As a childcare provider, it is likely you have worked with young children who were receiving physical, occupational, or speech therapy. Approximately 10-15 percent of children in the U.S. have special health needs, and many of these children receive one or more types of therapy as part of their early intervention services.

Therapists typically collaborate with childcare providers and families to develop strategies that promote children’s development at home and in the childcare environment.

Physical Therapy

The American Physical Therapy Association describes physical therapists as “experts in the science of healing and the art of caring.” Physical therapists work on gross motor function and movement with people who have been injured or have problems with mobility because of an illness, disease, or some type of disability.

Physical therapy focuses on gross motor skills like walking, jumping, and crawling, as well as aspects of movement, such as strength, range of motion, mobility, and endurance. Often, other problems with movement are accompanied by pain, and the physical therapist will develop therapeutic strategies to manage the patient’s discomfort.

Physical therapy is helpful to young children with a broad range of conditions, including developmental delays, cerebral palsy, muscular dystrophy, spina bifida, heart problems, limb deficiencies, muscle weakness, muscle and joint pain, and other health issues.

Children who suffer traumatic brain injuries, orthopedic or spinal cord injuries, or burns also are frequently given physical therapy to aid recovery. Infants who are not rolling, sitting, crawling, walking or have other physical delays may receive physical therapy to support their development.

Physical therapists evaluate how a child moves and plays. After observing and identifying problem areas, the therapist will develop a treatment plan to include stretching exercises, strength training, balance and coordination activities, adaptive play activities, water therapy, or other strategies that address and treat the child’s mobility issues.

The duration and frequency of therapy are developed according to the child’s needs. Physical therapy for young children is usually play-based so children may ride on a swing, balance on a beam or large ball, crawl through a tunnel, throw and catch balls, and engage in other fun activities that address the child’s particular area of difficulty.

Occupational Therapy

The American Occupational Therapy Association describes occupational therapy as a skilled treatment that “assists people in developing the ‘skills for the job of living’ necessary for independent and satisfying lives.” Occupational therapists address problems such as fine motor skills, hand-eye coordination, cognitive skills, play skills, feeding skills, exploration of the environment, and sensory integration (the ability to organize and process the information that is received from the senses).

The “occupations,” or jobs of children, are to play, learn, and develop so occupational therapists focus on helping children with these tasks in the context of everyday activities. An occupational therapist may work with a very young child who cannot grasp or pick up toys or a child who is delayed in achieving self-feeding skills. Occupational therapists help children develop skills they need on the playground, in the center or home, in group and individual settings, at mealtimes, and for toileting.

Occupational therapy benefits children with a variety of conditions, including autism, juvenile rheumatoid arthritis, developmental delays, burns, spina bifida, cancer, cerebral palsy, traumatic injuries of the brain or spinal cord, sensory processing and integration problems, and many other health concerns.

Occupational therapists observe and evaluate children to determine which activities of daily life are causing difficulty. They develop a detailed, step-by-step plan and implement it with the child, family, and caregivers.

The occupational therapist may introduce adaptive equipment to assist the child in successfully completing the task. As children grow and acquire skills, they may return to the occupational therapist for help in completing new tasks.

Like physical therapists, occupational therapists who work with young children often use a play-based approach for many activities. A child who is working on fine motor skills may use scissors to create an art project, or a child who needs support in taking turns may play games with others as part of occupational therapy.

Speech-Language Therapy

According to the American Speech-Language-Hearing Association, approximately nine percent of young children have a speech/sound disorder. Many of these children are referred to a speech-language pathologist, also called a “speech therapist.”

Speech-language pathologists provide services ranging from screening and assessment to diagnosis, treatment, and counseling for individuals with speech-language disorders. Speech disorders differ from language disorders.

Children who have speech disorders have difficulties with fluency (interruptions in the flow of speech), articulation (how sounds are formed and put together), or voice (pitch, quality, loudness, resonance, and duration of voice). Stuttering is an example of a speech disorder.

Language disorders occur when there are problems with understanding or using verbal, written, or other language systems, including sign language. A person with a language disorder may struggle with the form of language (word structure, sound systems, sentence formation), content of language (meanings of words and sentences), or function of language (how form and content of language function and are used appropriately). Some children have both speech and language disorders, and the severity of speech-language disorders varies greatly.

Speech-language pathologists work with children with a variety of conditions, including hearing problems, learning disabilities, developmental delays, cleft lip or palate, chronic ear infections, cerebral palsy, autism, swallowing disorders, breathing disorders, brain injuries, attention deficit/hyperactivity disorder, and weak oral muscles.

Because hearing is closely tied to speech and language, speech-language pathologists may collaborate with audiologists, who test hearing, identify hearing loss, provide hearing therapy, and fit people who have hearing loss with hearing aids.

A speech-language pathologist will assess a child’s needs and then address the child’s specific speech-language problem, typically using practice and repetition. Speech-language pathologists may use equipment, like mirrors, to help children practice sounds or words. They may also use games and other play-based therapies.

Marna Holland
Parent Educator, Asheville, NC, City Schools Preschool, and Instructor, Western Carolina University

Internet Resources

Finding Help for young Children with Disabilities, National Dissemination Center for Children with Disabilities; www.nichcy.org/pubs/parent/pa2txt.htm

Physical Therapy, The Children’s Hospital, Colorado, www.thechildrenshospital.org/wellness/info/parents/20557.aspx

Going to a Physical Therapist, Kids Health, www.kidshealth.org/kid/ill_injure/aches/physical_therapy.html

Occupational Therapy, The Children’s Hospital, Colorado, www.thechildrenshospital.org/wellness/info/parents/20556.aspx

Going to an Occupational Therapist, Kids Health, www.kidshealth.org/kid/feel_better/people/occupational_therapist.html

Occupational Therapy in Preschool Settings, American Occupational Therapy Association, www.aota.org/Practitioners/Resources/Docs/FactSheets/School/38510.aspx

Late Blooming or Language Problem? American Speech-Language-Hearing Association, www.asha.org/public/speech/disorders/LateBlooming.htm

Speech and Language Impairments, National Dissemination Center for Children with Disabilities, www.nichcy.org/pubs/factshe/fs11txt.htm

Speech-language Disorders and the Speech-language Pathologist, American Speech-Language-Hearing Association, www.asha.org/students/professions/overview/sld.htm