Collaborative Developmental Monitoring Part 1
This introductory online physiotherapy course focuses on the overall results of the Move & PLAY and On Track Studies, which are both cohort studies that were conducted with large samples of children with cerebral palsy and their families living in both Canada and the United States.
Two major products of the Move & PLAY study are:
- A comprehensive tool-box of measures that are brief and clinically feasible to administer, as well as being reliable and valid.
- Testing of a conceptual model of child, family and service determinants and their relationships to outcomes of motor function, self-care performance, and leisure participation.
In the On Track Study, we produced longitudinal curves and reference percentiles for all measures produced in Move & PLAY, which assist with understanding children’s prognoses, relative strengths and limitations, and interpretation of change over time.
These overall results assist in obtaining a more comprehensive understanding of individual children than has previously been possible, which assists with tailoring interventions. A weakness is that the Move & PLAY study was limited to children 18 months to 5 years of age.
The On Track Study included children 18 months to 12 years of age. The major barrier to implementing these results into practice is therapists’ need for TIME to learn how to administer, interpret, and use these research outputs. We have purposefully worked hard to ensure that each therapist- and parent-administered measures can be completed in a timely manner, once learned.
Relevance to Physiotherapy Practice
Children with cerebral palsy are heterogeneous and complex. This precludes the exclusive use of evidence from randomized controlled trials (RCTs) to inform clinical decisions about services for individual children. We propose an evidence-based approach to complement RCTs using results from the Move & PLAY and On Track studies.
We advocate for thorough comprehensive annual assessment of children with cerebral palsy, along with interpretation of scores over time, to contribute to intervention planning in collaboration with children and families as a means to contribute to more effective and efficient rehabilitation care.
This introductory session is appropriate for all physical therapists working with children with cerebral palsy and their families. Although the measures and their scoring might not be familiar to participants at the outset, the constructs measured and methods of the examination will be understood by all physical therapy practitioners, regardless of experience.
Practitioners who have served as assessors in either or both of the Move & PLAY and/or On Track studies will already be very familiar with the measures. The section on our approach to ‘collaborative developmental monitoring’ is new.
Upon completion of this workshop, and completion of on-line training materials alluded to in this introductory session, participants will be able to:
- Administer and score brief, psychometrically sound, and clinically feasible measures of balance, strength, range of motion, endurance, the impact of associated health conditions, gross motor function, and participation in self-care and leisure activities for use with children with cerebral palsy across all motor function ability levels.
- Understand how to use the results of the Move & PLAY study (i.e. relationships between determinants of primary impairments (balance), secondary impairments (impairments of strength, range of motion and endurance), impact of associated health conditions, adaptive behaviour, and family and service factors on outcomes of motor function, self-care performance and participation in recreation and leisure activities) to inform intervention planning.
- Understand how longitudinal curves and percentiles (products of the On Track Study) of all measures described in the first two objectives can assist with intervention planning by assisting with understanding:
- An individual child’s prognosis
- A child’s relative strengths and limitations relative to other children of similar functional level
- The interpretation of changes in scores taken over a period of a year.
- Understand how enablement frameworks, family priorities, family centredness, and collaborative approaches contribute to optimal care.
Doreen Bartlett , MSc, PhD,
Doreen Bartlett graduated from Queen’s University with her entry-to-practice physical therapy degree in 1979. After 10 years of clinical pediatric physical therapy practice in Newfoundland, Ontario and British Columbia, she embarked on graduate training and completed her MSc in Physical Therapy and Ph.D. in Rehabilitation Sciences with Martha Piper at the University of Alberta in 1992 and 1997, respectively.
Since completing post-doctoral training in Epidemiology and Biostatistics at Western in 1998 she has been a faculty member in the School of Physical Therapy. She is currently a Professor Emerita of the School of Physical Therapy at Western and Scientist Emerita with CanChild Centre for Childhood Disability Research at McMaster University. Most of her research program over the past 20 years has focused on understanding the development and function of children with cerebral palsy.
The Paediatric Division is a special interest group within the Canadian Physiotherapy Association. Our membership consists of clinicians from all practice settings, students, educators, researchers, physiotherapy assistants and administrators all of whom have a passion for promoting participation and enhancing the lives of children and their families. We are dedicated to providing resources and information for paediatric patients and their families to promote participation and function independence in all aspects of life.
The Paediatric Division is a special interest group within the Canadian Physiotherapy Association. Our membership consists of clinicians from all practice settings, students, educators, researchers, physiotherapy assistants and administrators all of whom have a passion for promoting participation and enhancing the lives of children and their families. We are dedicated to provide resources and information for paediatric patients and their families to promote participation and function independence in all aspects of life.
Paediatric physiotherapists employ clinical expertise in the early detection of health problems, treatment, education and management of congenital, developmental, neuromuscular, skeletal, cardiorespiratory or acquired disorders/diseases. Paediatric physiotherapists work with children of all ages, from infants through young adulthood to promote participation and functional independence. Paediatric physiotherapists have a unique role in that they not only work with the child, but also their families in the context of their daily home, school and recreational environment.
Paediatric physiotherapists use validated outcome measures to assess the level of strength, flexibility, gross-, and fine-motor coordination and overall functional capabilities to determine participation limitations or restrictions as a result of injury, disease or disability.
Through analysis of objective assessment findings, the paediatric physiotherapist uses evidence-based treatment interventions specifically tailored to the client and their family's goals. Treatment interventions focus on improving gross and fine motor skills, balance and coordination, strength and endurance, as well as cognitive and sensory processing/integration.
Course Material included in this course
Collaborative Developmental Monitoring Part 1
Paediatric Division Sponsored Webinar
Webinar Paediatric Division Collaborative Developmental Monitoring Part 1
Resources and References