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AutismBC Highlights

What is Physiotherapy (PT)?

February 23rd, 2023

AutismBC

For Caregivers

Are you wondering about the benefits of Physiotherapy (PT)? We sat down with Kelsey van Stolk, a Physiotherapist from Kids Physio Group, which offers services throughout BC. Join us as we ask Kelsey some questions about physiotherapy. What is physiotherapy? How can it help?  

What is Physiotherapy? Transcript

Sarah: All right, welcome everyone to AutismBC Talks. Today we’re going to talk about physiotherapy. I’m Sarah. I’m the Regional Coordinator on Vancouver Island and we’re super excited to have Kelsey with us today from Kids Physio Group. Thank you so much for being here we’re very happy to have you.

Kelsey: Thanks for having me! I’m happy to be here too.

Sarah: Would you mind just a little introduction about yourself and how maybe you got into this line of work?

Kelsey: Yeah so, my name is Kelsey and I am one of the pediatric physiotherapists with Kids Physio Group at our Kelowna location. I had an interest in pediatrics when I came out of physiotherapy school and was fortunate enough to do one of my clinical placements with Kids Physio Group in Vancouver, which transitioned into a job for me. I worked for our Surrey location since 2014 and recently relocated to the Okanagan, so now I’ve joined the Kelowna location. I absolutely love working in pediatrics. There are so many, I get to have just the most fun in my day that I think any person can probably have in their job, so I feel fortunate to be in this role.

Sarah: Yeah not a lot of people can say they love their jobs, so that’s amazing.

Kelsey: Yes.

Sarah: So, I’m curious about physiotherapy versus physical therapy I’ve heard both terms, and people shorten to PT. What’s the difference?

Kelsey: So, they’re generally interchangeable terms. Some may argue that there’s a very slight difference between physiotherapy and physical therapy, but mostly it’s just a regional difference in what it’s called. So here in Canada we’re referred to as physiotherapists although we still shorten it to PT as our acronym. Whereas, in the US you may find that I’m referring to it as physical therapy. So yeah, just generally interchangeable terms. And just to tell you a little bit about what we do as a profession, we are one of the allied health professionals. So those are professions like PT, OT (occupational therapy), speech and language pathology and, in very broad terms, we try to make the most of a patient’s mobility, their function, and their overall well-being. And we generally deliver that through some hands-on or manual therapy, exercise prescription, education, and, in pediatrics where I work, that’s all delivered in the context of play which is a child’s work. So, they don’t even know they’re doing therapy for the most part.

Sarah: And that’s the best kind of therapy.

Kelsey: Absolutely. The kind that you really want to participate in and can’t wait to attend.

Sarah: That’s great. So what age would you say a caregiver could reach out? I mean, is it the infant stage? Those early developmental milestones sitting and crawling?

Kesey: Yeah, so I always recommend that whenever a caregiver either has a new diagnosis of some sort or just notices something that feels warrants attention that they always reach out to their healthcare professional and oftentimes that’s the first line of the GP the family doctor. But certainly, if it’s something that they know is a mobility difficulty or a developmental delay in terms of their gross motor milestones or maybe a head-shaped asymmetry they can always contact a physiotherapist directly. Particularly in the private sector, we do not need a referral to be accessed. You do not need a referral from family doctor. You can just call us up and make an appointment and we’re obviously very well trained to assess red flags and things that are more medical concerns so, if that was needed, we would always refer back to the family doctor as necessary.

Sarah: Yeah, that’s really good to know because people get bombarded with long wait lists for all kinds of services so I’m sure that’s a relief that they could probably access you a little bit easier.

Kelsey: Yeah, some of the private sector is definitely more accessible. The public physiotherapists, which often support kind of one-to-one particularly in the younger age kids, but out of school the pre-school-aged kids um that’s also some place that the family can self-refer. But again, they do have a longer wait list so more and more private physiotherapy clinics for kids are popping up across the province and that really makes it more accessible for families. Particularly in the interim while they’re waiting for those public services.

Sarah: Yeah, that’s great because there can be that long gap and it’s very frustrating.

Kelsey: Definitely, yeah.

Sarah: You touched a little bit on gross motor skills so is that something a physiotherapist would work on?

Kelsey: Absolutely. Yeah, that’s development, early development things like, you know, tummy time, sitting, rolling, those skills. That’s our that’s our specialty, that’s our expertise. So, we can definitely thoroughly assess a child for the why behind the gross motor delay if there is one too. Which, I think is key. We’re not just, you know, they can’t sit let’s set them up. We’re looking at the pre-sitting skills and how those things are developing and then we’re able to intervene as we need to help them reach those early motor milestones.

Sarah: That’s great, and what about later on, when they’re trying to climb and kick a ball and keep up with their peers?

Kelsey: Yeah so um kicking and climbing and those types of skills are all super complex skills that again have those building blocks that lead up to it. So, that’s something that we can assess using some outcome measures to track exactly where a child’s at compared to their same age peers. So, that just gives us an idea of where are they performing in terms of those skills? And then we can help break down those skills into smaller easier tasks things that we can build on to help them reach that ultimate goal. And that might be something like, you know, working on a strength deficit or a muscle length issue that might be holding them back from that task. So yeah, it’s really key that we can see that child and help them achieve those ultimate goals because those are really life skills for a child. You know, playing on the playground, being able to go on up and down the slide, play with their peers, those are all hugely important. They’re not just physical skills, they’re life skills for a child.

Sarah: Yeah, that’s very true and what about fine motor?

Kelsey: So, fine motor tasks are certainly something that we like to incorporate into our sessions and they are often key to the gross motor tasks that we’re working on, but generally fine motor tasks are more the scope of an occupational therapist. We love to work in concert with OTs who are working with our kiddos to make sure that we can kind of translate some of the fine motor tests that they might be working on into what we’re doing, but generally if there are specific fine motor tasks things like you know buttons or zippers or putting on shoes or feeding then we’ll make sure to refer that child to an occupational therapist or an SLP, a speech-language pathologist, should they need it. So it’s nice to have a team of people helping that child.

Sarah: Yeah, that’s really good to know because people want to know you know where to go and who to see about different things.

Kelsey: Yeah, it can be super overwhelming I think to, you know, access one service and then maybe hear that there are other services that you need to be finding, but that’s where we can be a really great resource and help families just take that step by step. Very rarely is something so urgent it needs to be addressed in this exact moment, but we can help kind of create a plan for the family of where we think they might want to go and which other disciplines they might want to explore and then we can make those recommendations.

Sarah: That’s perfect and what about low muscle tone which is common with a lot of children on the autism spectrum?

Kelsey: Yeah so, low muscle tone, which we call hypotonia, that’s the technical term for it, can be common in kids with autism. While the muscle tone doesn’t necessarily change over time, it’s not something that a person grows out of, there are definitely ways that physiotherapy can help the child achieve their goals within the context of the tone that they have. We can use some strategies to help prime the muscles ahead of the gross motor test that we’re working on to help them recruit the muscles that they need to do that heavy work or jump or squat or all of those things that we’re working on. And then, while muscle tone and muscle strength are not interchangeable, we certainly want to make sure that the child has the strength, again in the context of that lower tone to do the tasks that they need to do. And that’s something that we definitely work on and we can also help ensure that the low tone doesn’t necessarily lead to any complications down the road.  It’s something that we can track and monitor, work on the control of their core in particular, to make sure they have good posture so that they’re not seeing complications from that low tone down the line.

Sarah: Yeah, that makes sense. What about sensory sensitivity, texture issues anything like that?

Kelsey: Yeah, so that is something we definitely work on that’s also kind of the role of an occupational therapist as well. But it’s certainly something that many disciplines are incorporating into their treatment with a child on the autism spectrum. We can utilize different textures, different temperatures, lights, sounds that are you know helpful to the child to regulate in our sessions, of course. We can also help in certain contexts to reduce those sensitivities by using gradual exposure to them and then we also, as physiotherapists more specifically, we love to incorporate vestibular input into our session. So that’s things like rolling, hanging, being upside down, crawling, those types of things and they can be really helpful to help a child regulate in our sessions. That’s helpful for all kids, really, but particularly with kids on the autism spectrum it can be something that they can really thrive on.

Sarah: That’s great and I know you focus primarily on children but would an adult on the spectrum also benefit from physiotherapy?

Kelsey: Certainly, yeah. It depends sort of what that adult is struggling with. They may do well to access, you know, a musculoskeletal physiotherapist, someone who’s working on muscle injuries, strengthening, things like that. I don’t… there’s no registry or anything that kind of outlines ‘these are the adult physiotherapists in BC who are treating people on the autism spectrum.’ However, I do know it’s becoming… more people are becoming more and more aware that that additional education and that additional knowledge can be really helpful so that we’re taking every single person we see in our clinic and making sure we tailor our treatment specifically to them. So, asking around and asking your therapist if they have any experience with working with people with autism is helpful and then just letting them know kind of what your needs are and, you know, being an advocate for yourself as an adult is really helpful. That’s obviously what the parents are helping, in my particular field.

Sarah: That’s great and can they use autism funding for your services?

Kelsey: Yes, kids definitely can use their autism funding unit money. It can be allocated only to certain therapists under the age of six, a family has to access what’s called a RASP therapist, which is the registered autism service provider like myself. Over the age of six, they can access any physiotherapist and still use that AFU funding. So, it’s a little more complicated under the age of six, but there are a number of us who are listed as RASP providers so hopefully there’s somebody in your area that can help you in that under-six category.

Sarah: Yeah. You guys have multiple locations? I believe you have one here in Victoria, if I’m not mistaken, and I think maybe Kelowna. That’s where you are right?

Kelsey: Many locations across BC and every single clinic of kids physio in BC has at least one RASP therapist, so there should always be somebody who you can access under that six years old.

Sarah: That’s really great, yeah. Do you do anything virtual like a consultation or anything like that?

Kelsey: We do, yeah. Thanks to the pandemic, telehealth has really exploded. We’ve been able to create a really good platform to offer telemedicine. Even now that, you know, many people can return to the clinic, it’s really helping us access kiddos who live in remote communities and maybe do our initial intake, our initial assessment, get an idea if we need to see that kid in person or if we can do telemedicine exclusively. So it’s definitely an option. Something that you can reach out to inquire about and you can access our website which is Kidsphysio.ca and you can choose any location and book an appointment right there online. You can view the different therapists and our bios, what our kind of interests are, and what types of kids we have experience working with. So, almost anywhere you find one of our clinics, you’ll find somebody who will probably be a really good fit with your child and then we can get them in and see what they need.

Sarah: That’s amazing, yeah. I’ll include the email, contact and website information as well underneath, so that’s awesome. Thank you so much for being here.

Kelsey: You’re very welcome thanks so much for having me. I’m really happy this will be a resource for families to learn more about what physiotherapy is how we can maybe help their child.

 

About the Speaker

Kelsey van Stolk Bsc, MPT  

Born and raised in Kamloops, Kelsey moved to Vancouver for her Masters of Physical Therapy in 2011. During that time, she had the opportunity to do a clinical placement at the flagship location of Kids Physio Group in Vancouver. She knew then that Paediatrics was her passion and has been with Kids Physio Group ever since. Kelsey worked for six years at Kids Physio Group’s Surrey location, serving families from Vancouver to Chilliwack. She recently moved to the Okanagan with her husband and two daughters and joined the Kelowna Kids Physio team.  

Kelsey believes that the most rewarding aspect of working with kids is treating the kid and their family as a whole. It is a privilege to be able to form such close connections with the children she works with. She believes this is key to helping a child achieve their goals, particularly when that child requires physiotherapy treatment for many months or years.  

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