Pediatric motor therapists see children of all ages with a variety of diagnoses. It can be overwhelming to decide how to evaluate and treat any given patient. In addition, each child is unique, and a “cookie cutter” approach to assessment and treatment should be avoided.
Michelle Fryt Linehan – The Child in Front of You
CURRENT MODELS FOR DECISION-MAKING
International Classification of Functioning, Disability, and Health (ICF)
Description of short lists
Evidence-Based Practice/Rehabilitation
Important concepts
Awareness
Consultation
Creativity
Judgment
CASE STUDY #1: CHILD WITH CEREBRAL PALSY
Description of Child
Diagnosis/background/video
Family’s goals
Goal Attainment Scale (GAS)
Use of Observation as Evaluation Tool
PIQ form
Use of ICF Template to Discuss Evaluation and Treatment Ideas
Evaluation tools for infants to older children
GMFCS
MACS
GMFM
Spasticity vs. hypertonicity
Oregon Project
Cortical visual impairment scale
Caroline Curriculum
UE assessments
SCALE
Intervention ideas
Kinesiotape
Aerobic exercise
Adaptive equipment
Electrical stimulation
Partial body weight training
Theratogs TM
When to discharge, discontinue, decrease therapy
CASE STUDY #2: CHILD WITH DEVELOPMENTAL DELAY
Description of Child Diagnosis
Background
Video
Family’s goals
Use of Observation as an Evaluation Tool
PIQ form
Use of ICF Template to Discuss Evaluation and Treatment Ideas
Evaluation tools for infants to preschoolers
BSIDIII
PDMS-2
TIMP/TIMPS
DAYC
HELP
Lois Bly’s checklist
Intervention ideas
When to discharge, decrease, change in frequency
CASE STUDY #3: CHILD WITH IDIOPATHIC TOE WALKING (ITW)
Description of Diagnosis
Evidence-based practice related to ITW diagnosis and assessment
Toe walking tool
Visually-related issues
Weakness related to biomechanics
Sensory processing issues
Long-term sequelae
Goals:
Patient’s/family’s
Clinical outcomes desired
ICF Format for Assessment and Interventions
Assessments
Body function
Structure
Activities and participation
Interventions
Evidence-based practice related to ITW treatment
Separation by etiology
Cincinnati Children’s Hospital Algorithm
Motor control sequence ideas
Lengthen and strengthen
Casting
Orthotics
Surgery
Weight on heels
Sensory approach
CASE STUDY #4: CHILD WITH DEVELOPMENTAL COORDINATION DISORDER (DCD)
Deciding on this Diagnosis
Definition and diagnostic code
Research related to co-morbidities
Profile of child with DCD
DCD questionnaire for parents
Assessment
Tests most commonly used
M-ABC2
BOT-2
COPM
COMPS
Intervention
Intervention from research
Dynamic systems vs. deficit-oriented
Neuromuscular task training
Cognitive orientation to occupational performance
Deficit-oriented
Proprioception
Strength
Timing
Other Research Ideas
Use of aquatic therapy and protocol
Rhythmic movement training
Motor imagery
Infinity walk
Case Study
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Description:
Pediatric motor therapists see children of all ages with a variety of diagnoses. It can be overwhelming to decide how to evaluate and treat any given patient. In addition, each child is unique, and a “cookie cutter” approach to assessment and treatment should be avoided. One must base the treatment plan on the child’s particular attributes, the family’s wants and needs, and the therapeutic environment.
This recording will introduce therapists to the use of the ICF model and Evidence-Based Practice (EBP) and show how these can be utilized to move from the initial evaluation until discharge, keeping the child, family, and environment as fundamental pieces of this process. This will be done in a case study format that will encourage general discussion. Diagnoses to be discussed include cerebral palsy, developmental delay, idiopathic toe walking, and Developmental Coordination Disorder.
