20 - Precision CPD

Dr. Quiara Smith, OTD, MOT, OTR/L, CEIM
Groundwork: Play Therapy That Starts on the Floor

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Dr. Quiara Smith a Pediatric Pelvic Health Occupational Therapist who is the CEO/Director of Aloha Integrative Therapy, the first boutique private OT practice exclusively created to treat children with pediatric pelvic floor dysfunction and bowel and bladder disorders. Quiara is passionate about creating and holding safe and inclusive space, in order to provide holistic and integrative approaches to pediatric clients and their families.

Connect:

Website: https://alohaintegrativetherapy.com/
Instagram: https://www.instagram.com/alohaintegrativetherapy/

References and Resources Mentioned:

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Barbosa, A. M., Silva, R. M., Pereira, L. C., & Santos, M. A. (2021). Core stability, postural alignment, and urinary continence in school-aged children: A cross-sectional study. Continence, 1(2), 78–85.
Bartlett, D. J., & Fanning, J. K. (2003). Relationships of equipment use and play positions to motor development at eight months of age. Pediatric Physical Therapy, 15(4), 196–206.
Bongers, M. E. J., van Wijk, M. P., Reitsma, J. B., & Benninga, M. A. (2013). Long-term prognosis for childhood constipation: Clinical outcomes in adulthood. BMC Pediatrics, 13, Article 112. https://doi.org/10.1186/1471-2431-13-112
Cameron, E. C., Maehle, V., & Reid, N. (2011). The effects of an early motor intervention on motor development in infants born preterm. Physical & Occupational Therapy in Pediatrics, 31(4), 361–373. https://doi.org/10.3109/01942638.2011.572149
Chase, J., Austin, P., Hoebeke, P., & McKenna, P. (2010). The management of dysfunctional voiding in children: A report from the Standardisation Committee of the International Children’s Continence Society. Journal of Urology, 183(4), 1296–1302. https://doi.org/10.1016/j.juro.2009.12.059
Dos Santos, J. N. A., de Andrade, A. D., da Silva, T. N., & de Melo, P. L. (2019). Altered postural control in children with constipation and pelvic floor dysfunction. Journal of Bodywork & Movement Therapies, 23(4), 816–822. https://doi.org/10.1016/j.jbmt.2019.03.006
Dusing, S. C., Harbourne, R. T., Lobo, M. A., McCoy, S. W., & Rosenberg, A. (2018). Daily movement opportunities for infants: Associations with development and participation. Early Human Development, 127, 7–13. https://doi.org/10.1016/j.earlhumdev.2018.09.002
Gomes, A. L. N., de Oliveira, R. N., & Dantas, E. H. M. (2025). Pelvic floor physical therapy for functional constipation in children: A systematic review and meta-analysis. Journal of Pediatric Gastroenterology and Nutrition. Advance online publication. https://pubmed.ncbi.nlm.nih.gov/40285877/
Harbourne, R. T., & Stergiou, N. (2003). Nonlinear analysis of the development of postural control in sitting. Physical Therapy, 83(6), 475–484.
Hewitt, L., Stanley, R. M., Okely, A. D., & Salmon, J. (2017). Tummy time and infant health outcomes: A systematic review. Pediatrics, 140(6), e20170694.
Hodges, P. W., & Sapsford, R. (2011). Automatic activation of pelvic floor muscles in postural tasks: Implications for children with pelvic floor dysfunction. Journal of Electromyography and Kinesiology, 21(4), 598–605. https://doi.org/10.1016/j.jelekin.2011.02.006
Krüger, J., Schlader, J., & von Gontard, A. (2020). Relationship between posture, breathing pattern, and pelvic floor muscle function in children with dysfunctional voiding. Journal of Pediatric Urology, 16(5), 620.e1–620.e7. https://doi.org/10.1016/j.jpurol.2020.07.008
Lee, J., Kim, S., & Park, J. (2023). Effects of abdominal muscle strengthening and pelvic control exercises on trunk control and pelvic movement in children with unilateral cerebral palsy. Journal of Exercise Rehabilitation, 19(1), 12–20. https://pubmed.ncbi.nlm.nih.gov/39781507/
Loening-Baucke, V. (2007). Urinary incontinence and urinary tract infection and their resolution with treatment of chronic constipation of childhood. Pediatrics, 119(1), e85–e90.
Lobo, M. A., Harbourne, R. T., & Dusing, S. C. (2013). Ground-based movement experiences and early development: Supporting infants’ participation through play. Infants & Young Children, 26(3), 231–245.
Mugie, S. M., Di Lorenzo, C., & Benninga, M. A. (2022). Functional constipation and dyssynergic defecation in children: A mini-review. Frontiers in Pediatrics, 10, Article 832877. https://doi.org/10.3389/fped.2022.832877
Riga, V., Papadopoulou, E., & McClelland, J. (2023). Sensorimotor development and its contribution to postural control in early childhood: A systematic review. Developmental Medicine & Child Neurology, 65(6), 712–723. https://doi.org/10.1111/dmcn.15488
Sapsford, R., McLaughlin, J., & Hodges, P. W. (2001). Co-activation of the pelvic floor and transversus abdominis in children during postural tasks. Neurourology and Urodynamics, 20(3), 327–328. https://doi.org/10.1002/nau.1001
Turan, N., Kibar, S., Özkul, K., & Tamer, S. (2025). Evaluation of pelvic floor muscle activity, pulmonary function, respiratory muscle strength, core muscle endurance, and functional capacity in children with lower urinary tract dysfunction. Journal of Pediatric Urology. Advance online publication. https://www.sciencedirect.com/science/article/pii/S1477513125004553
Yik, Y. I., Cook, I. J., & Catto-Smith, A. (2017). Physical therapy for fecal incontinence in children with pelvic floor dyssynergia. Journal of Pediatric Gastroenterology and Nutrition, 65(5), 555–559. https://doi.org/10.1097/MPG.0000000000001591

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