Step by Step Intensives Frequently Asked Questions

Why does an Intensive lead to better progress than weekly therapy?

Research has clearly shown that periods of intensive therapy lead to rapid progress in patients with neurological diagnoses. That has been best practice in stroke and spinal cord injury rehabilitation for many years.


Intensive periods of therapy for children with early acquired brain injuries, such as cerebral palsy, is still not standard of care in spite of the research that exists.

Dr. Karen Pape's new book, The Boy Who Could Run But Not Walk is the first book that clearly explains pediatric neuroplasticity, why intensive therapy works and how the therapy should be organized, both in terms of timing and content.


This  book is written for parents and it should be read by every parent who wishes to advocate for better therapy for their child.


Dr. Pape has been Pia's mentor for more than 15 years. Step by Step Intensives were created as a result of this mentor-ship.

What is the length of a Step by Step Intensive?

3 days, 3 hours per day:

A short Intensive contains a thorough assessment and creation of long and short term goals as well as a detailed home program. Parents will leave with a good understanding of of the components of the home program, the reasons for each component and the ability to carry out the program.

5 days, 3 hours per day:

A week long intensive contains the same components as a 3-day Intensive plus significantly more actual therapy provided by the highly trained therapists at Step by Step.

With this length of an intensive, the therapists will get a much deeper understanding of the child's strengths and challenges

10 days, 3 hours per day:

The 2-week intensive contains the same components as a 5-day Intensive, but much more time  is spent on actual treatment. Many, many repetitions of perfect movement patterns is what creates permanent changes, a well known paradigm for professional athletes

What are the components of a Step by Step Intensive?


is assessed and treated starting with the trunk and moving out to the extremities. This may involve fitting of a trunk orthosis such as a Spio garment or a TheraTog. Once alignment has been accomplished we move to the next component

A Step by Step Intensive consists of 4 specific components that are completed in the same order with each child.

2. Awareness

How aware is the child of different areas of his body? Without awareness we cannot learn movement.

Awareness interventions include compression garments, sensory stimulation and EMG Biofeedback.


/activation of muscles in the best possible patterns. Interventions include therapeutic techniques to facilitate movement such as tapping, vibration, EMG Biofeedback and EMG Triggered Stimulation

4. Strength

Many muscle groups are week: low-tone muscles, spastic muscles and muscles opposing the spastic muscles. Strength cannot be build until there is good alignment, awareness and the ability to activate appropriately

What are the different diagnoses Step by Step Intensives are designed for?

Step by Step IntensivesTM are designed for children and adults with the following diagnoses:


  • Mild to moderate cerebral palsy

  • Strokes

  • Pre and post Selective Dorsal Rhizotomy rehabilitation

  • Pre and post orthopedic surgery

  • Hemispherectomy

  • Brain Injury

  • Brachial Plexus Injury

How do I know if a Step by Step Intensive would be beneficial for my child?

You will be asked to provide detailed information about your/ your child's function including submitting videos and pictures. We will look at the information provided to determine if a Step by Step Intensive would be beneficial. In general the Step by Step Intensives are most beneficial for clients with mild to moderate disability.

If you/ your child meets the criteria, we will be able to schedule the intensive.  We are not able to perform extensive record and video reviews or schedule phone conferences as our clinicians are very busy.

It is an option to have a thorough record and video review and schedule a time to talk to one of our clinicians in detail about your child. There is a $150 fee for this service that will be deducted from to the cost of an intensive.

What is the cost of a Step by Step Intensive?

The cost of a Step by Step Intensive depends on how much direct therapy you/ your child needs. Once you are ready to book the intensive you will be asked to pay a deposit to hold the slot.

Where can we stay during the intensive?

There are multiple hotels within 5 miles of the Step by Step Therapy Center.


The Ronald McDonald House, 3 miles from our Center, may house families coming in for Intensives for a nominal fee. For more information about the Ronald McDonald House please contact us or the Ronald McDonald House directly:

For questions or to book an intensive

To request information about our intensive please contact:

Or call 585-258-3810 and ask for Laura C.

We will send you a list of information and videos we need for determining if your child would benefit from a Step by Step Intensive

Thank you for your interest in Step by Step Intensives

Call to schedule an evaluation


Fax: 585-427-7410

1057 East Henrietta Road,

Suite 500

Rochester, NY 14623

Clinic Hours: Mon, Tues & Thurs 9-5pm

                       Wednesdays 9-6pm

                       Fridays 9-2pm

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