Boston Children’s Hospital Department of Physical Therapy: Boston Children’s Hospital was a pioneer in the field of physical therapy, playing a significant role in the early development of the profession. Two nearby schools, the Sargent School of Gymnastics in Cambridge (1881) and the Boston Normal School for Gymnastics (1889) educated and trained students on corrective exercises and medical gymnastics which proved useful to the fields of orthopedic surgery and neurology. Three specialty clinics at Children’s would later contribute to the formation of an independent Department of Physical Therapeutics in 1914. First, Dr. Edward H. Bradford, Chief of Orthopedics, established the Lateral Curvature of the Spine clinic in 1897, the first clinic to address a specific diagnosis. Patient programs were organized and implemented by Miriam T. Sweeney, who would later become the first director of the Department of Physical Therapeutics. In 1911 Dr. Robert Lovett established the second diagnosis-specific clinic, the Infantile Paralysis Clinic, with Miriam T. Sweeney and Janet Merrill (the second director of the Department of Physical Therapeutics). A year later neurologists Dr. Bullard and Dr. Thomas established the third diagnosis-specific Clinic for Muscle Training of Paralytic Cases directed by Jennie Colby. On April 1, 1914, the Children’s Hospital Board of Directors, in recognition of excellent short and long term patient care, established the Department of Physical Therapeutics. The clinic on Longwood Avenue was open five days a week Monday through Friday, and also Saturday mornings. Dr. Robert Lovett and Miriam Sweeney actively taught courses to doctors and students at the Sargent School and the Boston Normal School. In the summer of 1914, Dr. Robert Lovett was asked by the Vermont State Board of Health to assist in providing treatment following an outbreak of infantile paralysis. Quickly training nurses and physicians, Lovett opened several free public clinics throughout Vermont in December 1914, with more added in 1915, 1916 and 1917. This clinical system of treatment became known as Lovett’s “Vermont Plan.” In 1914, his assistant Wilhelmine G. Wright, a physiotherapist educated in Germany, devised a system for evaluating muscle function and trained young women in this type of muscle testing. Janet Merrill, Helen King and Rebecca Selfridge were just a few of the many women who helped carry out the Vermont Plan, and brought elements and skills associated with it to their later work. The “Vermont Plan” was later applied locally in 10-15 communities around Boston by the Harvard Medical School, with the central supervising clinic based at Children’s called the Harvard Infantile Paralysis Clinic, headed by Dr. Arthur Legg with assistance from Janet Merrill.

World War I presented a significant concern due to the lack of organized care for the wounded, as was available in Europe. In order to properly assist the wounded of World War I, on August 22, 1917 the United States Surgeon General’s Office established the Division of Special Hospitals and Physical Rehabilitation. Two doctors at Children’s, Elliott Brackett and Joel Goldthwait, were asked to help devise a curriculum. In 1918, Dr. Robert Lovett along with Janet Merrill, the director of the Department of Physical Therapeutics, began organizing training programs for Reconstruction Aides at Children’s Hospital. After World War I, Harvard Graduate Medical School developed and offered a training program for Reconstruction Aides and post-graduates from 1921-1929, but the entry level graduate course taught by Dr. Arthur T. Legg, Dr. James Warren Sever and Janet Merrill continued to be offered until 1946. By 1930, only 11 schools met the educational standards of the American Medical Association (AMA) for physical therapy instruction, and two were in Boston: Harvard Medical School (Courses 441 & 442) and the Boston School of Physical Education. Wishing to preserve the role of Reconstruction Aides after the completion of training, many of the Reconstruction Aides trained both during and following the war helped establish the American Women’s Physical Therapeutic Association (AWPTA) in 1921 which served to develop standards for the new profession.

In 1917, the Department of Physical Therapeutics consisted of solely the director and one paid assistant, with most assistance coming from women enrolled in courses taught at Children’s. By 1929, the Department of Physical Therapeutics worked with patients in the Scoliosis and Posture Clinic, the Light Therapy Clinic, the Harvard Infantile Paralysis Clinic, the Muscle Training Clinic as well as with other medical, orthopedic and surgical patients. In 1930, the department moved to the new Bader building, which included a gym, library and heated pool on the first floor, and a large carbon arc solarium and a functional training room on the sixth floor.

In 1946, Harvard Medical School discontinued patient care relationships, officially ending the course for graduates which had been taught with the help of physicians at Children’s. As a result, Children’s moved its graduate course to Simmons College in 1947 and was renamed the Simmons College Physical Therapy Program. The affiliation between Children’s and Simmons lasted until 1981 when Simmons College assumed full responsibility for the program. Chief of the Department of Orthopedics Dr. William T. Green was the first Medical Director of the program and Shirley M. Cogland (the third Director of the Department of Physical Therapeutics) became the program’s first Technical Director. In January 1972, Claire F. McCarthy succeeded her as the fourth Director of the Physical Therapy Department and undertook the positions of Assistant Professor and the Education Director of the Simmons College Physical Therapy Program. In 1970, Dr. John Hall, Clinical Chief of the Department of Orthopedics, succeeded Green as the Medical Director, followed by Dr. Melvin Glimcher a few years later. During McCarthy’s tenure as Education Director, the Simmons College Physical Therapy Program expanded from 16 to 32 students per year, opened the certificate program to male students and hired two full-time faculty with dual appointments at Children’s Department of Physical Therapy for research and educational endeavors, though the latter arrangement ended in 1981 with the end of Children’s involvement in the Simmons program.

As a result of Harvard Medical School’s decision to discontinue patient care relationships, the Harvard Infantile Paralysis Commission moved to Children’s in 1946 and was renamed the Massachusetts Infantile Paralysis Commission. Polio epidemics of 1949, 1953 and 1955 necessitated the training of more physical therapists. By 1964, the department employed 20 physical therapists and assumed multiple responsibilities in other clinics. Under the urge of Shirley Cogland, Associate Director Elizabeth Zausmer approached Dr. Harry Shwachman about applying physical therapy techniques of breathing training and postural drainage to the treatment of patients suffering from cystic fibrosis as well as other respiratory diseases. As one of the first physical therapy departments in the country to do as, Children’s became involved in the teaching of two one-week courses throughout the country in postural drainage techniques.

In the 1960s, Dr. Alan Crocker and Elizabeth Zausmer, now Director of Training for Physical Therapists, directed the Developmental Evaluation Clinic. In 1971, Dr. John Hall and Dr. William Miller created the Boston Bracing System for adolescent scoliosis. In 1975, physical and occupational services began to be offered at the Wrentham State School for almost a dozen years. Claire McCarthy began Occupational Therapy Services at Children’s in 1978 and also helped establish the Sports Medicine Division for sports related injuries. In 1991, Children’s began offering on-site therapy for dancers at the Boston Ballet School making Children’s the first hospital in the country to sign a formal contract with a ballet company. McCarthy also oversaw the opening and functioning of the Functional Mobility Clinic and the Adaptive Equipment Clinic which were established in the late 1990s.

Physical Therapy Department Directors:

1914-1917: Miriam T. Sweeney 1917-1951: Janet Merrill 1951-1972: Shirley M. Cogland 1973-2002: Claire F. McCarthy 2002-2010: Michelina Cassella 2010 – present: Laura Jaweed

Information taken from:

Boston Children’s Hospital. The Annual Reports of the Children’s Hospital. 1910-1977.

McCarthy, Claire F and Michelina Cassella. “Department of Physical Therapy: 100th Anniversary, 1914-2014.” Presentation at the 100th Anniversary of the Hunnewell Building at Boston Children’s Hospital, Boston, MA, April 3, 2014.

Physical Therapy Associations: The American Women’s Physical Therapy Association (AWPTA) formed in 1921, with Mary McMillan as President and Janet B. Merrill (Second Director of the Physical Therapy Department) as Treasurer and Secretary. The association changed its name to the American Physiotherapy Association (APA) in the late 1930s, and then again in the late 1940s to the American Physical Therapy Association (APTA). In 1933, the APA asked the AMA for assistance with accreditation, leading to the creation of the American Registry for Physical Therapists (ARPT) in 1935, which helped establish an examination that aimed to standardize the education of the new profession. The American Physical Therapy Association – Organization of Vocational Rehabilitation branch (APTA-OVR) was established in 1955, and the American Physical Therapy Association – Vocational Rehabilitation Administration branch (APTA-VRA) was established in 1964 to further advance and establish the profession. Shirley Cogland was involved in the formation of the Council of Physical Therapy School Directors (CPTSD) which grew out of the School Section of the APTA in 1952 and elected to remain independent of the APTA as a separate organization focused on education.

Information taken from:

Swisher, Laura Lee and Catherine G. Page. Professionalism in Physical Therapy: History, Practice and Development. St. Louis, MO: Elsevier Saunders, 2005.