Frequency participation and type of physical therapy sessions performed during the four-week period before tracheostomy placement and after the first tracheostomy change were collected and compared. Supporting care giving tasks include obtaining vital signs, diaper change, suctioning and repositioning through containment, pacing etc. Facilitation of state control includes providing pacifier, rocking, patting etc. to assist with calming. Supine and/or side-lying play include reaching, hands to midline, exploration tasks. Postural skills include facilitation of improved posture in supported sitting and/or prone position. Postural re-education includes more active postural training such as head control, righting etc.