Toki Strong Keeps the Children of Marin Moving

Pediatric physical therapist works with youths who have physical disabilities and developmental delays to promote their progress & independence.

Toki Strong, a pediatric physical therapist working for California Children Services in Marin County, works with the youth in our community who have varying levels of physical disability and developmental delays to promote developmental progress to ensure that our kids can achieve lives of functional independence.


1. What department are you in, and what kind of work do you do?

I am a pediatric physical therapist working for California Children Services, which is part of the Health and Human Services department. My patients range in age from birth to 21 years of age and present varying levels of physical disability and developmental delay. I work to promote overall functional independence in daily activities through calculated developmental progression and constructive play.

2. How long have you been with Marin County, and what is a typical day like for you?

I’ve worked for the county for 12 years and our clinic is open from 8:00-4:30, daily. Each day is a different schedule of kids with treatment sessions last from 45 minutes to an hour.

A typical day for me will start with treating babies in the morning, working on developmental progression that involves rolling, transfers from supine to sitting up, and even crawling. I spend a good deal of time on the floor or on our raised mats working with kids on their level.

 As the day progresses I’ll typically have older and, sometimes, more physically active kids. We will work together on balance and coordination activities - that can include anything from obstacle courses or ball play to tricycle riding. I use swings, large gym balls, balance training tools and treadmills for treatments, varying on the developmental status of the patient and the goals that we establish in collaboration with their families.

3. What kinds of problems do you solve most frequently?

Sometimes, I will work with my patients weekly for several years to meet their developmental goals to do whatever we can to help them be as functionally independent as possible. However, I don't always get to "solve" problems, as the patients we treat don’t always progress as much as we would like and some continue against steep challenges and require assistance throughout their lives. But, other patients I work with will progress incredibly well and meet the goals for their appropriate function levels so successfully that we will graduate them from our program.

4. Is there one particular project or accomplishment you would say is emblematic of your work?

This is a touch question, as our work is not project based. Our treatment sessions change every day depending on progress already made and the new task at hand. Every day brings a different mix of kids and parents so it is always, literally, a new day. Any day can have a new success or a rewarding accomplishment but there can also be weeks with little progress and frustrations felt from our patients and their families. Overall, the kids make coming to work playful and fun every day and always keep it interesting and incredibly challenging.

5. What do you consider a victory on the job?

When a child can graduate from our program and no longer requires physical therapy intervention, it is an incredible moment. On one hand, it is sad to see them go – often we have known them since they were infants – but it is always so rewarding to know that we have helped them achieve their full motor-skill potential and  have enabled them to lead happy and productive lives.

6. What are the biggest challenges you and other members of your team face?

Our biggest challenge is working with those patients who do not make progress with their gross motor development and we don’t reach their physical therapy goals. As a state organization, we have to show developmental progress through reporting and standardized developmental testing. When a patient no longer shows progress, we need to decrease our services and this is always very difficult for the families to accept. Having to tell a parent that we can no longer work with their child is so very hard and incredibly emotional. This is the hardest part of my job.

7. What would happen to Marin if your department were downsized or eliminated?

The children of Marin County who need our services would no longer be able to access the physical and occupational therapy that enables them to become more independent and functional in their daily lives. They would, ultimately, require more surgery, hospitalizations and other (costly) interventions that can be incredible traumatic for kids and financially debilitating for families. 

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