Neonatal physical therapy fellowshipIn December 2012, Seattle Children’s became the first (and for now, the only) place in the nation that offers physical therapists an accredited fellowship in neonatology. For seasoned pediatric physical therapists who want to work with the tiniest, most fragile babies, the fellowship offers a unique opportunity for training.

In December, the American Board of Physical Therapy Residency and Fellowship Education (the credentialing arm of the American Physical Therapy Association, or APTA) accredited the neonatology fellowship, which is a partnership between Children’s and Rocky Mountain University of the Health Professions (RMUoHP) in Provo, Utah.

The fellowship, which focuses on babies from birth to 12 months of age, combines six academic credits at RMUoHP with 1,000 hours of mentored clinical training at Children’s.

A novel training model

While fellowships are the usual way physicians train in subspecialty fields, they are less common in other clinical fields. There are only 28 accredited subspecialty fellowships for all physical therapy disciplines combined – and just one (the neonatology fellowship at Children’s) is in a pediatric subspecialty.

“Traditionally, occupational and physical therapists who want expertise working with neonates and infants learn on the job,” says Gayle Bonato, PT, a physical therapist on the infant team at Children’s and the fellowship’s clinical site director. “But unless you’re in a setting with the right mix of babies and the right level of complexity, it’s very hard to get thorough training.”

Because Children’s has those elements – and a team of eight top-notch infant physical and occupational therapists – Bonato has long dreamed of creating a formal training program here. But when she started her quest a decade ago, she was ahead of her time; while the APTA has recognized pediatrics as a specialty area within physical therapy for 40 years, it did not formally recognize neonatology as an advanced practice subspecialty until 2010.

When that happened, Bonato and Jane Sweeney, PT, PhD, PCS, FAPTA, – director of doctoral programs in Pediatric Science at RMUoHP – finally had clear criteria on which to base a fellowship. The two, along with Cathy Graubert, manager of physical therapy at Children’s, immediately began building the fellowship and moving toward accreditation.

“It’s a rigorous process and it’s taken a lot of work,” says Bonato. “We are honored and excited to be the first program accredited.”

“This fellowship offers an amazing opportunity,” adds Sweeney, a pioneer in pediatric physical therapy who started her own neonatal physical therapy practice in 1972. “Gayle and I often say we would have loved to have participated in a program like this when we were learning the practice.”

Physical therapy…for babies?

Alison Wigstrom-Hoseth, of Tacoma, is the program’s second fellow and is currently completing her training. Although Wigstrom-Hoseth has been a physical therapist for 16 years, many of the skills she’s learning at Children’s are completely new to her. “In my practice with older kids, we’re thinking years and years down the road,” she says. In her work with babies at Children’s, she says, “The focus is on the here and now.”

Much of the training takes place at the bedside, where Wigstrom-Hoseth works closely with mentors from the infant occupational therapy/physical therapy team. “No other experience can substitute for mentored training,” says Sweeney.

The infant team is often called on to provide feeding therapy, techniques for helping babies coordinate the sucking, swallowing and breathing skills they need in order to eat. Wigstrom-Hoseth is also learning about positioning, stretching, splinting and developmentally supportive therapy for newborns who are hospitalized for extended periods.

When she finishes the program, Wigstrom-Hoseth will have a very specialized – and much in-demand – skill set.

“Alison will leave here with the skills she needs to work in any neonatal intensive care unit,” says Bonato. “It’s a great starting point for a career in neonatal physical therapy.”

If not for the fellowship, says Wigstrom-Hoseth, she would have had no way to get into this field. “For years I’ve been triaging charts and handing off medically fragile babies because I didn’t have the required expertise,” she says. “I’m excited to be learning how to safely care for these infants.”

Bonato and Sweeney both expect more accredited neonatal physical therapy programs to come online in the near future. Children’s Hospital of Philadelphia, which is in the midst of the accreditation process, will likely be next.

The Children’s team is proud to be first, but they are happy to see other programs coming on line. “Physical therapists are hungry to learn these skills, so one comprehensive training program is not enough,” says Bonato, who has already fielded inquiries from potential candidates for next year’s fellowship spot.

Learn more about neonatal and infant physical therapy at Children’s.

If you’d like to arrange an interview with Alison or Gayle, please contact Seattle Children’s PR team at 206-987-4500 or at press@seattlechildrens.org.