Helping high-risk infants is Smith’s passion

She’s known as “The Baby Whisperer.”

For 25 years, Cathie Smith has been a valuable member of the physical therapy department at the University of Tennessee at Chattanooga. During her tenure at the university, Smith has become a recognized expert in pediatric physical therapy — particularly for her work in neonatal intensive care units — and she is well-known in the Chattanooga community for her work in children’s therapy services.

“Cathie has an amazing gift when handling fragile babies and children,” said Debbie Ingram, Smith’s longtime friend and colleague.

Ingram, who began a yearlong transition as physical therapy’s outgoing department head last May, was one of the first people hired to launch the fledgling UTC physical therapy program 30 years ago. Five years later, Smith joined the department.

“Cathie can hold those teeny, tiny little babies that fit in the palm of your hand,” Ingram says. “As a neonatal physical therapist, she assesses movement and provides interventions for preterm babies. These fragile babies are the size of a glass Coke bottle. The calmness that she portrays is not something I could have done.”

It takes a unique person to devote one’s professional career to working with delicate tiny newborns. You must be an educator. You have to be a people person. You need to master the ability to navigate working with scared, confused parents; you’re advising them, you’re assuring them and reassuring them. And you’re doing the same with students and staff members.

What exactly does a neonatal physical therapist do? As a therapist working in the neonatal intensive care unit (NICU) with medically fragile newborns, Smith explained, “the primary role is to provide neuroprotective care to help reduce the extrinsic stressors that these very immature babies are experiencing because they are prematurely taken out of the protective environment of the maternal womb.”

Her work focuses on helping to support brain protection for babies as they grow, particularly those born prematurely or are extremely medically fragile because of some medical condition, congenital anomaly or other infectious disease process contracted as a newborn.

“As a physical therapist, we work collaboratively with the staff to help identify strategies to deliver the care that needs to be done for the infant in a way that helps to reduce the stress to their immature body systems,” she said.

“We don’t direct the care prescription but, if a baby has a low handling threshold, for example, we will work with staff to help identify ways to make the caregiving procedures less difficult and easier to tolerate. We also provide direct services to support the infant’s early movement experiences to help optimize development after being discharged from the NICU.”

Education is a big part of it. Smith works with parents to help them understand their infant and the limited capacities their baby has. She said it is imperative to help parents appreciate the baby’s strengths but also understand the limitations. There is always uncertainty when it comes to the birth of a preterm baby.

“Helping parents understand what’s happening and teaching them how to protect and support their young infant to get off to the best start possible is how I ended up in the neonatal intensive care unit,” Smith said.

“I found that the NICU is a compelling touchpoint for families. It provides an opportunity to help launch fragile families along a course that helps them better understand the strengths and challenges of their new baby as well as helping them learn how to access resources within the healthcare system that will support the infant after leaving the hospital. If follow-up is needed, they already know how to go about looking for resources for their children.”

Smith, who received her master’s and one of her doctoral degrees from UTC, initially came to Chattanooga as a pre-med student. She was recruited to participate in a couple of survey research projects being conducted by the psychology department.

“It was a profession/vocation preference survey,” she recalled, “and I said, ‘Sure, I’ll do it.’ It pointed to two occupations that would be well-suited to my temperament and personality—being an auto mechanic or a physical therapist.

“It prompted my interest because I didn’t know much about physical therapy, so I decided to find out more about it. I investigated the field, did some volunteering, was intrigued by what physical therapists did and ended up going into PT. I never looked back.”

With over 40 years’ experience in the field of physical therapy, including the last 25 in the educational arena, Smith can speak to the growth of the profession.

“Particularly in the area of pediatrics, there’s been a phenomenal amount of growth,” she said. “It has been interesting to watch how the profession of physical therapy and the practice of managing young children with mobility challenges has changed through the decades. Perhaps the most remarkable change has been the way technology has supported our understanding of what happens with the movement system as children mature.

“Since I’ve been at UTC, I have always maintained an active role in clinic practice by providing PRN services at the Children’s Hospital at Erlanger in the neonatal intensive care unit. As I have continued to watch the clinical side of our profession grow, as well as the academic side, it has become more evidence-based in the way we do things. There is so much physical therapy can do to enhance the movement experiences of children to enrich their life outcomes.”

Smith has earned many honors for her work along the way, including being one of the National Association of Neonatal Therapist’s inaugural Pioneer Award winners.

“That made me feel kind of old when I won that award,” she joked. “It’s always reassuring to be recognized by your peers as having made a significant contribution.”

But even more significant has been helping prepare new clinicians to carry on the work of physical therapy, calling it a privilege for which she will always be grateful.

“The thing that makes the most difference to me,” Smith said, “is when students contact me and say, ‘You may or may not remember me. I graduated five years ago, but I would like to ask your advice about a patient. Can you help me?’”

Smith and Ingram will be retiring from UTC later this spring, and the physical therapy department has created endowments for both. The fund for Smith is called “Expanding Horizons Fund in honor of Dr. Cathie Smith,” and it will support students as they participate in service-learning and community engagement.

It will be a lasting tribute to help future generations of UTC physical therapy students learn about the work of a forerunner in the field.

“Cathie has always had a gentle spirit about her,” Ingram said. “She’s a gifted professor and a cherished colleague, and we call her ‘The Baby Whisperer.’ She can cradle a baby, and that baby will quit crying, quit wrestling. She truly has a gift.”