Help! I Have Kids!

Intensive Therapy: Why It Works & Who It Helps with Meredith & Chloe | Episode 19

• Pam Marshall • Episode 19

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In today’s episode, Meredith Proctor, MSOT, OTR/L, CIMC and Chloe Isaacs, PT, DPT, CIMI-2 break down one of the most exciting services we offer at Marshall Pediatric Therapy — Intensive Therapy. If you’ve ever wondered what intensives are, who they’re for, and why they lead to such fast, meaningful progress, this conversation is full of hope, science, and so many heartwarming stories.

We talk about:
✨ What intensive therapy actually is and how it’s different from weekly sessions
✨ Why repetition, neuroplasticity, and motor learning help kids progress quickly
✨ How OT + PT teaming up gives children a fuller, more holistic approach
✨ The kinds of diagnoses and situations that benefit most
✨ Real breakthrough moments from families who’ve gone through intensives
✨ Encouragement for moms who feel stuck or discouraged in their child’s progress
✨ How to keep momentum going once the three weeks are over

Meredith and Chloe share their honest experiences — the joy, the challenges, the science, and the sweet stories that remind them why they do this work. If you’re a parent hoping to better understand your child’s potential, you’ll leave this episode feeling empowered and encouraged. 💜

✨ Want to learn more about Intensive Therapy?
Visit marshallpediatrictherapy.com to get started.

If this episode encouraged you, don’t forget to subscribe, share with another parent, and leave us a review so more families can find hope and support. 💜

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SPEAKER_02:

Welcome to Help. I have kids. I'm your host, Pam Marshall, a mom of five and a pediatric occupational therapist with over 35 years experience. This podcast is designed to equip you with practical tools, insights from experts, and real life stories. Because at the end of the day, you are the head of your child's care team. Each week you will hear from pediatric experts and fellow moms like you that will help build your confidence, they'll offer clarity, and empower you to make informed decisions that work for your whole family. We have some great friends with us today. My friend Chloe and my friend Meredith. Thank you. Tell us a little bit about who you are and what you do.

SPEAKER_01:

So I'm Chloe. I'm a pediatric physical therapist, and I've been doing this for about eight years.

SPEAKER_02:

Um that doesn't seem possible.

SPEAKER_01:

I feel like eight years? I know. I remember when you just started. I know. It feels like yesterday. It's wild. It is wild. Um but in the last it's been slightly over a year now, we had the privilege of launching an intensive program with Marshall. And so we're here to talk about that today, and super excited.

SPEAKER_02:

That is great. So, what is an intensive? That's what we're gonna learn today. And who are you? You're Meredith.

SPEAKER_04:

Yeah, so my name is Meredith. Um, I'm a pediatric occupational therapist and um sort of the co-team here that started the intensive program, and we're excited to share about it. Um, I've been with Marshall for five years now as well.

SPEAKER_02:

That doesn't seem possible either at all. Well, I can say these two are excellent at what they do, and I'm so excited you're gonna learn more about their wonderful skill set, what they do, how they work together, and how they're changing kids' lives. Yeah, you're amazing. All right, so intensive therapy. Some parents don't even know what therapy is, what a PT does, what an OT does. And you work with all ages. You work with infants all the way up to older children. Um, and I know we're gonna talk about intensive, so we'll stay focused on that. But tell us what it is, what is a therapy intensive, and do you do it together? Do you is it more than one therapy? What does that look like? How would how would a mom know what this is? So explain that.

SPEAKER_04:

So typically um, with like regular therapy, kiddos come one or two times a week. Um, we evaluate them and then see them over a three-month span or what we call a plan of care. Um, and then at that three months, we decide if we want to continue therapy or not. So that's like the traditional model of therapy. And intensive is more therapy in a shorter span of time. We see our kiddos for intensives um four to five times a week.

SPEAKER_03:

Yeah.

SPEAKER_04:

And see them for about a three-week span, working on more specific targeted goals. Um and yeah, it is a little bit different than the traditional model in that we typically are working on one specific thing or a few specific things, but most of the time our kiddos don't have the opportunity to have that much therapy in that short of an amount of time. So that's what makes it super special.

SPEAKER_02:

Yeah, that is. And how like when a child comes for an intensive, um, what do they do? What are the goals? How how would a parent even know that their child may be um a candidate for an intensive?

SPEAKER_01:

So each session of an intensive is completely individualized to who that child is and what they need. So sometimes we're working on getting those first steps in, sometimes it's crawling, and sometimes it's just strengthening balanced coordination, improving our walking pattern. I mean, it's really appropriate for like anybody who has a delay, anybody who needs to be strengthened, balanced coordination. We've done it pre-surgery, post-surgery. Um, any parent that is looking for a boost in their child's development, or they just feel like they're falling a lot, maybe there is a certain skill that's hard for them, like going up and down the steps or something like that, like and they are ready to really launch that rocket, like they would be a candidate for an intensive.

SPEAKER_02:

So the type of kids you're seeing um typically have something neurologic going on. So it's just means they have motor skill problems. And so what would be some of the children that would be ideal candidates? Like, explain that.

SPEAKER_04:

We have seen all ranges of kiddos, all ages of kiddos. We have done an intensive on a 13-year-old, we've done intensives on kids just that are a few months old. Um, a lot of our kiddos do carry a diagnosis, but they don't have to. Some kids, like Chloe said, are just delayed. We've seen various neurological conditions, various genetic conditions, um, cerebral palsy, and just general developmental delay. A lot of times the intensives are focused on gross motor, big body movement-based skills, which is very much our style. Yeah.

SPEAKER_02:

Um, but yeah, because some kids get stuck, right? They get stuck, they're not sitting up.

SPEAKER_04:

Absolutely.

SPEAKER_02:

And maybe they've been working on it for a year, and they come to an intensive, and all of a sudden you're getting them sitting, indefinitely. Yeah.

SPEAKER_04:

Um, we also offer serial casting, constraint-induced movement therapy. Um, so like more upper extremity kinds of targets as well. Um, but yeah, a lot of our kiddos, it means it can go either way. Some of them come in with a diagnosis, some of them are just a little bit delayed and need that boost. That's really cool.

SPEAKER_01:

I also think like as a parent who has a child and two different therapies a week, like those weekly therapies can be hard to attend. Like it's a big commitment, it's a lot on your schedule. So it's also like if you just want to come in and get a three-week boost of an intensive, and then you're done. And then maybe we come back in another like three to four months, and let's follow back up. It's just also like another way that you can do therapy.

SPEAKER_02:

Yeah, it is. And I remember it's been probably the last 10 or 15 years in the therapy world, a lot of children's hospitals started um, you know, getting kind of like guidelines down of what intensives look like and what following the outcomes. And so it's been talked about now, and you all are trained in a very special, unique type of um it's called dynamic movement intervention. Tell us about that, what it is, and what that training involves, and how it helps you lead these intensives with kids.

SPEAKER_01:

So DMI will challenge the child in a way that they've never been challenged before. It's really giving them that right amount of support and then starting to take it away. And then the brain and the body realizes like, oh, okay, I can do this. And we start to learn that motor pattern so that each time it gets easier and easier. Typically, you're gonna do like five reps of whatever movement you're working on, and then just seeing like from where we start, rep one to rep five, we've already made a ton of progress.

SPEAKER_02:

Yeah. And they learn it. I've always learned that it's high reps for a kid to learn it, like almost 10 in a row, really helps the brain map a new.

SPEAKER_01:

Which is why intensive is so effective. Yeah. Because I mean, we're getting those five reps of each movement and we're doing it every single day of the week.

SPEAKER_02:

Right. You're repeating, repeating, repeating. That's really neat. And so a lot of parents don't know what DMI is, or they've never heard of it, or they don't know because it isn't well known, I don't think, in our area or in Kentucky. It's not a a well-known thing. But there are parents who fly for intensives and pay all cash payment to get their kids in intensive programs. And I think one thing that's so unique about ours is we do bill insurance and some insurances cap out the number of visits they have, and our team can definitely walk you through it. Um so it's different in that res respect. You know, I hear a lot of parents say, yeah, most cost cash only. And it's not to say that we wouldn't have cash based, you know, because sometimes kids burn through their allotted 20 or 40 visits or whatever it is, and they need extra.

SPEAKER_01:

So and we wanted to be able to offer parents that too. I mean, not just in like the central Kentucky area. I think right now there's only one other company that's doing intensives in Kentucky, but like we realize that not every family has the resources that we do here in central Kentucky. So they may not have like a big pediatric therapy location there, and it certainly limits what your child can receive. So just having that ability to come up here and stay for a few weeks and get your child something that you've been looking for, I think, just opens up a whole nother door.

SPEAKER_02:

It really does. It feels pretty good to be able to offer that. Absolutely. Yeah. Absolutely. So OT and PT, we always think about that. Some people think, oh, it's the body split in half, but that's not really true. But how do you work together? Like, I want to hear like, what do you do, Meredith, as an OT that's different than what Chloe does? And how do you work together with a child in an intensive? Talk about that a little bit.

SPEAKER_04:

Um, I think I should probably start, you know, as good as anyone that OT is the best kept secret in healthcare. It is. So I should probably first explain what that means. Um I love OT, but I love PT too. OTs define occupation as any meaningful activity, and for our kids, that's learning to move. It's learning to play, it's learning to regulate our emotions, it is learning to engage with our hands and our feet, learning to move our body, learning to be in the community and feel safe. Um and so for me, I think that a lot of times while me and Chloe are working on similar goals, we're looking through a different lens. Um, I look through the sensory side and where a PT might be a little bit more biomechanical, um, I'm looking through how are they coping with this? I'm doing the same DMI exercises as Chloe, but I need to see how their body's responding. If there is um a barrier innocence, whether it's vision, whether it's vestibular, whether it's proprioception and body awareness, understanding, and how can I climb that mountain where I think a PT is gonna look at strength coordination, alignment from some of those more bio biomechanical systems.

SPEAKER_02:

You may be looking more at reflexes, like are they riding?

SPEAKER_04:

I might look at covenant reflexes, I might look at protective responses and safety. Um, vision is a big, big piece. Um, and so I think that's really how it is. Uh my sessions, the way that we have our intensive structured right now, are first. And so if they're if we're taking in a child, like Chloe said, we're very it's gonna be very child-based. If I'm taking in a child that needs a lot of help with regulation, I'm gonna spend a lot of time in my session to get them ready for that so that we can work toward those bigger skills.

SPEAKER_02:

That's good. And then your view. Let's hear the PT's view.

SPEAKER_01:

I don't ever feel like an hour is enough time to get everything done that I want to for a child who has like a complex condition. So I think what I love about it is that, you know, even if you have a kiddo that's coming in and they're not setting, but maybe they're 15 months old, they're 15 months old. So we want to work on those higher level skills. We want them standing, we want them walking. And so it's really great because in that first hour with Meredith, like she may be doing some of the DMI exercises or other treatment techniques that we use to target like core strengthening and setting balance and riding reactions. And then that allows an open door for me to really get them on the treadmill and do bodyweight supported treadmill training and to work on standing and just everything that I wouldn't be able to get to in just one hour.

SPEAKER_02:

Yeah, that is so neat. Maybe one day you'll do AM and PM treatments. Oh, we'll do double.

SPEAKER_01:

We'll love that. We'll do double.

SPEAKER_02:

Yeah, we'll love that. The AMPM three-week intensive would be amazing.

SPEAKER_01:

And the progress that we've saw just with the one time a day in three weeks, like I can only imagine where we could get twice a day.

SPEAKER_02:

So true. So tell me a story. Like what's um people love to hear stories, like what actually happened to a child, or what did a child look like before, and what did they do after? Can you share a story or two? Tell us about your good work and the life change that's happened.

SPEAKER_04:

So I have a friend, um, he's actually our shared friend, um, who uh started with us at Marshall when he was 11 days old. Um, I've been seeing him since he was about 11 months old. And when I got him, he couldn't sit up. He actually has a rare genetic condition that causes hypotonia. And so he's fairly weak, very hypermobile. Um, and this kiddo came to me being an OT, a lot of regulation stuff early on, didn't get to address as much gross motor early on as I would have liked because we were working through a lot of regulation things. Um, and his diagnosis is quadriplegic, so hands are also affected. So as an OT, I'm very spread out in what I need to do.

SPEAKER_02:

So all four limbs don't work the way they should.

SPEAKER_03:

Sure, correct.

SPEAKER_04:

Um and so we, I mean, I worked tirelessly with this kiddo on crawling on hands and knees. He had absolutely no form of independent functional mobility. And we know that having independent functional mobility is what promotes sensory regulation, it also promotes exploring the environment and then the ability to get to something that I want and then use my hands. And so hand skill development also comes out of that. There's so many pieces of motivation that come from functional mobility. And so I am just beating myself over the head trying to get this kiddo to crawl every single week. We worked tirelessly on it. And when I tell you that this man crawled on his hands and knees reciprocally in the first week of his intensive with us, what he just needed that repetition. You were like that time. Like we've been doing this a long time. He just needed the repetition. He needed the time, he needed to not have that week in between to, for lack of a better word, lose those skills, lose that strength. He need his brain needed that much repetition. That much repetition. And then by the end of the intensive, the kid is climbing up on furniture. Pulling to stand. Pulling to stand up to this girl. Meredith, what have you done? I know, I bet his parents were just they had to be flabbergasted. Like, what? Chloe, how are we supposed to keep him safe?

SPEAKER_02:

That's a good problem. That's a good problem to have. Have towelproof your your house overnight. Because I'm moving so much.

SPEAKER_04:

I know.

SPEAKER_02:

That's great. I love that story. What about you, Chloe? You have a story that I think I love.

SPEAKER_01:

The one we're working with right now has probably been one of my favorite. You know, they're they're not a regular patient of ours. So we're getting fresh eyes on them. He made incredible progress in that first week. I mean, he came in, he wasn't setting independently, wasn't weight bearing on his feet. By the end of week one, dad's like, he can stand up with me holding his hands. And it opened a door for them in a different way, too, because we were able to loan a standard out for them. We got them set up with a standard to have out of the intensive when we need ours back. Um, and even opening up like financial resources for them along the way that they had never heard of. So just being able to share that information and being a support system for them, it's been so much more than just the gross motor function.

SPEAKER_02:

I mean, that is a huge deal. Dude's sitting for three minutes. He sat for three minutes for me this week. And he's never sat before independently, not more than 20, 15, 20 seconds. Oh my word. Because mom's listening, like I always say, when a baby learns to sit, it's a game changer because now they can sit and play and they're independent, they're not so frustrated. So what a game changer for that kid. Wow. 100% that's amazing. I love hearing those stories. So, what does it look like? What's the training behind this? Because you have some unique skill set that not every therapist. So if a parent thinks about doing an intensive with an OT and PT out there, they may not be trained the same way you are. What kind of training does it take?

SPEAKER_01:

Yeah. Um, so I mean, we're definitely both trained in DMI. Um, we're up to entry level C now, and hopefully intermediate will come. Um, we are both trained in ESTEM, a specific, like task-specific ESTEM, um myofascial. I guess just keeping your toolbox full and never limiting yourself so that you have options because every kid is different and every kid may not respond the same well to every technique.

SPEAKER_03:

Right.

SPEAKER_01:

You know, like I mean, we do do a lot of DMI, but we also do a lot of other stuff to kind of help complement the DMI as well.

SPEAKER_02:

Yeah, and there's no one tool that works. No. Just like at home, when you're going to fix something, it's all about the right tool. If you don't have the right tool, it could take you 20 minutes to do something that if you had the right tool, it takes you two minutes to do. So you really have to have those different tools you do for the different things you're accomplishing with kids.

SPEAKER_04:

Every kid is different. And so when you're only when you only have three weeks to accomplish a set of goals, especially the kiddo she was talking about is is not our kiddo, we're not gonna probably see him immediately again after the intensive. And so if I am trying DMI and it's not working, then I've got to pull something else out of the toolbox. Um But yeah, she we utilize task-specific electoral stimulation a lot. Um, we also utilize sensory modalities to raise body awareness, whether that's applying a compression vest, using ace wraps for compression to cue body awareness. Um, we're really lucky to be in a clinic that has a lot of equipment. Yeah, and so we're able to choose from various skate trainers using um, we were, like she said, able to learn how to stander and using all of the skills at once because every every kid is gonna be different. They're gonna need something different or need a different combination of multiple tools.

SPEAKER_02:

And then how are the parents learning in this journey? What does that look like for the parent in an intensive? Like how are they learning what to do? So when the intensive's over, what is what does that look like? Does the parent uh join your session?

SPEAKER_04:

Do they yeah, parents are always welcome in our sessions. Um some parents stay out, some parents come in, depending on the kiddo, but we always make sure, even if parents don't come into the session, to circle back, touch base. I get parents' phone numbers and send them ideas or exercises. Um a lot of times we tell our families that are out of house or not our martial pediatric patients to return to the home program that was given to them by their primary treating therapist, but we'll also give them a few extra pieces to take along to continue the progress that was made in the intensive. Um, there are also families, we've been super lucky to have some families immediately want to schedule another intensive. Um, that's great. We are able to schedule them after another six months, so that's been a lot of fun to see kiddos go back to their primary therapist for six months and then come back and see us, and we see the progress that they've made there and held on to, and then we get to see them again.

SPEAKER_02:

So I bet getting on your schedule is an important thing because it's tough to get on your schedule because you're getting scheduled out, which is great. It's in high demand for sure, because they're because it's so such a game changer in the kids' life. Absolutely. Yeah, and kids are so neuroplastic. Let's talk about that for a minute. What that what that even means. Neuroplastic.

SPEAKER_04:

Um, so neuroplasticity is our brain's ability to make literal physical changes to pathways. And so we take information from our bodies and from the environment and we create a plan. And so, what I always tell my families when I'm trying to explain neuroplasticity is picture a truck driving through a field. The first time the truck drives through the field, it's bumpy, there's grass up, it's hitting the truck. It's a little difficult. But after the tenth time the truck has driven through the field, there are ruts. It's almost like it was made for that truck. And that's what our brain does. So whenever I introduce a new skill, whenever I change the child's position to change gravity on how they're moving, they're taking all that information in and creating a plan. Just like when you learn to ride a bicycle is really hard at first, and then it becomes easier. Our brain creates new pathways and then prunes the ones that it doesn't need. And what we want to work on are combining those things that we love, those sensory pieces, those toys, those games, that happy feeling with those tough gross motor skills that might feel a little bit scary. We always say what fires together wires together. And so we can create that positive, yeah. We can create that positive interaction with that really hard skill, then our brain learns this is okay. I'm safe. Not only am I safe, but this feels good. I'm happy, I can move, I can do this. And then just like riding a bike the tenth time you get on and you take.

SPEAKER_02:

If you see a new motor skill as scary because they've never done it before or feeling like I'm out in the middle of space and I don't know what my body's doing. Yeah.

SPEAKER_04:

Or I don't know if I can catch myself if I fall, or I don't know what it's gonna feel like if I look if my eyes are covered, or whatever it is, however, we change the environment. But yeah, um, eventually we hop on the bike and we take off, and it becomes a lot easier, and our brains do that for us.

SPEAKER_02:

Yeah, it's incredible. That's good. What does neuroplasticity mean to you?

SPEAKER_01:

So I always think about it like when we want to shoot for those higher level skills first, even if like, say we're not setting, but we do want to work on standing and walking. So I always think of it like a video game, kind of like if we can unlock level four, then level three, two, and one is automatically gonna open.

SPEAKER_03:

Yeah.

SPEAKER_01:

Um, and it has been crazy to see like kiddos that I've never worked on crawling with. We've only done walking, and one day they just start crawling. Yeah, it's wild, but it's it's not so much about what it means to me, it's like what I what I see and what I do with it, you know?

SPEAKER_02:

Yeah, yeah, and it it helps that kid have a whole new experience at the end of the intensive, they have a whole new set of skills they didn't have, which is I mean, that's why we get up and go to work every day, isn't it? Absolutely to see that kind of progress and see that kind of change. Oh yeah. Yeah, and parents they have such hope for their kids. They hold the hope meter, they're they're hoping that they're able to walk and be independent one day and accomplish great things. And so, you know, it has to start with holding their head up first, sitting, crawling, moving, gaining control.

SPEAKER_01:

I think that's also been another favorite thing of intensives for me. I have a lot of favorites about intensives, but like the way that parents have learned that their kids can do hard things and that it is challenging. Yeah. I think it's so hard for a parent to listen to their kid cry. And the reality is like we're gonna cry when it's hard because that's what we know as a child, and that's what's acceptable as a child. It's not acceptable for us to go to the gym and work out and cry when the tenth squat gets hard. But right, right, but it's okay for them. And it means that they're working and they're getting challenged. And then by the end of that, it's like, okay, I can push my child and they can do hard things.

SPEAKER_02:

I can be firm with them. I can be the tough love. Carry the tough love. I know I love all those stories about tough love and how moms just didn't treat their kids any different and they accomplished amazing things, you know, those kids that don't have any legs or you know, just have super challenges from infancy. And it's fascinating watching those kids achieve things. So I can imagine it's fascinating to watch your kids that you work with go through it. Yeah. Yeah. What about hope? Like parents sometimes feel like they lose hope, or maybe they've been told by professionals. Um, because sometimes doctors share a hard truth when the when the infant's born or when there's been a traumatic event that they're saying things like, your child may never walk or talk or move or do this or do that. And then that just cuts your legs out from under you as a parent. Um, and then they get to be the ones to decide am I gonna hope, am I gonna push, am I gonna not? How am I gonna do that? But what do you see in this journey? Like, do parents come in with hope? Do they leave with hope?

SPEAKER_01:

I think they come in a little scared, honestly. I think they want to hope. Like they are scared. Like the child that we're working with right now, the mom said to me, like, we had a dozen professionals tell us that DMI and intensives were not worth it. And here he is, hitting it out of the park. I mean, and mom's crying on day two. He's got a whole week left. Oh my god. Um so I think it can be a little scary, but Meredith and I are the practitioners that like if you come in and you tell us that the doctor said that you're never gonna walk, well, that just ups the game for us. And then you're like the challenge.

unknown:

Yeah.

SPEAKER_02:

Yeah, I know. I've heard a lot of them too over the years. It's it's amazing.

SPEAKER_01:

Like I love though that our profession has grown so much. I mean, in both disciplines, that like it's no longer let's maintain, right? It's let's gain, let's hit that functional independence. And I feel like we're finally at a place where parents are starting to see that too. So it's not just listening and learning to live with, it's listening and learning how to do better for their child.

SPEAKER_02:

And we all know it's if a child is not able to walk, be upright and walk, and they have to be in a wheelchair, we know that health is compromised. Like long-term health is compromised for those that are in wheelchairs in their life. So if we can help a child get upright and walking, and it doesn't happen overnight, and it's a journey for some of these kids, they'll be repeating intensives over the years, probably, to get there. But it's a powerful thing, and it's something that parents should hope for can my child get up and walk? You know? And a diagnosis doesn't define who they are or they're whether they're gonna be successful or not.

SPEAKER_01:

I've had parents ask me whether it's just regular sessions or attention, it's like, do you think they're gonna walk? And it's like maybe we're at two years old now, and it's so hard for me to even answer that question because I don't go in with eyes that like that's not gonna happen, or we're not gonna work on that. Because for me, it's always a goal, whether it happens when you're two or it happens when you're 10. Like, we are gonna work towards that and get there somehow.

SPEAKER_02:

Yeah. Yeah, it's good to talk to them about those fears and about their hopes and set realistic goals. And what does that look like? Like sitting down with parents and setting the goals, like after your initial evaluation, what how does that what does that process look like?

SPEAKER_04:

I think it's kind of a team approach because I think that a lot of times when parents get a diagnosis, or even parents that have been in therapy for 10 years, they already have an ex set of expectations. And maybe those expectations are less than what Meredith and Chloe like the expectations are. Yeah. And so some sometimes it's I think that this is what a lot of times parents come in and like the kiddo we were just talking about, he they wanted to work on sitting. We've worked on sitting. I'm really hoping that we can say once this is all over with that we've exceeded those expectations and we're getting a lot closer to standing. Um but it just depends. I think a lot of times uh first we have to help the parents break down their own expectations because as soon as they hear the words cerebral palsy, as soon as they hear the words wheelchair, as soon as they hear the words dependent, that can be a game changer for them. And I understand a hundred percent why, because we also can at times walk kids through those diagnoses, they come to us without them and then we refer out and make recommendations and things. But I think sometimes there's that barrier if we have to break down expectations in order to build them back up.

SPEAKER_02:

Yeah.

SPEAKER_04:

Um, but generally I think parents of kiddos that have been in therapy for a little bit know what they kind of what kind of is next, what they're working on in their regular therapy, and then other times we bring them ideas and we're like, hey, what if we could do this? And they get really excited. So that's super fun.

SPEAKER_02:

So bringing new ideas is really like infusing them with that excitement.

SPEAKER_04:

With hope and new expectations because a lot of times I understand where physicians are coming from when they're trying to be realistic or um be cautious in what parents' expectations are, and then they come to us and we hope to surpass that, of course, always. I mean, that's every therapist's school.

SPEAKER_02:

Yeah. And how do parents find out about services and where to go for an intensive? How do they find that out?

SPEAKER_01:

I feel like more than anything, it's social media. I think intensives grew um really wide after COVID. You know, a lot of things was were on the internet, and that's when a lot of businesses launched. That's when really DMI took off. That thing they launched like in 2020.

SPEAKER_02:

Um and I followed that one practice that did it, and it was fascinating watching it during COVID. I was like mesmerized, going, oh, this is really cool to watch.

SPEAKER_01:

Yeah. So I mean, just social media, learning where you can go. Um, I saw some blog posts that have it. I feel like it's definitely the parent finding the source, though, and looking for resources of what they can do for their child, more so than it is like this is what's offered to you. Um, I think typically parents just hear about like regular PT and OT and speech. And it's coming from a good place. It's coming from the we don't want you to have too much on your plate. We know this is hard already. But I think a lot of parents they want more. And when they hit that plateau in skills, they're ready to see their kid take off. Then they start seeking on the internet. Right.

SPEAKER_02:

For what else is out there? What else is out there? What can get us over this stuck point? Yeah. Are there physicians that are supportive of DMI or intensive, the whole intensive thought or model? Do you feel like physicians are supportive?

SPEAKER_04:

I would say so. I mean, we've shared some conversations, we've gone out in the Lexington community and done some education, met with some people, actually had a physician or two come to our office and see our spaces where we're treating and um talk about some of the tools that we're using. And I definitely feel like we've been supported. And the other thing is we couldn't do this without them because we rely on their referral. Right. Um, if people don't totally understand um physical and occupational therapy, rely on physician referrals, physicians have to initiate that. So if you're thinking about that for your kiddo, primary care would be the place to start. We've also um gotten referrals from neurologists, PMR doctors. Really a decent spread.

SPEAKER_02:

And I think, moms, if you're listening and your pediatrician or your primary care physician for your child doesn't know anything about intensives, um, I'd say research and bring the information to them and educate them. Um ask them to look it up, read about it, and get back with you. I think it's important to get the word out for those that don't really know much about it. But the doctors who treat complex children tend to know about it. Yeah. Um, and some of the clinics, there are clinics at our local hospital as well as um nearby children's hospitals that are aware of it as well. Absolutely. Yeah. So that's good. And what type of like do parents have to get a referral from a physician? Do you need that to start? Is that yeah?

SPEAKER_04:

So um typically physicians are happy to give you referrals for what you're asking for. Um, you do have to have separate referrals for OT and PT, and then if you were considering other disciplines, you would have to have those as well. Um we're working on getting a form in our site to put your information in so that we can get you connected. Um and yeah, otherwise, if you request a referral from your pediatrician, it'll come through our intake office and we'll be hearing about you.

SPEAKER_02:

That's amazing. And Meredith and Chloe are at our Lexington office. We have four offices in central Kentucky, and the Lexington office is near St. Joe East South Blazer Parkway, um, just for reference for people who are local and listening. And I think you know, give them a call. Check them, check out intensives. They're worth every every bit of effort and investment. So, what would you like to leave? Like, what's a word of encouragement for parents as we wrap this up?

SPEAKER_04:

I think the biggest thing about pediatric therapy, about uh having any children, but certainly children um with challenges and disabilities, is that we don't count milestones that we separate those milestones from the little wins because the little wins are just as big for our kiddos. Some of our kiddos, some of our diagnoses that we see, some humans in general just make slower progress, but we have to celebrate every inch that we gain. And I think a lot of parents, and with the rise of social media, which is a beautiful thing, but also can uh lead parents to put pressure on themselves to meet milestones to the date, yeah, to um keep up with the kid down the street who's the same age or whatever. And I think that there's something beautiful within our world that is celebrating a teeny tiny win. Um the kiddo that we're seeing right now, for example, smiled ear to ear while he was transitioning into sitting first two weeks of the intensive. It was a trying to use all the muscles that he's got to get this sit up. And then two days ago, he just grinned ear to ear because he was so happy and motivated. That felt like a huge win. Did I still help him sit up? Yes. It didn't matter that that we hadn't in that moment met that milestone. It mattered that he was moving his body and happy about it, that he was motivated, that he was calm and engaged, kiddos reaching for a toy for the first time, holding on to something for the first time. Those little milestones I think get overlooked.

SPEAKER_02:

Yeah.

SPEAKER_04:

But all of those little teeny tiny pieces are wins. And that we as a community, as parents, need to celebrate the small wins. Every teeny tiny small win should be celebrated.

SPEAKER_02:

It's so good, moms. Celebrate the small wins. And if you can't see it, because sometimes we're in the day and today, the thick of it, and we don't see it because everything looks the same when you're in the grind as a mom. But you know, get those people around you, those therapists, get them cheering for the little wins. That's good. How about you, Chloe? Do you have something to to share?

SPEAKER_01:

I think that progress isn't stopped just because it feels slow. I saw so many times that kids maybe will take a back step in a milestone because they're working in a different area. Maybe that's speech and language or fine motor skills or whatever. But then a week later, everything kind of comes together. So it's never a regression. That progress is still there. So keep believing and keep working towards it. Like there are gonna be times that it's slower and it's harder, but progress is still being made each and every day, just like Meredith said with those small wins. Yeah.

SPEAKER_02:

It's not always linear, not always linear. You two have so much passion for what you do, and I know you're really good at it. And I have loved learning more about this today, and I know our moms listening have. And if you moms want to know more about dynamic movement intervention, you can look that up on the internet. There's lots of videos out there too that kind of show what it looks like. And like Meredith and Chloe um explained, that typically an intensive isn't just DMI, it's lots of different tools they're using to help children with pretty severe, severe motor disabilities make big gains. So check it out. And thanks for coming on today. Yeah, thanks for having us. Thank you so much. Thanks so much for listening to Help I Have Kids. If you're tuning into this podcast, that means you're a mom who's curious, committed, and ready to learn. And we see you. We'd love for you to join our Help I Have Kids Facebook community where moms just like you are connecting, asking questions, and encouraging each other every day. It's a space for real conversations, expert insight, and support from moms who get it. Because we're all in this together. And if you know a mom who's feeling unsure or maybe overwhelmed, or just needs to be reminded that she can do it, she can advocate for her child with confidence, share this episode with her. We're building a village here, and we're glad you're a part of it.

SPEAKER_04:

Helping families build skills for life.