, or community environment. Integrated care helps close this gap.

When one provider introduces a communication strategy, self-regulation support, mobility goal, or feeding intervention, the rest of the team can reinforce that same skill during their own sessions. A child who practices requesting in speech therapy may use the same communication system during ABA and OT. A sensory regulation strategy introduced in occupational therapy may support participation during speech sessions or improve tolerance for physical therapy tasks.

This consistency can speed carryover and reduce the risk that gains remain context-dependent. For physicians monitoring developmental progress, that translates into more functional outcomes rather than isolated clinical wins.

The Importance of Early Multidisciplinary Access

Early intervention is well established as a major factor in pediatric outcomes, but access delays across disciplines remain common. A child may begin one service while waiting for another referral, evaluation, or authorization, even when needs in multiple domains are already evident.

Integrated models reduce that lag by allowing children to access multiple specialists earlier in the care process. This is especially important for patients whose communication, sensory, behavioral, and motor needs are intertwined. Earlier multidisciplinary involvement can support developmental momentum, reduce avoidable decline in function, and improve long-term participation outcomes.

For physicians, this means that an integrated referral may be appropriate not only when a child is already receiving multiple therapies, but also when the clinical presentation strongly suggests interconnected needs from the outset.

Which Patients May Benefit Most From an Integrated Referral?

Integrated therapy is particularly valuable for pediatric patients whose presentation crosses traditional discipline boundaries. This often includes children with autism spectrum disorder, global developmental delay, speech and language delays with behavioral or sensory components, neurological conditions, genetic disorders, feeding difficulties, and motor impairments that affect participation in daily routines.

It may also be the right model for children whose progress has plateaued in a single-discipline setting, especially when underlying barriers appear to involve multiple systems. In these cases, coordinated treatment can help identify whether communication, regulation, sensory processing, strength, endurance, or adaptive functioning is limiting advancement.

What Referring Physicians Can Expect

From the physician’s perspective, integrated care can simplify the referral and follow-up process. Instead of navigating feedback from multiple unconnected providers, physicians can expect more coordinated communication, a unified plan of care, and reporting that reflects cross-disciplinary collaboration.

Families also benefit from reduced navigation burden. When care is organized around the child rather than around separate service lines, it becomes easier for caregivers to understand treatment priorities and implement strategies consistently. This can improve adherence, engagement, and follow-through outside the clinic.

Most importantly, integrated care better reflects how children function in the real world. Development does not occur in isolated domains, and pediatric therapy is often most effective when treatment recognizes that reality.

A More Functional Model for Pediatric Referral

For pediatric patients with complex developmental, behavioral, sensory, and physical needs, integrated therapy models offer a more coordinated and clinically meaningful path forward. By aligning ABA, OT, SLP, and PT around shared functional outcomes, interdisciplinary care can reduce fragmentation, support faster skill acquisition, and improve generalization into daily life.

When multiple developmental domains are affected, a multidisciplinary referral is not simply convenient—it may be the most appropriate model of care.

To refer a patient, visit https://www.metroehs.com/referrals

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