F r e q u e n t l y   A s k e d   Q u e s t i o n s

MEDICAL REHABILITATION CLINIC QUESTIONS

What is Occupational Therapy?
Occupational Therapy (OT) uses purposeful activity to achieve improved function.  The goals of therapy are:

• to promote health
• to prevent disability or injury
• to develop or restore the highest level of function and independence possible

OT goals may initially focus on early developmental skills, such as muscular control in the trunk and shoulders, before moving to fine motor and hand skills.  Based on the client’s needs, the therapist may also work on visual perceptual skills, visual motor control, sensory motor skills and sensory integration, cognitive skills, and activities of daily living (ADLS).

What is Physical Therapy?
A Physical Therapist evaluates the way an individual moves, the movement patterns he or she uses, and his or her posture and postural control.  Factors that influence movement include:

• Muscle tone: How floppy or stiff the muscles feel
• Range of motion: How fully the joints can be moved
• Skeletal alignment: How the bones are shaped and how the joints are lined up
• Strength: The power and effectiveness of the muscles

Physical therapy focuses on developing or improving the prerequisites for normal movement to the highest level possible, with the therapist providing structured activities to improve strength, flexibility, range of motion, balance and control, coordination and dexterity, relaxation, motor planning, cardiovascular and/or respiratory endurance, and sensory integration and modulation.

What is Speech Therapy?
The Speech-Language Pathologist (often informally referred to as a Speech Therapist) assesses and treats speech, language, and swallowing disorders.  Speech Therapy activities may be designed to improve speech, language, swallowing, and/or cognitive skills.  For clients who are unable to produce intelligible speech, therapy may focus on use of an alternate communication system,such as picture boards, sign language, or a communication device.  Swallowing therapy may focus on indirect pre-feeding exercises and oral-motor exercises, or on direct swallowing exercises using food/liquid.

What kinds of activities are used in therapy?
Therapy with adults is generally based on the consumer’s goals and special interests, and in the case of acquired disabilities, on prior and current levels of functioning.  With both children and adults, therapy activities are geared toward helping the individual acquire the highest level of function and independence possible for the performance of daily activities.  Physical therapy for both children and adults uses activities that facilitate movement, and may include gait training, the use of adaptive equipment (e.g., walkers, standers, braces), and/or direct hands-on manipulation to alter abnormal movement patterns or to facilitate improved gross motor function.

Therapy with children often includes play, using activities that are specific to each type of therapy.  For example, sensory integration therapy may use activities that allow the child to use touch or taste, or to swing, spin, jump, and climb.  Speech therapy may include play activities that help develop turn-taking skills, or the ability to imitate an action, gesture, sound, or word, or the ability to use an alternative communication system.

What is sensory processing?
Sensory processing is the ability to take in information through our senses, organize it, and produce a meaningful response. Effective sensory processing influences our behaviors and allows us to perform our daily activities, from simple tasks such as sitting in a chair to complex ones like mathematical equations.  People with sensory processing problems/or deficits often have difficulty making sense of this input, and may have difficulties/problems relating appropriately to others and to their environment.

What is sensory integration therapy?
Sensory integration therapy uses a variety of activities to help develop the client’s ability to respond appropriately to sensory input and to regulate interactions with others as well as their environment.  This therapy has been effective in treating a variety of disorders, including:

• Attention Deficit-Hyperactivity Disorder
• Developmental Coordination Disorder
• Pervasive Developmental Disorder
• Other Autism Spectrum Disorders

What ages and types of disabilities do you serve?
We serve clients from birth through the geriatric years, in a wide variety of programs.  Our clients are individuals with many different types of developmental and acquired disabilities, including:

• Autism
• Cerebral Palsy
• Genetic Disorders
• Muscular Dystrophy and other Muscular Disorders
• Neurologic Disorders
• Orthopedic Disorders
• Sensory Processing Problems Traumatic Brain Injury

Who should be evaluated for an augmentative communication system?
Our Program for Augmentative Communication Enhancement (PACE) provides comprehensive evaluations and training to infants, children, and adults who are unable to communicate through speech alone:

• Individuals may have some speech, but not enough to express their thoughts, needs, and feelings effectively
• Or they may be very verbal, but difficult to understand
• Or they may have no speech at all

Does the Clinic offer Social Work services?
The Clinic offers Social Work and Service Coordination services.  The treatment plan is individualized to client/family needs, and may include coordination of therapy and medical services, individual and/or family counseling, parent training, support groups, referrals to community resources, and assistance with obtaining funding.

What is a Physiatrist?
A physiatrist is a medical doctor who specializes in rehabilitation.  As with other medical specialties, physiatrists complete medical school, followed by several years of internship and residency.  During the residency, physiatrists learn about the diagnosis and treatment of various handicapping conditions.  The primary focus of the residency is on treatment, and physiatrists receive training in occupational, physical, and speech therapy, and in the use of adaptive equipment and devices, such as braces, splints, and walkers.  The physiatrist often helps coordinate the activities of the rehabilitation team, which may include therapists, teachers, nurses, social workers, orthotists, and other medical doctors, such as orthopedists and neurologists.

What type of training and experience do your therapists have?
All Medical Rehabilitation Clinic therapists, physicians, and social workers are licensed by the New York State Department of Education.  In addition to the college degree(s) and work experience required for licensure, many of our staff members have 10 or more years of clinical experience in rehabilitation services for individuals with developmental and acquired disabilities.  The Abilities First Clinic is committed to excellence in service delivery, and our staff often exceeds NYS continuing education requirements.  Many clinicians have advanced training in specialty areas such as:

• Augmentative and Alternative Communication (AAC)
  
• Lee Silverman Voice Treatment (LSVT)
• Neuro-Developmental Treatment (NDT)
• Sensory Integration and Praxis Test (SIPT)
• Treatment and Education of Autistic and related Communication-handicapped Children (TEACCH )

Where are services provided?
Most Clinic services are center-based and are provided at our North Road site or at our own school and preschool in Poughkeepsie, NY.  Some services also are provided in other locations such as area preschools and schools, and occasionally in other community settings such as daycare centers, homes, community centers, and sheltered workshops.  Prior authorization by the child’s home county (i.e., Dutchess, Ulster) is required for Early Intervention services. Preschool-based and school-based services require prior authorization by the child’s local school district.

Can I purchase medical equipment at the Clinic?
Clinicians who participate in Equipment Team and Brace Clinic appointments evaluate the need for adaptive equipment, but we do not make or sell any equipment.  As a courtesy to clients, area vendors are on-site during appointments to provide information regarding availability of equipment.  Consumers may use the services of the attending vendors to purchase equipment, or may request referral to vendors in the community.

What types of referrals do you accept?
The Abilities First Medical Rehabilitation Clinic accepts self-referrals from patients, as well as referrals from parents and family members, community agencies, county Early Intervention programs, local school districts, physicians, public health nurses, service coordinators, and other health care providers. 

Do I need a doctor’s prescription or insurance authorization before starting therapy?
Consumers should consult the specific program authority (e.g., insurance plan, Early Intervention, school district) to determine whether authorization and a doctor’s prescription are required prior to initial evaluation.  All on-going occupational and physical therapy and some speech therapy services require a prescription from a licensed physician, and may require prior authorization from third-party payers.

Does the Clinic provide services in area schools?
For many children with disabilities, therapy services are an essential part of the child’s academic plan.  The Abilities First Medical Rehabilitation Clinic works in partnership with area school districts, as well as internally with our own preschool and school, to provide therapy services to assist a child’s school performance.  Eligibility and authorization for services is determined by the child’s local school district special education committee: 

• Committee on Preschool Special Education (CPSE) — Determines eligibility and authorizes services for children aged 3 – 5 years
• Committee on Special Education (CSE) — Determines eligibility and authorizes services for children aged 5 – 21 years.

Services are educationally related to the child’s school program, and are documented in the Individualized Education Plan (IEP) developed by the child’s school district.  Authorized therapy services may be provided in the child’s preschool or school, or at the Clinic’s North Road site in Poughkeepsie, NY. Occasionally, IEP-mandated services are provided in another community setting, such as a day care center or the child’s home.