Treatment Guide

Interdisciplinary Collaborative Therapy Program for Individuals with Muscular Dystrophy

Program Description (Revised)

The Interdisciplinary Collaborative Therapy Program for Muscular Dystrophy is a coordinated, hybrid service model designed to support individuals with Muscular Dystrophy through comprehensive Physical Therapy (PT), Occupational Therapy (OT), and Speech Therapy (ST). Services are delivered through in-clinic Physical Therapy and virtual Occupational and Speech Therapy to ensure accessibility, continuity of care, and consistent interdisciplinary collaboration.

This program utilizes a family-centered, developmentally informed, and medically appropriate approach to address progressive muscle weakness, functional independence, communication, sensory processing, and participation across home, school, and community environments. Providers collaborate routinely to align goals, monitor disease progression, and adapt interventions proactively.

Service Delivery Model

Physical Therapy (PT): In-clinic sessions emphasizing safety, mobility, developmental transitions, endurance, and equipment management

Occupational Therapy (OT): Virtual sessions addressing sensory, feeding, self-care, regulation, cognition, developmental motor skills, joint protection, and adaptive participation

Speech Therapy (ST): Virtual sessions focusing on language, communication, and multimodal communication systems including AAC

Interdisciplinary care coordination includes shared treatment planning, caregiver training, and ongoing team communication.

Core Areas of Intervention

1. Muscle Weakness, Joint Protection & Endurance

Interventions are designed to address progressive muscle weakness while preventing overexertion and joint strain. Therapy includes:

Strength preservation and energy conservation strategies

Joint protection techniques and body mechanics education

Functional task adaptation to reduce fatigue

Caregiver training in safe mobility and handling

OT and PT collaborate to ensure activities, equipment, and daily routines support joint integrity and long-term functional participation.

2. Developmental Motor Skills & Functional Transitions (PT Focus)

Physical Therapy will address developmental and functional mobility skills with an emphasis on safety and efficient movement patterns, including:

Safe transitioning between positions (lying, sitting, standing, and transfers)

Developmental progression of gross motor skills

Postural control and balance training

Functional mobility within natural environments

Fall prevention and safety awareness

PT will incorporate therapeutic play and task-based activities to support developmentally appropriate movement while accommodating disease progression.

3. Positioning & Equipment Use Across Environments

Positioning is addressed collaboratively across disciplines to promote comfort, alignment, and functional engagement in all equipment and daily settings. This includes:

Stander tolerance, alignment, and caregiver education (PT-led)

Gait trainer training for supported mobility and endurance (PT-led)

Wheelchair (W/C) positioning, pressure relief, and functional access (PT & OT collaboration)

Positioning in adaptive seating, activity chairs, and therapy equipment (OT & PT)

Ongoing equipment assessment and modifications based on growth and functional changes

4. Sensory Processing, Regulation & Sensory Feeding (OT Focus)

Occupational Therapy will address sensory processing differences and sensory feeding disorders through:

Sensory regulation strategies embedded in daily routines

Sensory modulation techniques to support attention and participation

Feeding interventions addressing texture tolerance, oral sensory processing, and mealtime routines

Caregiver education for structured sensory supports

Interventions are individualized to promote regulation, engagement, and safe participation in feeding and daily activities.

5. ADL Development, Self-Care & Self-Management (OT Focus)

OT will support functional independence through targeted intervention in:

Dressing, grooming, hygiene, and feeding skills

Adaptive techniques for decreased strength and endurance

Environmental and routine modifications

Self-care sequencing and independence development

Energy conservation within daily routines

Therapy will emphasize skill carryover into home and school routines.

6. Cognitive Function, Social Engagement & Developmental Participation (OT & ST Collaboration)

Cognitive and social participation will be supported through:

Executive functioning and task initiation strategies

Attention, problem-solving, and adaptive learning approaches

Social engagement and play-based interaction skills

Structured routines that promote independence and participation

OT will address functional cognition within daily activities, while ST supports cognitive-linguistic skills within communication contexts.

7. Communication & Language Using a Multimodal Approach (ST Focus)

Speech Therapy will prioritize functional communication using a multimodal framework that may include:

Verbal communication

Gestures and sign supports

Visual supports and communication boards

High-tech and low-tech AAC systems

Social communication and pragmatic language skills

Receptive and expressive language development

Intervention will focus on maximizing communication access across environments and communication partners.

8. AAC Implementation & Communication Access

For individuals requiring alternative communication methods, ST will:

Conduct AAC assessments and system selection

Provide device customization and programming

Train caregivers and interdisciplinary team members

Integrate AAC into therapy sessions, daily routines, and social interactions

AAC use will be embedded across PT and OT sessions to support consistent communication opportunities.

9. Adaptive Equipment, Switches & Adaptive Toys (OT Focus)

Occupational Therapy will utilize assistive technology and adaptive play tools to enhance engagement, development, and independence, including:

Switch-access toys for cause-and-effect learning

Adaptive toys to support fine and gross motor access

Environmental control switches and activation systems

Fine motor adaptations for limited dexterity

Participation-focused adaptive play strategies

These supports encourage developmental skill acquisition, motivation, and meaningful engagement.

Family & Caregiver Education

Caregiver training is a foundational component and includes:

Home programs for positioning, regulation, and mobility

Safe equipment use and joint protection education

Sensory and feeding strategy implementation

Communication and AAC carryover training

Support for developmental transitions and daily routines

Interdisciplinary Collaboration & Ongoing Monitoring

The PT, OT, and ST team will:

Conduct regular interdisciplinary case reviews

Monitor functional changes and disease progression

Adjust treatment plans proactively

Coordinate with physicians, specialists, schools, and caregivers

Maintain consistent documentation and goal alignment

Program Goals

Promote safe mobility and developmental skill progression

Support functional independence in ADLs and self-care

Enhance communication through multimodal and AAC approaches

Improve sensory regulation, feeding participation, and engagement

Protect joint integrity and optimize positioning in all environments

Foster cognitive development, social participation, and quality of life

Empower caregivers with practical strategies and ongoing support

This collaborative hybrid model ensures comprehensive, developmentally appropriate, and medically responsive care tailored to the evolving needs of individuals with Muscular Dystrophy.