Becoming a pediatric physical therapist takes about seven years after high school: four years of undergraduate study followed by three years in a Doctor of Physical Therapy (DPT) program. After earning your degree and passing a national licensing exam, you can begin working with children immediately, though optional residencies and board certification can further sharpen your expertise. The median annual salary for physical therapists was $99,710 as of May 2023, according to the Bureau of Labor Statistics.
Undergraduate Prerequisites
There is no single required undergraduate major for admission to a DPT program. Many aspiring pediatric PTs major in exercise science, kinesiology, or biology, but any bachelor’s degree works as long as you complete the prerequisite coursework. The most commonly required courses are:
- Anatomy and Physiology (two semesters, with labs)
- Biology (two semesters, not botany or zoology)
- General Chemistry (two semesters, with labs)
- General Physics (two semesters, with labs)
- Psychology
- Statistics
Some DPT programs are particular about where you take your anatomy and physiology courses, only accepting them from biology, neuroscience, or integrated physiology departments. Combined anatomy and physiology courses or those completed in a kinesiology department may not count at certain schools. Programs also typically require that prerequisite science courses be completed within seven to ten years of enrollment at a four-year college or university.
Most DPT programs set minimum GPA thresholds, though the actual GPA of admitted students tends to run well above those minimums. The GRE is required by most programs, and each school sets its own acceptable score ranges and policies on retakes. Gaining observation or volunteer hours in a physical therapy clinic, ideally one that treats children, will strengthen your application and help you confirm that this career fits.
The Doctor of Physical Therapy Program
A DPT program is a three-year graduate degree that covers anatomy, biomechanics, neuroscience, pharmacology, and clinical reasoning. You do not need to choose a pediatric track at this stage. All DPT students rotate through multiple clinical settings during their final year, and you can request or select pediatric placements to start building relevant experience.
During clinical rotations, you will work directly with patients under the supervision of a licensed PT. If you already know you want to specialize in pediatrics, seek out rotations in children’s hospitals, school-based programs, or outpatient pediatric clinics. These placements introduce you to the conditions you will treat most often: cerebral palsy, developmental delays, torticollis, Down syndrome, spina bifida, and musculoskeletal injuries in young athletes.
Licensing: The NPTE
After graduating from an accredited DPT program, you must pass the National Physical Therapy Examination (NPTE) administered by the Federation of State Boards of Physical Therapy. Registration, payment, and approval from your state licensing board all need to happen before you receive authorization to test. Exam dates are scheduled throughout the year, and it is your responsibility to confirm your state board has everything it needs before the registration deadline.
Each state also has its own licensing requirements beyond the NPTE, which may include background checks, jurisprudence exams on state-specific practice laws, or additional paperwork. Once licensed, you are legally permitted to evaluate and treat patients, including children, in that state.
Pediatric Residency Programs
A pediatric physical therapy residency is optional but valuable. These programs run roughly 55 weeks and include about 1,000 hours of supervised clinical practice focused entirely on children. Residents treat a high volume of pediatric cases while receiving structured mentorship and advanced coursework.
Completing a residency is one of two pathways to sit for the pediatric board certification exam (more on that below). It also compresses the learning curve dramatically. A new graduate who enters a residency will handle more pediatric cases in one year than many generalist PTs see in several years of mixed practice.
Board Certification as a Pediatric Specialist
The American Board of Physical Therapy Specialties offers a Pediatric Certified Specialist (PCS) credential. Board certification is not required to treat children, but it signals advanced expertise to employers and families. There are two ways to qualify for the exam:
- Option A: Log 2,000 hours of direct patient care with children as a licensed PT within the past ten years, with at least 500 of those hours occurring in the last three years.
- Option B: Complete an accredited pediatric physical therapy residency within the past ten years.
Pediatrics has no additional requirements beyond these two options, making the certification process relatively straightforward compared to some other specialties. Both options require an application fee and a separate examination fee.
Where Pediatric PTs Work
Pediatric physical therapists practice in a wider range of settings than most people expect. The work is not limited to hospitals and clinics. According to the Academy of Pediatric Physical Therapy, treatment often happens in “natural learning environments,” which include homes, childcare centers, preschools, schools, job sites for older teens, recreational centers, and other community locations.
Early intervention programs, which serve children from birth to age three, frequently employ pediatric PTs who visit families at home. School-based PTs work within the special education system, helping students access their educational environment, whether that means navigating a wheelchair through hallways or building the core strength to sit at a desk. Hospital and clinic settings are where you will see children with acute medical conditions, post-surgical recovery needs, or complex diagnoses requiring specialty care, including neonatal intensive care units for premature infants.
Your setting shapes your daily routine. A school-based PT might see eight to ten students a day across multiple buildings. A NICU therapist works with fragile newborns in short, carefully monitored sessions. An outpatient clinic PT might spend 45-minute sessions using play-based exercises with toddlers who have developmental delays, then transition to sport-specific rehab with a teenager recovering from an ACL tear.
Key Skills and Treatment Approaches
Working with children requires a fundamentally different skill set than treating adults. Your patients may not be able to describe their pain, follow complex instructions, or stay focused during a treatment session. Building rapport with both the child and their caregiver is central to every interaction.
One of the most widely used treatment frameworks in pediatric PT is neurodevelopmental treatment, often called NDT or the Bobath approach. This technique uses guided handling and task-oriented activities to help children with neurological conditions develop better movement patterns, balance, and coordination. For a child with cerebral palsy, for example, an NDT-trained therapist uses specific positioning and gentle physical cues to encourage the child’s body to move in more typical patterns, promoting motor learning through active participation rather than passive stretching.
Beyond NDT, pediatric PTs use therapeutic exercise, aquatic therapy, gait training with assistive devices, orthotics management, and constraint-induced movement therapy. Play is not just a way to keep kids engaged. It is a deliberate therapeutic tool. A therapist might have a three-year-old reach for bubbles to improve trunk control or climb an obstacle course to build strength and motor planning skills.
Full Career Timeline
Here is what the path looks like from start to finish:
- Years 1 through 4: Complete a bachelor’s degree with all prerequisite coursework. Accumulate observation hours in pediatric settings.
- Years 5 through 7: Earn your DPT degree. Choose pediatric clinical rotations when possible.
- Year 7: Pass the NPTE and obtain your state license. Begin practicing as a physical therapist.
- Years 7 through 8 (optional): Complete a pediatric residency, roughly 55 weeks of intensive clinical training.
- Years 8 through 10 (optional): Accumulate enough direct patient care hours with children to qualify for the PCS board certification exam, or sit for the exam immediately after residency.
You can begin treating children the moment you are licensed. Residency and board certification enhance your credentials and earning potential but are not prerequisites for pediatric practice. Many PTs build their pediatric hours organically by choosing jobs in children’s hospitals, school systems, or outpatient pediatric clinics right out of school.