The Lasting Impact of a Pioneer in Pediatric Therapy: Meet Mary Massery, PT, DPT, DSc – See Why Every Pediatric Professional Can Benefit from Her Holistic Approach
KIN: Mary, you got your start in physical therapy in 1977 and have dedicated the majority of your career to pediatrics. What are some of the most impactful shifts in clinical treatment styles you have witnessed in your career?
Mary: There have been many shifts in interventions over the decades of course with the most impactful ones being:
- Recognition that the child you treat is made up of multiple body parts constantly interacting to give the child greater or lesser skills depending on the effectiveness of those interactions. The “problem” is never just a single body part.
- Recognition that the child’s life within his/her family unit will have a profound effect on his/her motor outcomes. Partnering with the family and caregivers is not just a good idea, it is ESSENTIAL for maximizing long-term positive outcomes.
KIN: What aspects of your approach to patient care and clinical decision-making make it applicable for use by various pediatric disciplines and adaptable across a variety of therapy settings?
Mary: Haha, that’s a trick question. The answer is all of it! I look at physiology first. Is the child having difficulty supporting their own physiology such as breathing and oxygenation? Physiology ALWAYS wins! If a child can’t breathe, they won’t care (nor have the energy to care) about rolling over or reaching for toys, etc. EVERY pediatric therapist should be screening their patients for physiological deficits, especially in early intervention when diagnoses may not be known yet.
Don’t focus on “my patient can’t sit up.” Focus on WHY can’t my patient sit up. Is it weakness … maybe … or maybe it is a yet to be diagnosed cardiac, pulmonary, vascular or gastrointestinal condition that saps his/her energy, imitating neuromuscular weakness. Ahhh … that would be a whole different problem, right?
KIN: How do you envision the integration of breathing and posture in treatment strategies and clinical decision-making evolving over the next 5-10 years in patient care?
Mary: I think you are asking, “what is my dream about the future of peds PT?” I would like to see peds therapists (PT, OT, ST) approach motor deficits from a physiologic basis, looking beyond our comfort zone in neuromotor and musculoskeletal deficits, and seeing the child as a whole entity with physical, physiologic and psychology components. Which system(s) is the cause of the presenting motor symptoms, and which is the consequence? That approach could help the clinician identify the real problem rather than just treating what we see in front of us. We need to become expert motor detectives. That is our skill set, we just need to recognize it and run with it. Other medical disciplines are intentionally focused on a single system, but pediatric therapists are trained to look at the whole.
For example, years ago I was evaluating a 5 y/o boy with “low tone” (no formal dx) at clinic. He had 3 older brothers in a very athletic family (dad was a professional baseball player). The young boy couldn’t keep up with his sibs and was eventually labeled as “lazy” and “disengaged” by his family.
Traditionally, you might look at strengthening his core and trying to motivate him to participate, but I wouldn’t move immediately to treatment. I would focus on the WHY can’t he keep up? Why is this otherwise apparent typically developing child uninterested in participating in motor activities with his siblings? It could have been just straight forward benign hypotonia, but don’t assume that to be the case. Look deeper. After probing his family more on his medical/behavioral history, doing some simple testing in the clinic, and analyzing his motor preferences and endurance, I suspected the primary problem was cardiac or vascular, not neuromotor or psychologic.
I recommended they seek a cardiac consultation. I got an email from his mom a few weeks later with a picture of her son lying in bed in a hospital with bandages across his chest. It turns out that he needed open heart surgery; playing baseball could wait. Mom sent a simple message with the picture: “eternally grateful.” Not every child will need “open heart surgery,” but the point is to look at the body to determine the likely cause of the problem.
KIN: What are some key milestones in your career that have shaped your current practice and philosophy as a physical therapist?
Mary: I had a very strong cardiopulmonary background in PT school (Northwestern University, Donna Frownfelter, instructor) and a very strong neuro background (Mary Alice and Scott Minor, instructors), so it was natural for me to see patients from a multisystem approach from my very first job (Rehab Institute of Chicago, now called Shirley Ryan Ability lab). That set me up to develop my own unique approach to pediatric rehab linking breathing and postural control.
KIN: What do you like most about teaching?
Mary: I love watching light bulbs go off in clinicians’ brains when I help them tie breathing (physiology) to motor skills (anatomy, kinesiology). I still get goose bumps after 40+ years of teaching watching their reactions. I love breaking down complex subjects, such as cardiopulmonary, and making that knowledge accessible for every clinician. I want to empower my colleagues, so they can empower their clients’ families. My goal has always been to “teach my way out of a job.” When I retire at 112 y/o, I hope that every practitioner links breathing to motor function, hence I can retire feeling that my job is truly done!
A heartfelt thank you to Mary Massery, PT, DPT, DSc for this insightful and engaging exploration of her foundational holistic approach, and for demonstrating how it has shaped—and will continue to shape—pediatric assessment and treatment methods by all disciplines.
Want to learn more from Mary Massery PT, DPT, DSc ? Sign up today for her two LIVE webinars this May, you won’t want to miss them!
https://www.knowledgeisnow.com/live-events/
Here’s what her multidisciplinary students have to say:
Breathing & Postural Control, Part-1
- PT: “Very informative, can be used across such a wide spectrum of patients!”
- OT: “Great course. She kept me engaged the entire time and I learned so much!”
- SLP: “So helpful as an ST, I learned so many new things that I could start implementing immediately with my own patients. An awesome CEU!”
When Reflux Comes Up, EVERYTHING is Affected
- PT: “Such an interesting course! I will definitely use this with my families and provide them some helpful “tips” for those reflux babies. Loved it!”
- OT: “Such an incredible lecture!”
- SLP: “Very informative and very helpful. The instructors were knowledgeable, and it was so helpful.”
Upcoming Learning Opportunities
May 2025
Breathing & Postural Control, Part-1
When Reflux Comes Up, EVERYTHING is Affected
September 2025
Breathing & Postural Control, Part-1
November 2025
When Reflux Comes Up, EVERYTHING is Affected
December 2025
Breathing & Postural Control, Part-1
Other Important Links:
Mary’s website
