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The pediatrician needs to understand the role of physical, occupational, and speech-language therapists in the overall treatment of children with motor disabilities and the therapeutic interventions that may improve function and participation. If the child has motor problems severe enough to interfere with mobility, self-care, or communication, therapists may provide a program to help the child ameliorate, compensate for, or adapt to the impairment or disability. Physical, occupational, and speech-lan-therapists, working with the family, child, physician, and teacher, promote a positive functional adaptation to impairment or disability in the context of the child’s developmental progress. Physical therapists focus on gross motor skills and functional mobility, including positioning; sitting; transitional movement such as sitting to standing; walking with or without assistive devices (eg, walkers, crutches) and orthoses (braces) or prostheses (artificial limbs); wheelchair propulsion; transfers be-tween the wheelchair and other surfaces such as a desk chair, toilet, or bath; negotiation of stairs, ramps, curbs, and elevators; and problem-solving skills for accessibility of public buildings. Physical therapists often have responsibilities for procuring adaptive equipment related to ambulation, positioning, and mobility. Occupational therapists focus on fine motor, visual-motor, and sensory processing skills needed for basic activities of daily living such as eating, dress-ing, grooming, toileting, bathing, and written com-(handwriting, keyboard skills). Occupational therapy services may include training in school-related skills and strategies to help children compensate for specific deficits. Speech-language pathologists address speech, language, cognitive-communication, and swallowing skills in children with disabilities. Speech therapy is the therapy most commonly prescribed by pediatricians. The services that can be provided by physical and occupational therapists and speech-language pathologists overlap. For example, a physical or occupational therapist can address motor delay or dysfunction in the very young child. Depending on the community, occupational therapists or speech-language pathologists may address deficits in oral mo-tor skills associated with feeding dysfunction related to motor disability. Occupational therapists and/or speech-language pathologists provide expert consultation related to adaptive equipment, environmental modifications, and assistive technology devices such as environmental control units, augmentative communication systems, adapted computers, and adaptive toys.

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