Intensives

Intensive Rehabilitation Services in Charlotte, NC

What is an “intensive”?

Intensive (re)habilitation for pediatric clients is a “structured (re)habilitative approach characterized by a higher frequency of therapy sessions over a defined period, typically aimed at accelerating functional gains in children”1.

During an intensive bout of therapeutic intervention, typically over 1-2 weeks, the frequency and duration of sessions is increased, typically with a daily frequency and for 2-4 hours of therapy a day.  Therapeutic intensives are goal-directed interventions, focusing on repetition of task-specific activities to achieve new skills more rapidly with condensed therapeutic benefit.

Caregiver involvement is a critical component of an intensive program.  Each intensive is client specific and completely unique to the client and their needs; as well as the caregiver(s)’ goals and training to complete activities for continued success following the intensive.  “Multiple studies show that therapies are most effective for improving motor function and self-care when they are focused on goals set by the child and family and involve frequent practice of the specific tasks needed for those activities”2.

Why consider an “intensive”?

Intensive therapeutic intervention is often recommended for children because children demonstrate more neuroplasticity than adults. “Neuroplasticity is the brain’s capacity to continue growing and evolving in response to life experiences”3.  While neuroplasticity is present throughout the lifespan, the brain is the most plastic and most dynamic and changing during childhood.

A study completed in 2020 states, “some basic principles are pertinent to the argument for early, intensive intervention: (1) There are critical times during neural development when a certain task is most easily learnt; (2) Reorganization and reprogramming of neural tissue is use dependent (‘use it or lose it’), and repetitive active movement has the greatest potential for stimulating neural growth; and (3) A young brain is more adaptable than an older brain”4.

Children go through ‘critical periods’ of development.  These periods are marked by increased receptivity and plasticity for change.  While these periods are not ages and times set in stone, they are typically marked by a burst in new skills; sometimes language, sometimes movement or coordination.  Critical periods of developmental skill acquisition should be highly considered as an appropriate time for a therapeutic intensive.

Research also continues to support both intensive therapeutic models as well as traditional therapeutic models, this can be client and family dependent. Factors that should be considered are client and family engagement, client age, presence of critical period, client and family goals, and client tolerance to each model.  Many clients have seen gains in both models and may choose to participate in both traditional and intensive models5,6.

What does an “intensive” look like at Child & Family Development?

As with all (re)habilitative services at Child & Family Development, we begin with a phone consultation with a family to discuss their interest in an intensive therapy session.

Based upon a client being clinical fit for Child & Family Development’s program, a 45-minute caregiver conference is scheduled with the therapist(s) and the caregiver(s) only.  This conference allows an opportunity to discuss a client’s strengths, likes, dislikes, abilities, and goals.  During this time the clinician gathers insight into intervention possibilities for a client to work towards the client’s and family’s goals.  At Child & Family Development this may include occupational therapy, physical therapy and/or speech therapy.  It may also include specialties like craniosacral therapy, TASES, NDT, CIMT, aquatic therapy, SOS, and others.

An evaluation is required within the past year for an up-to-date medical history, physical evaluation, and standardized assessment.  If there has not been an evaluation in the past year, an evaluation per discipline will need to be completed prior to the start of an intensive program.

Upon completion of the consultation and review/completion of an evaluation, an individualized intensive program will be designed by the clinical team and through collaboration with the client and family.  This program will include frequency, duration, planned interventions, methods, caregiver education and training.

Typically, intensives at Child & Family Development are run for 1-2 weeks for 2-3 hours a day.

At conclusion of the intensive, there will be a 30-minute caregiver conference scheduled with the therapist(s) and the caregiver(s) only.  This will include review of documented goal progression, presentation and review of a home program and future recommendations will be shared.

 

Does Child & Family Development accept insurance for “intensives”?

Child & Family Development will work with families to bill components of intensives to insurance as plans allow for coverage.  The components that are not covered by insurance will be at a self-pay rate and the family’s responsibility, Any additional supplies needed for specialties (CIMT materials, TASES materials, etc.) will be self-pay and non-billable to insurance.

References:

  1. (2025). Pediatric Physical Therapy Intensive.
  2. Noritz G, Davidson L, Steingass K; Council on Children with Disabilities, THE AMERICAN ACADEMY FOR CEREBRAL PALSY AND DEVELOPMENTAL MEDICINE; Council on Children with Disabilities, THE AMERICAN ACADEMY FOR CEREBRAL PALSY AND DEVELOPMENTAL MEDICINE . Providing a Primary Care Medical Home for Children and Youth With Cerebral Palsy. Pediatrics. Published online November 21, 2022. doi:10.1542/peds.2022-060055
  3. Psychology Today. (2025). Neuroplasticity.
  4. Rahlin M, Duncan B, Howe CL, Pottinger HL. How does the intensity of physical therapy affect the Gross Motor Function Measure (GMFM-66) total score in children with cerebral palsy? A systematic review protocol. BMJ Open. 2020;10(7):e036630. Published 2020 Jul 19. doi:10.1136/bmjopen-2019-036630
  5. Janssen-Potten YJM, Roks L, Roijen R, Vermeulen RJ; Adelante Study Group, Rameckers EEA. Effectiveness of functional intensive therapy on mobility and self-care activities in children and adolescents with cerebral palsy – a prospective clinical study. Disabil Rehabil. 2023;45(21):3529-3538. doi:10.1080/09638288.2022.2130445
  6. Trahan J, Malouin F. Intermittent intensive physiotherapy in children with cerebral palsy: a pilot study. Dev Med Child Neurol. 2002;44(4):233-239. doi:10.1017/s0012162201002006

Contact us to schedule an appointment

Contact Us