Frequency of Rehabilitative Therapy Models

The focus of therapy is to provide children and families with the knowledge and skills necessary to manage daily activities after therapy has ended. The goal of therapy is to help each child develop the skills necessary for the job of living.

As the child grows and changes, the need and frequency of therapy services is expected to change. Therapy programs are short term with clearly identified functional goals. We continually assess progress toward these goals and determine at least every three months whether or not therapy is still necessary.

Intensive physical therapy is a program using a greater frequency than traditional therapy. Clients participate in two to four hours of therapy per day at an increased frequency (two to five times per week for six to 12 weeks) with specific goals to reach the next developmental milestone in gross motor skills and/or improve functional mobility. The six to 12 weeks is usually followed by a break in therapy.

The family receives education in a home program to continue with the new skills learned. This program can be repeated once every six to 12 months depending on the patient’s needs. Programs will typically include activities and exercises needed to reach specific, functional goals set with the child's primary therapist.

The program may include the use of clinic equipment and modalities as appropriate including but not limited to: body-weight supported treadmill training, pediatric specific resistance training equipment, functional electrical stimulation, TheraTogs and other adaptive equipment.

This model of therapy is recommended for patients who

• Continue to make steady progress in skills but need an intensive boost
• Are in a critical period for skill acquisition or for potential regression related to a medical condition
• Have recently undergone a surgical procedure
• Are able to follow one or two-step directions and perform active movements
• Have immediate and complex needs following a significant or extensive trauma or illness
• Have had a significant change in medical status
• Have families that understand commitment and dedication to appointment attendance and home program following intensive episode

This therapy plan is appropriate for patients who are showing continuous progress toward functional and measurable goals. Physical therapy visits are scheduled at a frequency range of twice weekly to once every other week. Participation in a home exercise program is required to enhance skills practiced during therapy sessions. The therapist intermittently monitors and adjusts the program.

This model of therapy is recommended for patients who

• Are making steady changes towards goals and require frequent modification of home exercise program activities
• Are recovering skills or function lost due to illness, trauma or surgery
• Have complex equipment or home program needs that require frequent modification by the therapist

This therapy plan is appropriate for patients who are showing small changes toward established functional goals or are in a period of relative stability. Therapy visits occur every one to three months. Participation in a home exercise program is required to enhance skills practiced during therapy sessions. Modification of the program is needed less frequently.

This model of therapy is recommended for patients who

• Do not have potential for regression of skills
• Continue to make progress but at a slow rate of attainment
• Have caregivers who are able to safely carry out a home program with periodic modifications by a therapist
• Have equipment needs that require intermittent modification or adaptation
• Are receiving therapy services from other agencies, such as school or early intervention
• Cannot cooperate or participate in therapy sessions due to stranger anxiety or behavior problem

This therapy plan is appropriate for patients who may have moved through the other therapy plans, or are making minimal progress toward established therapy goals. Therapy visits are scheduled as needed, depending on the patient's and family's needs. The patient and family should be able to safely complete a home exercise program recommended by the therapist. Less monitoring and modification of the home program is needed.

This plan is recommended for patients who

• Need ongoing care and monitoring 
• Have a need for specific adaptive equipment
• Have new challenges or issues that require the skilled knowledge of a therapist to assist in problem solving (upcoming planned medical intervention, major change in physical environment or new developmental or life stage)
• Require the help of a skilled therapist for addition or modification of home exercise program activities
• Have therapeutic needs that are being met through intervention at another agency and/or through community resources

Transitioning from one frequency of therapy to another is to be expected. Transitions occur when the child moves from one life stage to another, from one functional level to another and from one environment to another. Discharge from therapy occurs when expected goals and results have been reached or when therapy services are no longer providing functional gains.