The perspective on the relevance of neuromusculoskeletal and biomarker components for assessment interpretation and treatment strategies, was initially started by myself but came into fruition when my colleague (and very good friend!!!) Elizabeth G. Harvey, DPT, MSR, CKTI, CEIM got involved!
Elizabeth is a physical therapist. She is also an expert on postural alignment and body system integration impacting swallow disorders. She has practiced for 16 years in a variety of settings, including outpatient sports rehab, subacute rehab, school settings, and early intervention. She is the owner of ABC Therapies LLC (founded in 2008) and serves early intervention patients in rural South Carolina. We met a little over two years ago. Elizabeth was the lead author in our peer reviewed paper on the PaSS Method® (click here to retrieve it). She again was the lead author to our newest publication entitled, “What is the impact of your therapy? The PaSS Method® may offer insight”. Her perspective on the integrative relationship with afferent processing pathways and motor behavior has merged with mine into a proof of concept we are both very proud to share!
Below please find Elizabeth’s journey how she has evolved into the therapist she is today!
Elizabeth G. Harvey, DPT, MSR, CKTI, CEIM
ABC Therapies LLC
I am a pediatric physical therapist specializing in medically-fragile populations with complex neurological issues. I have been referred to as a dysphagia specialist, but I cannot claim this title myself. I feel I am more of a mechanic. I work on improving posture, alignment, respiration and neuromuscular reeducation – all these factors impact swallowing function. However, I am not versed in feeding therapy or in swallowing diagnostics. I leave that to my esteemed speech colleagues!
But what an adventure! I have been working with oral motor assessment and exercises for over 12 years, using Beckman Oral Protocol. When I made the transition from adult outpatient orthopedics to the school system, I requested a mentor for a year. I was given Darcy Jones. Darcy had worked in New York with Rona Alexander, PhD, CCC-SLP, BCS-S, C/NDT. We attended my first oral motor course with Debra Beckman, MS, SLP-CCC. I have since kept in contact with Debra Beckman and have proctored her course twice.
I found the Beckman Oral Motor Protocol course to make complete sense to me as a physical therapist. How wonderful to be able to assess for strength and range of the structures of the face (lips, cheeks, tongue) as well as alignment of the jaw. When transitioning my practice from adults to babies, I realized even more how pertinent this information was! When you are dealing with a little one and a third of their body is the head and neck, I have found conducing an oral motor assessment to be vital!
Two years ago, I had a medically fragile child whom had plateaued. As the physical therapist, I pushed for head control, positioning, and maintaining range. One day, I asked his father what questions he had regarding his son’s therapy. His response surprised me. “I just want my kid to swallow,” he said.
I sought out a speech pathologist I hoped could help (Judith Macias-Harris). After two conversations regarding posture, symmetry and superficial stimulation, I flew to Texas to consult with her in person. She introduced me to vibroacoustic therapy that weekend. I was very skeptical of the tuning fork theory. So, she offered to try it on me. She applied it to my wrist, on the thenar eminence and palm. I was truly amazed at the increase in wrist extension range of motion after one treatment!
I have continued to work with this child, using a multi-modality approach, i.e., vibroacoustic therapy, elastic therapeutic taping strategies, low level LED light therapy, manual therapy, to impact afferent feedback to improve upon function. Two years ago, this child couldn’t roll over or prop sit independently and is now creeping, sitting up for short periods of time once positioned, standing at a support surface, cruising with assistance, rolling, and walking with minimum assistance at this trunk (but self-initiated). He creeps over to the gait trainer and reaches for it to indicate a desire to walk! And he is going for a swallow study the end of this month!!! My colleague, SLP Kelly Brown, feels very confident that he will pass with flying colors this time!
It’s a journey - trying to problem solve through multiple factors impacting function and participation in life. The process of researching and developing the PaSS Method® with Judee has been my biggest rehab adventure to date! We continue to press on to understand the intricacies of the body as a system. I have great respect for my many colleagues who work diligently to put this puzzle together in a meaningful way.
We will continue to endeavor together – Ever onward!
Elizabeth
Harvey, E.G. and Macias-Harris, J. (2017). What is the impact of your therapy? The PaSS Method® may offer insight. Massage Message, 33/2, 22-23.
Disclaimers: Information presented in this blog is designed to promote ideas and stimulate discussion. The goal of this blog is to provide a safe and friendly place to share stories or experiences, build an understanding of various teaching and treatment styles, and to network with each other. The author(s) of this blog do not dispense medical advice nor prescribe the use of information as a form of treatment for medical problems with or without the advice of a physician. Clinicians are recommended to receive proper training and certification as governed by their professional association. The intent of the author(s) is only to offer information of a general nature. The author(s) assume no responsibility for your actions, assessment, nor interpretations. No one associated with this blog will have liability for loss, damage, or injury resulting from the use of any information found on this or any page of this site.
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