Written by Physiotherapist Emma Bolt
“Hey Emma, what are therapy intensives and why do some of these kids seem to live in the clinic for a few weeks?”. Thanks for asking! In this blog post, we’ll be talking about all things therapy intensive. The why, the how long, and the when.
What Are Therapy Intensives?
Therapy intensives are blocks of time where a child participates in a high-frequency therapy program – think of it like a bootcamp. I have met and worked with families from all across Canada, as well as the United States, and even as far as Croatia, who have sought out therapy intensives for their child.
As an intensive completion present, the family is provided with a comprehensive and customized home exercise program so that the gains made during the intensive can be maintained and progressed at home. Typically, the final few sessions are dedicated to the teaching and coaching of the exercise program to ensure the family is comfortable with the program prior to the intensive end date.
How Long Should a Therapy Intensive Be?
At Peak Health & Performance, we offer therapy intensives of 2 or 3 weeks in duration where the child participates in 1 to 2 hours of physiotherapy each day. I like to explain the 2 to 3-week reasoning, based on my clinical experience, to families like this:
- Week 1: The first week is for the child to get to know me and for me to get to know the child. What do they like? What do they dislike? What is the primary focus of this intensive to achieve the family’s goals?
- Week 2: This is when I begin to hone in on the child’s current skill set. If you were to go to a boot camp for a week, would you show the trainer your maximum effort on day one knowing full well that they’ll make things extra hard for you as a result? Probably not. A lot of kids I’ve worked with try to play a similar trick. “Let’s pretend I can’t do X, Y, or Z so this lady I’ve never met before makes things easier for me”.
- Week 3: The primary focus of the intensive, and the child’s true current skill level, has been identified which means the final week is dedicated to building a comprehensive home exercise program based on the child’s full achieved potential during that intensive.
It is important to point out that even after a 2 week intensive, a comprehensive home exercise program can still be created. This is especially true when the child and the therapist providing the therapy intensive have a pre-existing relationship.
The number of hours each day is dependent on the child’s age, level of endurance, goals, and familiarity with an intensive therapy structure. If a child is younger with no previous experience of intensive therapy, or DMI therapy, it would be preferable to start with 1 hour a week. If the child is on their 6th intensive, or if the family feels confident that their child could participate in 2 hours of therapy each day, then a greater number of hours is appropriate.
A great way to help support the decision-making process of how many hours per day your child’s therapy intensive could be is to try a few DMI sessions prior to booking your intensive. This decision would be based on how your child participated during the session, as well as how they recovered following the session in regards to mood, energy, and sleep.
When Is The Ideal Time To Do An Intensive?
If your child has been close to achieving a new gross motor milestone, but hasn’t quite seemed to figure it out, a therapy intensive might be for you. If your child has just been cleared for physiotherapy after a surgery and is deconditioned, a therapy intensive might be for you. If you feel the town or city where you live does not have knowledgeable or skilled physiotherapists to work with your child and are interested in receiving DMI therapy, an intensive might be for you!
If your child’s condition is progressing requiring frequent hospitalizations, or if they have had a recent change in their baseline resulting in increased seizure activity, increased fatigue, reduced appetite, or reduced sleep quality, a therapy intensive may not be right for you at this time. If your child is participating in a research study, please discuss whether a therapy intensive would be appropriate with the research team.
Key Takeaways
A therapy intensive is like a bootcamp for gross motor milestones. An exercise program is developed and provided to the family to support maintenance and progression of the gains made during the intensive. While almost any time is a good time to have a therapy intensive, it is hard work! Any child starting an intensive should be in reasonably stable medical health to ensure their safety and to optimize the gains made during the intensive.