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If you are a parent exploring therapy options for your child with a chronic condition — such as cerebral palsy, spina bifida, muscular dystrophy, or other developmental or physical challenges — you may have come across the term “episodic care.”
At first glance, episodic care might sound technical, but it is actually a simple and thoughtful approach to physical, occupational and/or speech therapy that focuses on what’s best for your child — and your family.
The Basics of Episodic Care
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Episodic care is an evidence-based model of therapy in which treatment happens in focused periods, or episodes, followed by intentional breaks. Think of it as working toward a specific, functional goal during therapy sessions, then taking time off to practice and apply new skills in everyday life. These cycles of therapy and breaks are carefully planned and adjusted to meet your child’s unique needs. Episodic care in pediatric rehabilitation can include physical therapy, occupational therapy and/or speech-language therapy, and usually takes place in the outpatient setting.
Why Episodic Care Works
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This approach recognizes that therapy is not just about showing up to appointments. It is about making meaningful, lasting improvements in your child’s abilities. By breaking therapy into manageable bursts, episodic care helps your child:
1. Build new skills: Therapy sessions focus on specific goals, like improving walking, building strength or enhancing speech. These goals are targeted during each episode to maximize progress.
2. Practice in real life: The break periods allow your child to apply what they have learned at home, school or in the community. For example, if therapy helped improve balance, your child might practice riding a bike or playing on the playground.
3. Stay engaged: Therapy can be hard work, and kids (and parents!) can get burned out. Taking planned breaks gives your child a chance to rest and re-energize, making the next therapy episode more effective. It also provides you, as a caregiver, with the chance to focus on other activities or opportunities — whether for yourself or for your other children.
4. Celebrate successes: Instead of ongoing therapy with no clear end in sight, episodic care gives your family moments to reflect on progress and celebrate milestones along the way.
Who Benefits from Episodic Care?
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Episodic care often is recommended for children with lifelong or chronic conditions, including neurological, developmental or genetic disorders. These children may need therapy at different points in their lives — for example, to improve walking during a growth spurt or to regain strength after surgery.
It is also a great option for families who want a therapy plan that fits into their busy lives. By focusing on specific goals, episodic care allows you to balance therapy with school, sports and family time.
What Does Episodic Care Look Like?
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Here’s an example: Say your child is working on improving their ability to walk longer distances. An episode of care might include 8 to 12 weeks of outpatient physical therapy, with two to three sessions each week. During this time, your child’s physical therapist works on focused exercises and activities to build strength and endurance. When the episode ends, your family continues with a home exercise plan tailored to your child’s needs.
When is the Right Time to Return to Therapy for a New Episode of Care?
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During therapy breaks, we encourage families to involve their child in community activities, such as group classes or adaptive sports, and to keep them engaged in their home exercise plan to maintain the progress made in therapy.
Parents often wonder: “When is the right time to bring my child back to therapy?” Here are a few examples of when returning might be appropriate:
- Following a growth spurt.
- With the emergence of a new functional skill. Examples include:
- Physical therapy: Gross motor skills such as sitting, standing, walking.
- Occupational therapy: Activities of daily living, such as dressing and toileting.
- Speech therapy: Voice production, feeding and communication.
- When your child identifies a self-directed goal (for example, going to middle school and wanting to use the stairs independently and without the help of an aide).
- Before and after surgery.
- During critical periods of growth and neuroplastic changes, such as during puberty.
Why Parents Love Episodic Care
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Parents often tell us they appreciate episodic care because it feels manageable. Instead of an endless cycle of appointments, it is a partnership between your family and your child’s care team. This approach also helps parents stay involved, making therapy part of daily life at home and in the community instead of something that only happens in the clinic.
Episodic care puts your child’s goals at the center of the plan, while considering the needs of your whole family. Whether your child is mastering new skills or taking time to enjoy being a kid, episodic care can help them thrive at their own pace.
Shirley Ryan AbilityLab offers comprehensive, interdisciplinary rehabilitation for pediatric patients from infancy through early adulthood. We welcome families to schedule an evaluation with our therapists to learn more about how a customized episodic care plan can optimize therapy goals for your child.
Meet the Writer
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Meaghan Rubsam, PT, DPT, is a pediatric physical therapist with more than 11 years of clinical pediatric experience. She currently works in outpatient pediatrics and research at Shirley Ryan AbilityLab, where her clinical and research interests focus on the implementation of evidence-based interventions and intensive programs for children with neuromotor disorders. Additionally, Meaghan is currently a PhD candidate in Rehabilitation Sciences at the University of Illinois Chicago. She is the recipient of the prestigious Ruth L. Kirschstein National Research Service Award Individual Predoctoral Fellowship (F31) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, where she is investigating the impact of cognitive-motor interference on balance control in children with cerebral palsy. In addition to her research and clinical practice, Meaghan has published articles in several prominent physical therapy journals and teaches as an adjunct faculty member in various Doctor of Physical Therapy (DPT) programs. She has presented her work at local, national and international conferences.
