Meet Pediatric Pelvic Floor Play Skills: Functional Movements for Children with Pelvic Dysfunction

Mora Pluchino is instructing her new course, Pediatric Pelvic Floor Play Skills, which is scheduled to debut on October 22, 2023. This short course is targeted to pelvic health providers looking for specific “child-oriented” treatment techniques for pediatric pelvic health patients. This class will cover some basic challenges and changes for a new or experienced pelvic health provider entering the realm of treating pediatric patients with pelvic floor diagnoses. Pediatric Pelvic Floor Play Skills is intervention focused and does not delve into specific pediatric diagnoses.

As an only child, I have lived my life working to be surrounded by children. From the age of 11 when I could take the Red Cross’s babysitter training, I worked as a mother’s helper, babysitter, and nanny. I never even had a “real” job until beginning my career as a physical therapist in 2009. Before I entered the world of treating pelvic floors, I was a physical therapist who spent the beginning years of my career caring for mostly pediatric and neurological patients. I was in charge of a pediatric program and helped with their specialty programs for kids including cardiopulmonary, feeding, and robotics.

I got brave and jumped into pelvic floor treatment in 2016 and have never looked back.

Because I had so much “kid” experience both personally and clinically, I quickly took Dawn Sandalcidi’s course Pediatric Incontinence and Pelvic Floor Dysfunction (now called Pediatrics Level 1 - Treatment of Bowel and Bladder Disorders). I started treating these kiddos and realized that being a pediatric therapist and being a pelvic floor therapist can feel like two completely different “hats.” I would have internal conversations like “I want to teach this child to bear down, but they’re two years old and on the autism spectrum and cannot even tolerate sitting on a toilet - what do I do?”

Having a pediatric background and skills made me feel like I had tools in my toolbox to create ideas to address my plan of care. I found my colleagues who did not have as much pediatric experience really struggled with taking the pelvic floor skills they had and applying them to working with children in the clinic.

Here is an example of calls I get from fellow pelvic floor practitioners…

“A 5-year-old child presenting with bedwetting, stool staining, and daytime urinary urgency. Limited food choices - eats mac and cheese, grilled cheese, quesadillas, chicken nuggets, hot dogs, and goldfish - no veggies, fruit choices - bananas and strawberries only. The child does not drink water but will drink juice, Coke, and chocolate milk. The child does not like sports and prefers to read and watch TV. The child avoids sitting on the toilet for BMs and complains they are painful. Parents are willing to try anything but don’t know where to start. The child is very motivated to please caregivers and loves stickers and watching YouTube videos of cute cats. On assessment, the child has a weak core, poor sitting posture without back support, and has trouble bearing down when asked.”

The therapist and I talked about how these symptoms all screamed “pediatric constipation” with a little bit of core weakness and poor pelvic floor coordination mixed in. She knew what would happen with an adult. She knew that increasing fiber and water intake as well as activity were all great lifestyle changes to start. She mentions that utilizing a squatty potty and regular toilet sits are also indicated. But HOW do you get a 5-year-old to do these things? How do you teach parents to implement these changes? How do you make these changes easy and peaceful for busy parents and potentially resistant children?

 In the case of this kiddo, we created the following plan:

1. Referral for feeding therapy to address problem feeding - SOS Program with an OT at local children’s hospital with reinforcement and collaboration from a PF therapist.
2. Spoke to the pediatrician about dietary changes including using higher fiber options of preferred foods and eliminating foods that are bladder irritants or known to be constipating.
3. Pelvic floor therapy working on core and pelvic floor coordination with functional play utilizing the child’s preferences.
4. Review of HEP with family including ILU massage, time voiding (created a child-friendly routine), and implementation of a reward system for child’s compliance with the program.
5. Daily check-ins with family to make sure they and their child are able to stay compliant with the prescribed changes.

If you are looking at this plan thinking “BUT HOW” this may be a great class for you. Pediatric Pelvic Floor Play Skills is an intervention-focused one-day remote class is targeted to pelvic health provider looking for specific and “child-oriented” treatment techniques for the pediatric pelvic health patient (it does not delve into specific pediatric diagnoses). This class will cover some basic challenges and changes for a new or experienced pelvic health provider entering the realm of treating pediatric patients with pelvic floor diagnoses.

The course goal is to review topics related uniquely to treating the pediatric population and then review treatment skills for different age groups. Get ready to learn basic pediatric care topics such as postural, developmental, feeding, and behavioral considerations. The labs will include both observational and interactive lab experiences designed to teach ANY therapist multiple treatment and play techniques to incorporate into their pediatric practice. The in-person aspect of this course involves movement and play, so be ready to observe and then practice some kid-friendly activities.

Pediatric Pelvic Floor Play Skills

Course Dates: October 22

Price: $275
Experience Level: Beginner
Contact Hours: 10

Description: This one-day remote continuing education class is targeted to any pelvic health provider looking for specific and “child oriented” treatment techniques for the pediatric pelvic health patient. This class will cover some basic challenges/ changes for a new or experienced pelvic health provider entering the realm of treating pediatric patients with pelvic floor diagnoses. This class is intervention focused and does not delve into specific pediatric diagnoses.

This course will begin with a combination of lectures on basic pediatric care topics such as postural, developmental, feeding, and behavioral considerations. The labs will include both observational and interactive lab experiences designed to teach ANY therapist multiple treatment and play techniques to incorporate into their pediatric practice. The in-person aspect of this course involves movement and play, so please plan your space and clothing accordingly.

This course will be instructed by Mora Pluchino, PT, DPT, PRPC who is a physical therapist with experience in both pelvic health, pediatrics, and pediatric pelvic health. This class is designed for a clinician who has already taken pelvic floor education including Pelvic Floor Level 1 and/or Pediatrics Level 1 -Treatment of Bowel and Bladder Disorders or something equivalent and is looking for play oriented treatment ideas.