Tots FAQs - Parents

TMR Tots (Tots) is a therapy concept in which the therapist assesses the mobility in the whole body (Total Motion) and treats areas of limited mobility (Release). Areas of limited mobility create imbalances in posture and ability to perform skills. A solid balanced vertical postural foundation is a prerequisite for skill achievement. Using a systematic assessment key areas of blocked mobility are identified and treated to free up and correct imbalances, improving mobility in a fun, effective, scientifically based and pain free method. The Total Motion Release (TMR) system includes both treatment by the therapist plus caregiver instruction to build on a child’s strengths and comfort. A home program of therapeutic play and positions to empower the family to help their child progress between therapy sessions and is developed and customized to match the families schedule, interests and participation in daily routines. Therapists require licensure in the state in which they are practicing.  Many states allow telemedicine visits if travel is difficult, however, in an in-person consult it is often easier to identify subtle blocks in mobility. State regulations concerning telemedicine are varied. Please contact your local therapist to determine if this service is available.

1. The objective of Tots is not to try to make you a therapist or give you more work.

2. It is developed and customized to match the families schedule, interests and

participation in daily routines. 

3. The Tots system includes both treatment by the therapist plus caregiver instruction to build on a child’s strengths and comfort.

4. A home program of therapeutic play and positions empowers the family to help their child progress between therapy sessions.   

5. It helps you understand what makes your child comfortable and what he can do that is easy to able  build on these positions and activities in comfortable play and positions.

6. Tots also helps you understand where you child struggles to eliminate frustration and discomfort.

Tots positioning and play activities are incorporated in your daily routine matched with your activities and interests to make the time you are already spending together therapeutic, not give you more work in an already too busy schedule!

The primary goal of Tots is to develop symmetrical alignment and postural control needed as a foundation for balance and skill development. Rather than working on a skill that a child may be struggling to achieve, Tots identifies and treats the block limiting achievement.

Each session follows an assessment and treatment protocol.  Following a brief assessment of your concerns the therapist will test the TMR TOTS motions to identify key areas of limited mobility which will guide the treatment. The therapist will select the exercises that will be the most comfortable for your child to learn to assist moving into directions of ease and emerging control. Following exercises their new found mobility will be measured to identify the area previously inaccessible.

Your child is then provided sensory experiences to feel, learn to explore and move into this new abatable range which we call “The Discovery Zone”  EG: This range might be improved range of head control, ability to roll further, or reach for an object.

Next an activity is selected that motivates the child to reinforce the new found range supporting or using the improved alignment or posture and maintain the gains made in the session.

Finally the therapist provides the caregiver with a choice of positions and activities that will enhance and build on abilities in the newly accessed range.  The caregiver discusses and explores how they might fit these positions of fun and comfort into their daily routine.  They demonstrate their ability to assist their child and are provided feedback to insure confidence in continuing to help their child at home.

A. Total Motion is Total Child/Total Family. Traditional therapy practices utilize the 3 objectives of the International Classification of Function (ICF) Model for treatment:

• Body Structure & Function

•.Activities

• Participation

Focus, in an ideal treatment include the 5 F’s of Therapy:

• Family

• Fun

• Fitness,

• Friends,

• Function.

Tots matches these areas in development of the individualized Tots home program with the family and adds 3 additional F’s to the treatment concept

•  Future -Analysis and projection of the negative impact of alignment problems with growth

•  Faith -Optimism and inspiration to discover  hidden potential not yet accessed

•  Flexibility - Matching family’s unique needs and interests for empowerment and participation       

Therapists require licensure in the state in which they are practicing.  Many states allow Telemedicine visits if travel is difficult, however in an in-person consult it is often easier to identify subtle blocks in mobility. State regulations concerning Telemedicine are varied. Please contact your local therapist to determine if this service is available.

The website branchly.com is a Parent/Caregiver resource list where many therapists are listed Should you not find a therapist listed on that site branchly feel free to contact Susan Blum PT, C/TMR at (717) 880-7244 or tmrtots@gmail.com

You can register for the Tots training as a parent at a special discounted rate. Once you register you will have access to a home study to get started. Later you can stream or attend a class when it is convenient   Once you complete the home study or attend a class, you can contact the instructor for individualized coaching to help you implement the Tots concept with your child. To register for a seminar, go to

tmrtots.com, click on Register for a Seminar, click on register for Tots 1, pick a date that fits your schedule, and click the Parent link to register

a)  Alaska, Hawaii and European participants can attend Sat & Sun afternoon/evenings for 4 hours on 2 consecutive weekends since classes are streamed from the New York (Eastern USA time zone)          

b)  Asian & Australian/New Zealand/Singapore/Philipine participants can attend on Saturday & Sunday mornings or afternoons for 4 hours on 2 consecutive weekends since classes are streamed Fri & Sat evenings from the New York (Eastern USA time zone).

To register for a seminar, go to tmrtots.com, click on Register for a Seminar, click on Register for Tots 1, pick a date that fits your schedule, and click the Parent link to register

Onsite courses are offered on 2 consecutive weekdays when faith limits weekend attendance. Streaming options are available on Thursday and Saturday for 2 consecutive weekends.

a) No. Classes are offered both onsite and online to meet your learning style. All labs are done using only a doll so that streaming Tots 1 can be just as beneficial as in person class.       

b) 1:1 feedback is available in post course coaching.       

c) Since telehealth strategies were added to the course in 2020, many attendees reported that they no longer needed to come in person. The class is live streamed to 6 continents.         

a) No. As long as you have a computer you will just click on a link to be taken to a zoom webpage. All you need to know is how to get on a Zoom video using the link provided.       b) Your best option is to use a PC or Mac in order to view both the lecture slides and demonstrations in a side by side setting You are invited to chat and ask questions throughout the day.Note: A computer is preferable to a tablet so that you can simultaneously view both the PowerPoint videos & the instructor as well as pin fellow participants during certain online Demos.

c) The moderator can generally help you if you are having issues once you are signed on.

 a) Coaching (Free) - Free post course follow up via zoom, email, or by phone is included in your registration. This allows the instructor opportunities to support the participant in understanding and implementing the course material. Coaching provides an opportunity bring your question or challenges and share successes. Hours are planned to accommodate various time zones and schedules.       

b) Consults (Fee based) - Observation of the treating therapist by the instructor as they work with an individual client during a therapy session. Most beneficial for challenging cases to brainstorm and offer assessment and treatment ideas 

Retakes are always free. Depending on space limitations new participants have priority registering for an onsite course. Confirm availability with the instructor before booking non-refundable travel arrangements.

 Ideally your current therapist can take an online training offered frequently throughout the year.  Often parents either do a consult or take the training to get started and then encourage a local therapist to register for a class to continue the progress in their treatment.

You and your therapist can have a zoom consult to develop a care plan. This will enable them to apply the specific strategies you need now. There is a small charge for the instructors time

At your TMR consultations, the therapist will develop a specific plan of care to bring back home to your treating therapist.

Many states require a prescription for a physician either for insurance reimbursement or treatment.   Request a prescription with your child’s diagnosis and diagnosis code written as “Physical Therapy - Evaluate & Treat” “Occupational Therapy - Evaluate & Treat”. Many providers are cash based for a nominal fee and will provide an invoice for out-of-network services such as evaluation, therapeutic exercise, manual treatment, etc. Check with your insurer for your coverage.