Author: Darlene K. Sekerak, PT, PhD
Kristie is an eight year old girl who has had been receiving weekly physical therapy for as long as she can remember. She has spastic hemiplegia (increased tone on one side of her body) resulting in poor coordination of her right arm and leg. She walks by herself, but awkwardly, and can?t run. She also has trouble with activities that require two hands, like throwing or caching a ball. Kristie has lots of friends at school and is very sociable and outgoing. Her mom often arranges play dates for her on the weekends so that she and a friend can play dress up or watch movies together. They especially love Disney stories about princesses. Most of Kristie?s friends are now getting involved in active sports and Kristie is feeling left out.
Kristie?s Mom wants to enroll her in a soccer program at the YMCA but her Dad is opposed to this. He is concerned that she ?will get hurt?, ?the other e kids will make fun or her? and that she will feel bad because she ?can?t keep up? or ?won?t get to play?. Mom is intent on her playing soccer because Mom also played soccer as a young child and she believes that Kristie will benefit from a similar experience.
Kristie?s Dad brought her to her therapy appointment after school and asked the physical therapist what she thought about Kristie playing soccer. The therapist sensed that she was being put in the middle of an argument but thought that this was an ideal opportunity to talk with both mom and dad about her growing concerns about Kristie?s level of physical activity and the need to develop leisure interests that included exercise and movement.
The therapist suggested they schedule a conference that would include both parents and Kristie to talk about soccer and perhaps some alternatives. At the conference, the therapist talked to Kristie and her parents about how important it was for Kristie to get involved in recreational activities that also included physical activity. Both parents talked about the idea of enrolling Kristie in soccer, but it was obvious by her facial expression that Kristie was less enthusiastic about this. The therapist suggested that there might be some other options that Kristie might like and that would provide and good match with her interests and abilities. She offered them information about a swim program offered by the local parks and recreation association. The swim instructor was particularly receptive to working with children with disabilities and the therapist was willing to talk with her about Kristie?s special needs and suggest realistic goals. She also shared information about a beginner ballet class that she herself was starting for children with movement and balance difficulties. She hoped to individualize the instruction to the therapeutic needs of each child and still keep it fun and interesting. She had already made arrangements with a local dance school and one of the dance instructors was going to work with her. They planned to include the children in their dance recital in the spring.
At the first mention of ballet classes, Kristie started to beam! This activity seemed to be a much better match than soccer to her natural interests and it responded to Dad?s concerns about her getting hurt and need for a special program approach. Everyone agreed that ballet classes were a great idea. The therapist recommended that they reduce the frequency of individualized therapy sessions to once a month for the next two months. This would allow her to monitor Kristie?s progress toward her therapy goals and be sure that there were no negative effects of the ballet classes on her spasticity, muscle tightness and coordination.
|
