Every year, we ask you to nominate a colleague who does outstanding work. During this challenging and unusual school year, we wanted to highlight a therapist who has provided outstanding in-person and tele-therapy. Here's a conversation with our physical therapist of the year, Silvia Vaher, who works at PS 229 in Queens.
How many years have you been a school-based physical therapist?
I have worked as a physical therapist for 25 years, most of those at PS 229 in Queens. I initially worked as an exercise physiologist at corporate fitness facilities. I conducted stress and exercise tests, taught classes and provided personal training. I also worked in the Intensive Care Unit and Cardiac Care Unit at the now defunct St. Vincent’s Hospital, performing electrocardiograph (EKGs) and monitoring cardiac patients’ hearts.
What type of students do you work with?
I work with elementary school students, including those who are physically challenged, have cognitive impairments, genetic disorders or autism.
How would you describe your approach to physical therapy?
I use a child-centered approach and work with students in their natural settings whenever possible. Working in classrooms, the hallway, the stairs, the gym and the playground allows me to observe which movements my students struggle with. I work closely with the entire school staff, the family and, when appropriate, the child’s doctors. Though my primary focus is physical therapy, my goal is to address the student’s emotional state, readiness to learn and other Individualized Education Program goals. Each child has a specific set of strengths, weaknesses and needs, and varying levels of family support. Whenever possible, the child must actively participate in setting goals. Giving them ownership increases their commitment toward reaching those goals.
Many professionals interact with students throughout the day. We share insights and collaborate to help students excel.
Does your work take you out of school sometimes?
I accompany my students to wheelchair clinic and orthotics appointments. I exchange ideas with the clinic therapists and doctors.
With proper equipment, the child has a better chance of achieving functional goals. Communication is especially important after a child has surgery or requires new equipment.
You have certifications in Neuro-Developmental Treatment (NDT), Zumba and yoga. How does this knowledge inform your practice?
Since childhood I have been interested in dance, sports and athletics. Many teachers inspired me. I try to instill the joy of movement in my students. I try different approaches to learn what works best for a child and I take note of their energy level and moods. I am always prepared to adapt to the needs of the child and my background in various practices allows me to customize my approach.
I became an NDT-certified pediatric therapist 18 years ago. NDT has the most logical approach to dissecting movement. I became certified to teach yoga to adults and children 14 years ago. Yoga is an exciting tool to teach children how to improve strength and calm themselves. It also teaches them to move slowly and to grade their movements. Using yoga in combination with NDT helps the child achieve proper alignment and properly weight shift their body. For many years, I have enjoyed teaching yoga to students with special needs and those without. This integrated therapy model allows students to work on their skills alongside their peers, and the entire class benefits from learning yoga. I have also provided yoga classes for staff at the day’s start.
Students in wheelchairs are often unable to participate with their peers in physical activities. These students are so excited when they can participate during my integrated yoga sessions. My students transfer from the wheelchair to the floor at the front of the class. Facing their peers, they demonstrate yoga poses with my assistance. All the students enjoy these activities.
I became certified to teach Zumba four years ago. This was helpful for integrated therapy movement classes. With this training, I can more easily create simple choreography. I tailor the movements for my students. My students love being in the front of their classrooms in their wheelchairs or standers and participating in a movement session with their class. It’s good for everybody!
I am not certified in Pilates yet, but I like to incorporate Pilates activities and tools into my therapy sessions for strengthening, particularly during tele-therapy. Students are more engaged when using Pilates-friendly tools such as a TheraBand, yoga blocks, a chair or a medium-sized ball. The resistance of the band or ball lets them know where their body is in relation to space.
How do you adapt Zumba for individual therapy sessions and in-person classroom sessions?
1. I begin with a visual schedule that lists the activities the student will do during the session. This helps them focus and stay on task. I use five elements for my direct therapy sessions and incorporate some of them into integrated sessions as well. I establish a rhythm. Students bounce on a ball, jump, run and do other activities to a steady beat. This warms them up and helps prepare the child’s brain for new information. This is very important, especially for children who have difficulty regulating their bodies.
2. Using the basics of NDT, students hold different positions in proper alignment.
3. I work on helping a child develop focusing skills by keeping the rhythm for an entire song or exercise. We work up to having a child stay on task for several exercises or songs in a row. Some children have difficulty staying on task, so seeing the progress is rewarding; they can identify changes in music that signal a transition. Some children have great difficulty with this. They cannot grade their movements, they move too quickly and they have difficulty stopping their movements. Music provides an extra cue to keep the child on task, engaged and coordinated.
4. After our Zumba, we transition to more traditional school-based functional activities. We work on stairs, walking, starting, stopping, finding the proper spacing between peers and carrying a tray in the cafeteria. Because of the work we did on focus with movement and music, they can then work on the demands of their school environment. They are better prepared for busy hallways, tight staircases or peer-to-peer playground games.
5. We end with stretching, deep breathing and calming moves to transition seamlessly to academic subjects.
How does Zumba develop a student’s confidence in socializing with peers?
The premise of Zumba is having fun with movement and music. When you choose a song your students enjoy, they usually begin to sing and dance together. They enjoy dancing together when a skilled therapist can break down the movements to their abilities. All students benefit. They have fun together and learn valuable social skills.
Obviously, this year was a challenging one. How did you manage?
This year, dealing with tele-therapy, was the most challenging year of my career but also the most rewarding. Learning the technology for therapy sessions and figuring out how to work effectively with students was initially daunting. In time, however, I acquired the technical skills I needed and found the activities that worked best in motivating my students. Connecting to the children’s family was an asset. My student’s parents and siblings would sometimes participate, which motivated the student. I found the blended approach of in-person and tele-therapy sessions to have some advantages. Tele-therapy prompted me to discover a new set of online resources that I could use in my in-person practice. Tele-therapy also facilitated increased communication with families, improving collaboration and carryover.
How has the union supported you as a physical therapist in New York City’s public schools?
I am grateful to be in a union and have benefitted enormously from the UFT’s support. When I started with the city, physical therapists worked during the summer with no additional pay while most school personnel were off. The UFT fought for us to work a 10-month schedule with no reduction in salary. The 10-month schedule gave us the option to be off in the summer, like other titles, or work and receive additional compensation.
At times, the paperwork was excessive and burdensome and there wasn't enough time to complete it during school hours. Thanks to the UFT, the paperwork was reduced, and administrators were instructed to allocate adequate time in our day for documentation. Many members also received back pay for the extra hours they had worked.
Prior to the last contract, most school personnel were covered by the Family and Medical Leave Act, but not us. This last round, the UFT fought for and won this important benefit. The union has also stepped in to rectify unsafe working conditions for members. And the UFT has been invaluable during this last school year navigating the pandemic. The union ensured our schools were safe for us to return to for in-person work.
Can you share an inspirational story?
I am blessed to have many of these stories. My favorite involves a 2nd-grade student with autism in an Integrated Co-Teaching (ICT) class. He had difficulty playing with peers at recess, participating in gym and coordinating movements. He had difficulty focusing. He lacked rhythm, timing and grading of his movements. During conversations with the student, he told me that during recess he often played alone and didn’t feel part of a group. My hope was to help him to improve his gross motor abilities, maintain focus to engage in group activities and feel included.
His teachers and I decided we could achieve this with weekly Zumba instruction with the entire class. This strategy worked perfectly. The student enjoyed the Zumba class with his peers so much he put his best effort into improving his dancing skills during his individual physical therapy sessions; his focus and engagement increased dramatically.
During the weekly Zumba classes, I placed this student in the front row so I could guide him. Because the children danced with a partner, everybody wanted to partner with him so they could be in the front row. He was suddenly much more popular. He was so inspired, he came up with the idea of having his class put together a dance performance for parents. Although his performance was not perfect, it was apparent from his smile that he felt like a star. He was thrilled about participating with his peers and being a front-row dancer in the show for the parents.
You have created YouTube videos for your virtual sessions. What inspired you to create them and what was the response from students and their families?
During the pandemic, I recorded myself doing exercises and movement routines to create a home exercise programs for my students. I posted them in my physical therapy Google Classroom. At the time, my principal was looking for videos to post on the school YouTube channel. I had never edited a video before but decided it was a terrific opportunity for me to share some Zumba routines for the school community and for me to learn a new skill. It took time, but I worked at my own pace. The videos were so well received that I decided to offer free remote Zumba for families over the summer.
Here are a few of my YouTube videos to inspire anyone!