Physical & Occupational Therapy

Therapy Approaches & Techniques

We provide therapy services to children using a wide variety of neurological, sensory, and/or motor treatment techniques. Some of the techniques and approaches used include:


  • Neurodevelopmental treatment (NDT)
  • Sensory Integration theory and practice (SI)
  • Proprioceptive Neuromuscular Facilitaton (PNF)
  • Handwriting remediation: “Loops and Groups”; “Handwriting Without Tears”
  • Myofascial Release
  • Joint mobilization
  • Constraint Induced Therapy (CIT): we offer intensive 3-week camps in the summer for children with significant differences between right and left sides in muscle tone and function.

Evaluation Of Developmental Skills

We administer standardized tests, to evaluate a child’s performance and compare it with that of others in their age group. To evaluate gross and fine motor development, some of the tools we commonly use based on a child’s age include:

  • Bayley Scales of Infant Development: Behavior, Mental, and Motor Scales
  • Peabody Developmental Motor Scales: Fine Motor and Gross Motor Scales
  • Bruiniks-Oseretsky Test of Motor Proficiencybuilding-blocks1
  • Movement Assessment of Infants (MAI)
  • Infant-Toddler Symptom Checklist (DeGangi)
  • Alberta Infant Motor Scale (AIMS)

We also assess processing of sensory information and sensory skills using:

  • Sensory Profile (Dunn)
  • Test of Visual-Motor Skills (Gardner)
  • Test of Visual-Perceptual Skills (Gardner)
  • Informal evaluations of sensory processing

Other areas of growth and development that need to be assessed may be evaluated using the following tools:


  • Range of motion
  • Muscle strength
  • Handwriting assessment; ETCH
  • Oral Motor/Feeding Assessment
  • Self Care skills: Pediatric Evaluation of Disability Inventory (PEDI); transfers, techniques and equipment for bathing, dressing, toileting

Therapy Modalities & Tools

 Lite Gait

This is a body-weight supported suspension system that allows the therapist to facilitate proper walking patterns for children who are not yet walking or those with gait deficits, by providing a safely supported environment for the child. It consists of two elements: a postural control device (harness) that reduces the amount of weight born by the child, and a treadmill operated at slow speed to train proper patterns of walking. Proper coordination is further assisted by the manual placement of the feet and/or weight shifting by the therapist. Once coordination is established, treadmill rates and the degree of weight bearing are increased.

Neuromuscular Electrical Stimulation, NMES

This is a form of mild electrical stimulation that is used to strengthen muscles. NMES is used for individuals who have joint mobility problems, such as contractures; muscle weakness from disuse (atrophy); spasticity (tone abnormalities) and gait abnormalities. NMES is also used for orthopedic rehabilitation for musculoskeletal problems. This therapy is used in conjunction with other physical and occupational therapies to normalize muscle tone and improve functional abilities.


sdfsfThe use and goals of kinesiotaping are to facilitate or inhibit muscle activity (depending on how the tape is applied), and to increase blood flow and lymph flow to an area. At Cascade Children’s Therapy, we are using this technique with children of all ages and a wide variety of conditions, to enhance movement and function. Kinesio tex® tape is a very thin, porous cotton fabric with a medical grade acrylic adhesive. This tape is latex-free and non-medicated. Kinesio tex® tape was designed to be worn for multiple days (3 to 4). This tape is very skin friendly and irritation is rare.

Compression/Facilitation Garments

We use Stabilizing Pressure Input Orthosis (SPIO™) garments to enhance stability and proprioception through deep pressure, in an effort to improve dynamic stability and postural activation.


These are also used to address mobility, sensory input, and stability issues. This system provides postural, and sensory training, and allows the child to engage in routine activities with improved joint alignment, throughout the day.

Wii Video Games

e2dc80b1-ebd2-4937-8138-40d06e88c341-2060x1236The use of the Wii video games as a treatment tool has been validated by research studies and current therapy practice in a broad range of ages and conditions. We have been incorporating this tool for work on: balance and weight-bearing, motor planning, reaction times, grading of movement, strengthening, promoting symmetry and body awareness. It also offers a socially appropriate avenue for peer interaction.

Supplemental Services Offered

Lower Extremity Orthotics: consultation and casting is done at our facility by Don Buethorn, CPO (owner of Cascade DAFO’s, in Ferndale, WA). We are very fortunate to be a facility that Mr. Buethorn comes to regularly to consult and cast; we therefore have a very short turn around time of 1-2 weeks, in the fabrication of orthotics.

Upper Extremity Orthotics: We coordinate referrals to Children’s Therapy Unit, Good Samaritan Hospital, Puyallup for weight-bearing, night resting, and functional splinting for upper extremities.

Adaptive Equipment: We work closely with equipment vendors and manufacturers to evaluate and facilitate provision of appropriate and current adaptive equipment such as wheelchairs, strollers, car seats, bath seats, gait trainers, walkers.