For the past 18 years, Christina Setkoski has diagnosed, evaluated and treated the mobility challenges of District 75 students at PS 138 in Manhattan.
What do physical therapists do?
We work to get the individual participating in their environment by supporting movement. We understand all parts of movement, from the brain to the muscles. We’re supporting the whole body in strength, balance and coordination to help people do the activities they want to do.
How is your work distinct from that of an occupational therapist?
Textbooks will tell you that physical therapists focus on mobility and gross motor skills (skills using large muscles, like walking) while occupational therapists focus on academics and fine motor skills (skills using small muscles, like writing). In reality, we’re all trying to help students access education and participate in school. We work closely together in District 75 schools.
What’s the difference between physical therapy in a clinic versus a school?
In a clinic, the goal might be “I will sit in my car and drive to work for the hour-long drive.” Whereas in a school, our goal might be to help a child sit in a chair during a lesson or walk down the hall to get to their next class on time.
What’s unique about physical therapy in a District 75 setting?
At my school, we have many children with autism, and for physical therapy, that diagnosis tends to manifest itself in challenges with motor planning.
What’s motor planning?
Imagine I ask a student to sit criss-cross applesauce on a scooter board. Even if I demonstrate, that student might lay on the scooter on their stomach. That has to do with motor planning. To do a movement, multiple things happen in your brain: You must understand the movement, picture it, initiate it, execute it and then stop when the movement is done. There are a number of things that can go wrong in that sequence.
I love working on motor planning. Many of the things we do are hand-over-hand guidance, nudging the students’ bodies into movement patterns. And repetition, repetition, repetition! Novel tasks that might seem so easy to some of us, like walking into a classroom, taking off your jacket and hanging up your backpack, are all motor-planning movements that are very difficult for many of my students. By taking them through all these motor patterns and therapies, practicing these skills and creating neuron connections, they master these movements and eventually participate more fully in school.
How do you keep learning and growing in your job?
One of my favorite parts of the job is watching my colleagues work. It’s inspirational and educational. I work in an incredible therapy department at my school. We’re always helping one another. For example, if I’m working with a student who walks on their toes, I might look over and see my colleague doing an exercise to help a student bear weight through their heel that I hadn’t thought of.
How many students do you work with?
Thank God for the union, I see only eight students per day, and I work with the same student for the whole school year. Often, I see the same students for the whole time they’re in elementary school.
What kind of impact can you have on the lives of your students?
I remember one student I worked with who had many physical limitations. Some of his joints moved in every direction and others didn’t move at all. When he began school, he was unable to walk. By the time he graduated, he was running, walking up stairs and even climbing up the playground slide in the opposite direction.
He got so far. I gave him safe opportunities to move, to harness his own strengths. That’s my joy in life.
—As told to Hannah Brown