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When I first meet Nicholas, he’s helping Sue Carder, a physical therapist with Wendell Foster’s Campus’ (WFC) outpatient rehab facility (CORF), make copies by pushing the “copy” button on the machine. Sue introduces me to Nicholas, telling him that I will be observing him in his physical therapy (PT) sessions. Upon introduction, I offer my hand to Nick, which he takes and asks if my name is Carolyn, as if he’s logging the information in a databank. In this first exchange I notice Nick’s speech impairment. His grandmother Mimi stands close by and “translates” his slurred pronunciation to be sure I understood what he asked. Sometimes you can make out what he’s saying, other times not so much. I learn Nick also takes speech therapy which follows his PT appointment, and thus, I am invited to observe both therapy sessions for a few weeks.
Sue has worked as a physical therapist for thirty-two years, fourteen of those with CORF. Before clients start therapy, evaluations are conducted to assess their abilities and challenges, to discuss client and/or family goals they seek to achieve through therapy, and then to develop a plan. Nicholas began physical therapy at CORF three years ago. At this time, he wore braces on his legs that helped support him in standing. He couldn’t walk without them or without holding on to someone’s hand or something. Today, Nicholas wears no braces (removed in 2011) and walks, even runs without any assistance!
Nicholas is an amazing little boy with a charming personality. Despite all odds, he has overcome a great deal to be the active little boy with determined goals to play T-ball in the spring and eating a meal at Chucky Cheese one day. Nicholas’ curiosity easily distracts him during his physical therapy sessions. Active and ready to go, he’s eager to learn, to do, and to be. A country boy that likes to keep up with his big brother Jake, Nicholas abounds with energy, never one for sitting still. He believes he can do anything despite his physiological challenges, and doesn’t shy from trying. Nick is sociable and confident enough to do anything, including selling candy bars to women who are on Weight Watchers! Nicholas seems to want to take on the world.
Some of Nick’s physical challenges include balance and coordination, especially when it comes to climbing stairs and playground ladders. Nicholas exudes greater confidence in his ability to do so than we adults watching him as he tackles Sensory Park’s Jungle Gym. His PT goals include: keeping his ankles limber as he grows; further strengthening his leg muscles; greater endurance in running, and; coordination and control in throwing and hitting a T-ball. All the goals are in effort to physically integrate these typical childhood movements in facilitation towards their being effortless and automatic. Because of his physical challenges, the process of early intervention in therapy is like “rewiring” or reconnecting the brain’s communication of what Nicholas wants his body to do with the part of his body with which he wants to do it. With consistent practice, focus, and repetition, Nicholas incorporates into his physical presentation some movements that are closer to what’s natural to children his own age without developmental issues. He will always be physically challenged, but PT’s ultimate goal is that he functions with little impairment to the best of his physiological ability.
In my first observation, Sue begins by stretching Nicholas’feet and ankles to ensure limberness as they continue to grow. It also provides a good warm up for his physical activities. Knowing Nicholas wants to play T-ball this spring, Sue purchased a T-ball stand, bat and a ball for the young budding baseball player of tomorrow. The Green Therapy Pavilion has a large open space in the center of the building that connects all the therapy areas: speech, occupational, hydro- and physical therapy. Also in this area is a basketball goal. Yeah, it’s that big!
Sue tells Nicholas she has a surprise, and pulls out the T-ball equipment. He becomes very excited as the prospect of playing T-ball becomes more real to him. We move to the large open space to set up the equipment to continue the therapy session.
And it’s here we will “Play Ball!” Yes, even me, ever the “observer.”
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