Pediatric physical therapists work with children who have a wide variety of motor problems. In recent years there has been an increase in the number of children who present with both generalized motor difficulties and sensory-based delays in developmental skills. Since our brains are constantly processing sensory information, it is important to understand the relationship between sensory processing and the development of movement and how physical therapy can help children identified with challenges in their gross motor skills.
One of the sensory-based motor disorders is described as Postural Disorder where the sensory-motor challenge is demonstrated as poor core strength, decreased endurance, and often exhibit poor balance in movement skills. The underlying sensory systems most related to Postural Disorder are tactile (touch) and proprioception (muscles and joints).
These children can be seen to have difficulties with body control and awareness of where their body is in space. This can lead them to exhibit slow cautious movements and have difficulty transitioning surfaces such as stepping onto an escalator or walking on uneven surfaces. They have decreased ability to engage muscles in co-contraction which provides stability so they often feel unstable or insecure in everyday movement skills and may also fatigue easily.
Postural strength and ability are necessary to be able to stand or sit in an upright position so children with postural disorder often “slump”, tire easily, lean against something like a wall or furniture or may hold their head in their hands at their school desk. They may not have a good response to being “bumped” when in a crowd so may choose to not move or participate with other children in play. The postural disorder can also impact the ability to perform age-appropriate skills like catching a ball, running, skipping, or riding a bicycle.
This can lead a child to avoid movements and prefer more sedentary activities or choose not to participate in group motor play. Often they are identified as “clumsy” or uncoordinated and these perceptions can, of course, impact their self-esteem and interactions with peers.
Pediatric physical therapists are uniquely capable of addressing these challenges by identifying the underlying sensory-based dysfunction and the impact it has on the child’s ability to move and then using a platform based on “play” to facilitate improved balance and motor skills. Each child presents with their own individual needs and the PT will develop a program along with the child’s family to work toward increasing the child’s abilities to move, balance, and develop all motor skills they need to confidently engage with their peers thus increasing self-esteem which can lead to solid peer relationships, ability to participate in sports if they choose to and increase overall confidence as they grow and “move’ through life!
