Sarah Clark calls a brief halt to the proceedings at the Lindsay home in Bothell. The family has been one of her clients for three years. On this occasion, Clark needs to run out to her car to grab a piece of PCV pipe.

No, as you probably guessed, Clark is not a plumber. She is a physical therapist. Her patient is, in this case, 4-year-old Haley Lindsay, who is a bit of a medical mystery.

Incidentally, the pipe ended up stuffed into a child-size sneaker, one of those with the lights in the soles. The combination became a cane Haley used to stand up for a few minutes and even take a few wobbly steps, Clark on her knees right behind her.

Clark is, by the way, one of 15 physical therapists working throughout the state for the Washington Elks Association.

“I hear that all the time: ‘You work for who?’” Clark said.

Each state Elks association in the country has a charitable enterprise they operate and support. For Washington’s Elks, since 1954, that enterprise has been physical therapy for young children. Clark said if you’ve never heard of the program, don’t be embarrassed.

“The Elks are terrible at tooting their own horn,” she added, though they recently launched a public-relations campaign aimed at advertising the free, in-home therapies available. Young Haley is one of two poster children for the program, gracing billboards and bus advertising throughout the area.

Mom Robin Lindsay said after Haley was born two months premature, she couldn’t roll over, she couldn’t hold up her head. Doctors were mystified.

“Their favorite word for her was ‘perplexing,’” Lindsay said.

Haley’s chief health problem is weak muscle tone. Doctors still don’t know what caused her condition, but Lindsay said her focus long has been on dealing with that condition. She started taking Haley to a physical-therapy clinic, but the therapist wanted an exact diagnosis of Haley’s illness. She also would whisk Haley away from her mom for an hour or so of treatment, which obviously didn’t include mom and which mom couldn’t see.

“It’s a common clinic practice. There’s nothing wrong with it,” Clark said, though she then named several disadvantages to the approach.

For example, as parents often don’t see what’s going on, it’s hard for them to recreate the exercises or experiences later at home. Further, the clinics use highly specialized equipment rarely available outside the clinic. At the same time, Clark insists therapy has to be a regular activity.

“If you only diet once a week, you’re not going to lose any weight,” she said.

Eventually, Lindsay was referred to the Elks program and Clark has been coming to visit at least weekly ever since.

“When she first started coming here, every time was like a revelation,” Lindsay said.

Clark said the Elks place none of the restrictions on her activities that might be imposed by an insurance company or school district, if either was providing or paying for the therapy sessions.

In most cases, the Elks do not impose a limit on the number of visits as would many insurance policies. There is no lifetime maximum benefit after which service is eliminated. On other fronts, many insurance companies demand an exact diagnosis, which Lindsay still doesn’t have for her daughter. For participants, there are no transportation issues. And most importantly to Lindsay, the in-home therapies involve her directly and the activities are designed to be easily recreated.

“I get to be part of it and I know what to work on,” Lindsay said.

The therapy even involves Haley’s younger sister, Addison, and Clark’s loyal assistant, daughter, Rachael, 8.

One technique popular with Haley involves a squeeze bottle and soap bubbles. Producing the bubbles makes her work her lungs along with her arm and hand muscles. When somebody else then takes a turn producing the bubbles, Haley learns some hand and eye coordination popping them.

Haley was a little shy when it came to answering questions. But she now walks with the help of braces and a walker, goes to preschool and swims.

“She has all the components except for strength,” Clark said.

For those interested in the Elks physical therapy program, call 877-544-ELKS or visit their Web site at www.discoverelks.com.