What age group does EMpower PT cater to?

EMpower PT caters specifically to children ages 0–5 years. We also offer specialized programs such as school readiness and scoliosis treatment for older children who may benefit from continued support.

What are early intervention services in pediatric physical therapy?

Early intervention services support infants and toddlers ages 0–3 with developmental delays or disabilities. These sessions target movement, strength, and coordination to promote healthy development. EMpower PT provides private early intervention services and can supplement state-based programs when families need more frequent therapy.

What is the role of caregivers in pediatric physical therapy?

Caregivers play a vital role in pediatric physical therapy. By sharing observations, participating in home programs, and reinforcing therapeutic exercises, parents and caregivers help ensure steady progress and greater carryover of skills into daily life.

Why is school readiness important in pediatric physical therapy?

School readiness programs in pediatric physical therapy focus on improving balance, coordination, and fine motor skills so children can participate confidently in classroom activities. These programs also promote social skills, independence, and confidence, preparing children for successful transitions into group learning settings.

What is Dynamic Movement Intervention (DMI)?

Dynamic Movement Intervention (DMI) is an advanced therapy approach designed for children with neurological or genetic conditions affecting movement. DMI uses guided, repetitive movements and sensory input to promote proper posture, coordination, and strength.

What is gamified rehabilitation in pediatric therapy?

Gamified rehabilitation uses interactive games and Bluetooth-enabled sensors to make therapy sessions fun and motivating for children. At EMpower PT, we use LusioMATE Rehabilitation to track movement and engagement, turning exercises into games like basketball, bowling, and jumpy rabbit.

What is the Schroth Method for scoliosis?

The Schroth Method is a specialized exercise program for scoliosis that helps elongate and de-rotate the spine. It emphasizes breathing techniques, postural awareness, and individualized exercises designed to improve spinal alignment and stability.

How do pediatric physical therapists track progress?

Therapists at EMpower PT perform reassessments every 4–6 weeks to measure your child's progress. We review strength, coordination, and motor skills to adjust goals and celebrate successes, ensuring treatment stays effective and motivating.

What makes EMpower PT’s approach unique?

EMpower PT blends science-based methods with creativity and compassion. Our therapists use play, technology, and family-centered collaboration to make therapy engaging and effective. Each session is customized to your child’s unique needs, ensuring lasting developmental progress.

For the Summer Babies: What to Know About Head Flatness and Side Preferences

Sep 14

Written By Emily Schlicht

Welcome to your first Fall with your infant! This age FLYS by so be sure to soak it in! While you (a little obsessively) check the baby monitor, you may notice that your baby lays with their head always facing one direction. As a first time parent, or a seasoned veteran, we know this can be worrisome and hope that this information can help ease concerns.

Congenital Torticollis

Laying with their head towards one side is commonly due to muscular tightness in the sternocleidomastoid muscle. Congenital torticollis occurs when the sternocleidomastoid muscle, which runs along the side of the infant's neck, becomes shortened or tightened, often due to limited space or positioning such as a breech position during pregnancy. This muscle tightness causes the baby's head to tilt toward the affected side and limits the range of motion in the neck. Parents might notice a soft lump within the muscle, which is a sign of muscle fibrosis. Early recognition is crucial because untreated torticollis can lead to developmental delays, including difficulties with head control, sitting position, and hand-eye coordination.

Acquired Torticollis

Acquired torticollis, which develops after birth, is often related to external factors such as prolonged positioning on one side, injury, or muscle strain. Newborns spend a lot of time on their backs, while they sleep, while in a car seat or stroller bouncing in their Bjorn, etc. Because your baby's skull is soft, this can cause a flattening in areas that get the most pressure. Additionally, some babies develop a “side preference”, meaning they prefer to rotate their head towards one direction or they tip their head laterally to one side.

Notice here the lateral flexion of this baby's neck. When babies move in and out of this position, this is completely normal. However, if your baby frequently rests in this position they are at risk for flat spots or torticollis.

Is Torticollis 'Bad', should I be worried?

We want to reassure you that torticollis is incredibly treatable when intervention is provided early on. Research suggests that 98.6% of infants who began physical therapy before 1 month of age had no head tilt and complete passive range of motion in their neck after only 1.5 months of treatment. Those who did not receive physical therapy until 6+ months of age required an average of 9.8 months of treatment with only 19% of infants reaching complete neck range of motion and no head tilt.

One reason that intervening early is so vital, is so that Torticollis does not influence other aspects of your baby's physical development. Torticollis is associated with increased risk for hip dysplasia, retained primitive reflexes, delayed protective extension reflexes, scoliosis, and eventually gait abnormalities.

When torticollis affects the baby's neck muscles, it can lead to an imbalance in muscle strength and flexibility. This imbalance may cause the baby to favor turning their head to one side, which over time can impact not only the neck but also the alignment of the spine and hips. Hip dysplasia, a condition where the hip joint is improperly formed, is more common in babies with torticollis due to the asymmetric positioning and muscle tightness.

In addition, retained primitive reflexes—automatic movements present at birth that typically disappear as the baby develops—can persist longer in infants with torticollis. This delay can interfere with the baby’s ability to develop normal motor skills, such as rolling, sitting, and crawling. Protective extension reflexes, which help the baby respond to loss of balance by extending the arms to prevent a fall, may also be delayed, increasing the risk of injury as the baby becomes more mobile.

Scoliosis, or curvature of the spine, can develop as a secondary effect of torticollis because the uneven muscle pull on the neck and upper back can cause the spine to curve abnormally. This spinal misalignment can contribute to discomfort and further developmental challenges.

Finally, gait abnormalities may emerge as the child grows, particularly if torticollis and its related complications are not addressed early. These gait issues can affect the child’s balance, coordination, and overall mobility, potentially requiring more intensive therapy or intervention later in life.

Early intervention with physical therapy focusing on stretching exercises, strengthening, and encouraging symmetrical movements can help prevent these complications. By addressing torticollis promptly, parents and healthcare providers can support healthier physical development and reduce the risk of long-term effects.

For those of you unsure if your child really has Torticollis, this is another common questions we hear. Torticollis ranges from a mild side preference and positioning asymmetries to craniofacial asymmetries with a lump in the sternocleidomastoid muscle. Whether your child has a very mild case, or a more notable case, we want to assure you that physical therapists are trained to help you manage every presentation of torticollis.

Notice here the lateral flexion of this baby’s neck. When babies move in and out of this position, this is completely normal. However, if your baby frequently rests in this position they are at risk for flat spots or torticollis.

What Parents Can Do?

The good news is that noticing Torticollis and intervening early can make a HUGE difference! Here are a few things you can do to help reduce flat spots and side preferences:

Tummy time, tummy time, tummy time! Even short sessions throughout the day help strengthen your baby's neck, shoulders, and back, while relieving pressure from their flat spot. This simple yet essential activity encourages your baby to lift and turn their head, which promotes muscle balance and improves head control. Starting tummy time early and practicing it regularly can also enhance your baby's motor skills and cognitive milestones by allowing them to explore different textures and sights from a new perspective. Remember to always supervise your baby during tummy time and make the experience enjoyable with toys or your own interaction to keep them engaged and motivated to move.

Switch feeding and play positions. While feeding, offer bottles or breastfeed from both sides. During play, position toys on your baby's less preferred side and try side lying as an alternate position to tummy time and back play. Encouraging your baby to move their head in both directions through gentle stretching exercises and tummy time during brief periods throughout the day can help improve neck muscle flexibility and strength. Using brightly colored pictures or toys on the less preferred side can attract your baby's attention and encourage them to turn their head, promoting balanced development of the infant's neck muscles and overall motor skills.
Seek support if you don't notice improvements. If your baby continues to favor one side and their flatness persists, it may make rolling difficult for your little one as well as delay other milestones down the line. Babies who receive physical therapy early make improvements much faster than those who don't receive physical therapy until later on. With gentle stretches, strengthening activities, and positioning strategies, we can support your baby's head shape, motor skills, and overall development.

What can physical therapists do?

Physical therapists are specially trained to assess your baby's range of motion, strength, and posture then design individualized programs that fit your baby's unique needs. These programs often include guided stretching exercises to lengthen the shortened sternocleidomastoid muscle, neck and shoulder strengthening exercises, and techniques to encourage symmetrical movement and head positioning during tasks of daily living.

Parents and caregivers also play a vital role in this process by incorporating recommended exercises and positioning tips into daily routines. We provide home exercise programs to each of our patients, but we make sure these programs are short and sweet so you can actually find the time to fit them in. Consistency and patience are important, as gradual improvements often occur over weeks to months.

Remember, every baby develops at their own pace, and close communication with your pediatrician and physical therapist will ensure your baby receives the support needed to thrive. Monitoring progress and addressing any concerns promptly can help your baby enjoy a healthy, active start in life.

Final Thoughts

For summer babies, Fall is often when these early head shape changes become noticeable. If you have any concerns, don't wait - simple, proactive steps now can set your baby up for healthy growth and development. And remember, you don't have to figure it out alone. Our pediatric physical therapy team is here to guide you and your little one every step of the way.

👉 Email us at info@empower.pt.org to schedule an evaluation for your child’s side preferences, neck tightness, or flat spots.

Emily Schlicht