OACRS Best Practice - Physiotherapy Intervention in School for Ambulatory School Age Children with Developmental Delay
Contact(s)/Date(s): Audrey Zambon-Farrant, PT ErinoakKids azambon-farrant@erinoakkids.ca (905) 315-6618 |
Goal:
Definition:
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Measurement of Change (Assessment or Outcome Tools): |
Assessment/Outcome tools used by Physiotherapists for children with Developmental Delay: 1. Outcome Tools:
2. Assessments that contribute to above: 1. Impairment Assessments:
2. Functional/Activity Assessments/Tools:
3. Environmental Assessments:
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Supporting Information: | |
1. Evidence Based Research:
2. Clinical Expertise
3. Family/Client Values
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Intervention Protocols or Process Tools: | |
Therapists determine model and frequency of service each child receives. These decisions are influenced by CCAC guidelines and limitations During times of transition, environmental or physical change there maybe a need for increased service 1. Models of service delivery:
2. Frequency of visits/year:
May also depend upon:
3. Age of child:
4. Parental Contact:
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Discharge Criteria: |
Discharge may be considered when one or more of the following conditions are present: 1. Current therapy goals have been achieved plus:
2. Situation is not amenable to intervention:
3. Minimal or no measurable change over a set period of time was achieved since the onset of intervention. 4. Parent, guardian or client declines further therapy CCAC criteria may affect discharge planning. Re-referral: Does not occur often Reasons:
Checklist of goals (see addendum 1) Clinical pathway (see addendum 2) Next Steps: 1. Dissemination of information to ErinoakKids school care physiotherapists 2. Send Guideline to OACRS BPC 3. Final presentation at OACRS conference 2008 as part of the Best Practise Working Group Presentation |
References:
1 Iversen S et al. Intervention for 6-year-old children with motor coordination difficulties: Parental perspectives at follow-up in middle childhood. Advances in Physiotherapy 2005; 7: 67-76.
2 Chiarello L, Palisano R. Investigation of the Effects of a Model of Physical Therapy on Mother-Child Interactions and the Motor Behaviours of Children with Motor Delay. Physical Therapy 1998; 78(2).
3 Tetreault S, Parrot A, Trahan J. Home activity programs in families with children presenting with global developmental delays: evaluation and parental perceptions. International Journal of Rehabilitation Research. 2003; 26(3): 165-173.
4 Mahoney G, Robinson C, Perales F. Early Motor Intervention: The Need for New Treatment Paradigms. Infants and Young Children 2004; 17(4): 291-300.
5 Valvano J, Rapport MJ. Activity-focused Motor Interventions for Infants and Young Children with Neurological Conditions. Infants and Young Children 2006; 19(4): 292-307.
6 Iverson, M et al. Creating a Family-Centered Approach to Early Intervention Services: Perceptions of Parents and Professionals. Pediatric Physical Therapy. 2003; 15(1): 23-31.
7 Cameron E, Maehle V, Reid J. The Effects of an Early Physical Therapy Intervention for Very Preterm, Very Low Birth Weight Infants: A Randomized Controlled Clinical Trial. Pediatric Physical Therapy. 2005; 17(2): 107-119.
8 Wong SY et al. Effects of an Education Program on Family Participation in the Rehabilitation of Children with Developmental Disability.
9 Sayers L, Cowden J, Sherrill C. Parents perceptions of motor interventions for infants and toddlers with Down syndrome. Adapted Physical Activity Quarterly 2002; 19(2); 199-219.
10 Schreiber, J. Increased intensity of physical therapy for a child with gross motor developmental delay: a case report. Physical & Occupational Therapy in Pediatrics. 2004; 24(4): 63-78.
11 Montgomery, Patricia C. Predicting potential for ambulation in children with cerebral palsy. Pediatric Physical Therapy. 1998; 10(4).
12 Campbell S.K.: Physical Therapy for Children; W.B. Saunders Company, Toronto, (1994) p.459-488
13 Thames Valley Children Centre: A Physiotherapy Model of Service Delivery For Children with Developmental Delay Who Walk Independently at School; August 31, 2004
14 Client Groupings Model: Physical and Cognitive Descriptors; Erinoakkids, Mississauga, October 2008
Significant contributions to this project
Jayne Temple, PT (ErinoakKids)
Jacqui Rivers, PT (ErinoakKids)
Ann MacPhail, PT (Uof WO)
Joanne Assini, PT (TVCC)
Sada Hallman, PT, (ErinoakKids)
Brenda McNair, PT
Addendum 1
(Adapted from Thames Valley Children Centre’s “A Physiotherapy Model of Service For Children with Developmental Delay Who Walk Independently at School”) 13
PT Goals Checklist
(Percentages were calculated from the Survey Monkey of how common the goal is addressed by Physiotherapists across the Children’s Treatment Centres. Items without a percentage were taken from comments sent back in the Survey Monkey but not from the questions therefore a percentage could not be obtained.)
- Primary Goals
- Safe ambulation to all places within the school
- Safe on playground equipment (home or school) 100%
- Safe on stairs (89%)
- Classroom gym participation 78%
- Equipment needs 78%
- Additional School Goals
- Ride a bike/trike
- Safety and mobility for school trips into the community (this may be achieved with specialized equipment). 56%
- Successful transition from elementary school to high school 56%
- Musculo-skeletal Related Goals
- Client has been provided with an exercise program to address needs and prevent secondary impairments 89%
- Appropriate footwear and orthotic inserts as required
- Community Related Goals
- Client and caregivers have been provided with information of appropriate Community programs and their physical benefits have been outlined 89%
- Participation in community athletic program/recreational activities 56%
Other
Referral to other services ( e.g. nutritionist, behavioural program)
Addendum 2