Showing papers in "Physical & Occupational Therapy in Pediatrics in 2012"
TL;DR: Although the current level of evidence is weak, a synthesis found that children with spastic CP, Gross Motor Function Classification System (GMFCS) levels I–III, aged 4 years and above are likely to have significant improvements on gross motor function as a result of hippotherapy and THR.
Abstract: Purpose: This systematic review examined the efficacy of hippotherapy or therapeutic horseback riding (THR) on motor outcomes in children with cerebral palsy (CP). Methods: Databases were searched for clinical trials of hippotherapy or THR for children with CP. Results: Nine articles were included in this review. Although the current level of evidence is weak, our synthesis found that children with spastic CP, Gross Motor Function Classification System (GMFCS) levels I–III, aged 4 years and above are likely to have significant improvements on gross motor function as a result of hippotherapy and THR. Evidence indicates that 45-min sessions, once weekly for 8–10 weeks, result in significant effects. Conclusions: The current literature on hippotherapy and THR is limited. Large randomized controlled trials using specified protocols are needed to more conclusively determine the effects on children with CP. From the current evidence, it appears that hippotherapy and THR have positive effects on gross mo...
101 citations
TL;DR: The results support the importance of coordination of PT and OT services for children with cerebral palsy and highlight the need for better communication between therapists and parents.
Abstract: The aims of this study were to describe physical therapy (PT) and occu- pational therapy (OT) services for a cohort of 399 children with cerebral palsy (CP), 2-6 years old, residing in the United States and Canada. Parents completed a ser- vices questionnaire by telephone interview. Therapists classified children's Gross Motor Function Classification System (GMFCS) level. Mean minutes per month of PT and OT were greater for children receiving services in both an educational and clinic setting. Mean minutes per month of PT and OT were greater for children in levels IV-V than children in level I and greater for children in the United States than children in Canada. Parents reported that interventions focused a moderate to great extent on primary im- pairments, secondary impairments, activity, and structured play activities, a moderate extent on environmental modifications and equipment; and a moderate to small extent on self-care routines. The results support the importance of coordination of PT and OT services.
82 citations
TL;DR: The Assessment of Preschool Children's Participation (APCP), a newly developed measure to capture the participation of children aged 2 to 5 years and 11 months in the areas of play, skill development, active physical recreation, and social activities, has potential use for assessment and identification of activity areas in which the child is participating and areas inWhich participation may be restricted.
Abstract: Participation in activities provides the means for young children to learn, play, develop skills, and develop a sense of personal identity. The Assessment of Preschool Children's Participation (APCP) is a newly developed measure to capture the participation of children aged 2 to 5 years and 11 months in the areas of play, skill development, active physical recreation, and social activities. Data from a clinical trial involving 120 children with cerebral palsy indicated that the APCP has moderate to very good internal consistency. The measure distinguishes between children below or above 4 years of age across levels of the Gross Motor Classification System, and between income levels below or above the median regional income range. The APCP, with a focus on preschool children, has potential use for assessment and identification of activity areas in which the child is participating and areas in which participation may be restricted.
68 citations
TL;DR: This study demonstrates strong reliability of the Quality of Upper Extremity Skills Test for children aged 2–12 years for children with cerebral palsy aged 18 months to 8 years.
Abstract: Aim: To investigate reliability of the Quality of Upper Extremity Skills Test (QUEST) scores for children with cerebral palsy (CP) aged 2–12 years. Method: Thirty-one QUESTs from 24 children with CP were rated once by two raters and twice by one rater. Internal consistency of total scores, inter- and intra-rater reliability findings for total, domain, and item scores were calculated. Results: Total scores inter-rater reliability, Intra-class Correlation Coefficient (ICC) was 0.86, and for intra-rater reliability, ICC was 0.96. Domains had high reliability (ICC > 0.80) within raters and between raters except for grasp (moderate at ICC = 0.67). Item inter-rater reliability was moderate or better for 80% of items; item intra-rater reliability was moderate or better for 87% of items. Total score internal consistency was high (α = 0.97). Implications: The QUEST has proven reliability for children with CP aged 18 months to 8 years. This study demonstrates strong reliability for children aged 2–12 years.
59 citations
TL;DR: The Dutch SOS test (Systematic Screening for Handwriting Difficulties) allowed discrimination between typically developing children and children in special education, males and females, and different age groups.
Abstract: Poor handwriting has been shown to be associated with developmental disorders such as Developmental Coordination Disorder, Attention Deficit Hyperactivity Disorder, autism, and learning disorders. Handwriting difficulties could lead to academic underachievement and poor self-esteem. Therapeutic intervention has been shown to be effective in treating children with poor handwriting, making early identification critical. The SOS test (Systematic Screening for Handwriting Difficulties) has been developed for this purpose. A child copies a sample of writing within 5 min. Handwriting quality is evaluated using six criteria and writing speed is measured. The Dutch SOS test was administered to 860 Flemish children (7–12 years). Inter- and intrarater reliability was excellent. Test–retest reliability was moderate. A correlation coefficient of 0.70 between SOS and “Concise Assessment Methods of Children Handwriting” test (Dutch version) confirmed convergent validity. The SOS allowed discrimination between t...
59 citations
TL;DR: This study explores physiotherapists’ description of these interventions in comparison to virtual reality (VR) video game-based therapy and considers unique characteristics of this population when providing interventions that promote learning of motor skills.
Abstract: Little is known about how therapists promote learning of functional motor skills for children with acquired brain injuries. This study explores physiotherapists' description of these interventions in comparison to virtual reality (VR) video game-based therapy. Six physiotherapists employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using thematic analysis. Physiotherapists describe using interventions that motivate children to challenge performance quality and optimize real-life functioning. Intervention strategies are influenced by characteristics of the child, parent availability to practice skills outside therapy, and therapist experience. VR use motivates children to participate, but can influence therapist use of verbal strategies and complicate interventions. Physiotherapists consider unique characteristics of this population when providing interventions that promote learning of motor skills. The VR technology has advantageous features but its use with this population can be challenging; further research is recommended.
52 citations
TL;DR: Although recommended to provide a comprehensive assessment, the measures of double simultaneous, stereognosis, and tactile texture perception may not be responsive to change over time in children with unilateral CP.
Abstract: A systematic review identified tactile assessments used in children with cerebral palsy (CP), but their reproducibility is unknown. Sixteen children with unilateral CP and 31 typically developing children (TDC) were assessed 2-4 weeks apart. Test-retest percent agreements within one point for children with unilateral CP (and TDC) were Semmes-Weinstein monofilaments: 75% (90%); single-point localization: 69% (97%); static two-point discrimination: 93% (97%); and moving two-point discrimination: 87% (97%). Test-retest reliability for registration and unilateral spatial tactile perception tests was high in children with CP (intraclass correlation coefficient [ICC] = 0.79-0.96). Two tests demonstrated a learning effect for children with CP, double simultaneous and tactile texture perception. Stereognosis had a ceiling effect for TDC (ICC = 0) and variability for children with CP (% exact agreement = 47%-50%). The Semmes-Weinstein monofilaments, single-point localization, and both static and moving two-point discrimination are recommended for use in practice and research. Although recommended to provide a comprehensive assessment, the measures of double simultaneous, stereognosis, and tactile texture perception may not be responsive to change over time in children with unilateral CP.
49 citations
TL;DR: Developmental quotient scores were significantly lower than composite scores, giving rates of developmental disability and more closely matching both clinical impressions of delay and the proportions of those children who were also delayed on standardized tests of adaptive function.
Abstract: In response to concerns that the Bayley Scales of Infant and Toddler Development III (BSIDIII) underestimate delay in clinical populations, this study explores developmental quotient scores as an alternative to composite scores for these children. One hundred and twenty-two children aged ≤42 months, referred for diagnosis of developmental disability from January 2007 to May 2010, were assessed, and their composite and developmental quotient scores on each scale were compared. Composite scores identified only 22% (cognitive), 27% (motor), and 47.5% (language) of children as having a developmental disability. Developmental quotient scores were significantly lower than composite scores, giving rates of developmental disability of 56.6% (cognitive), 48.4% (motor), and 74.6% (language) and more closely matching both clinical impressions of delay and the proportions of those children who were also delayed on standardized tests of adaptive function.
43 citations
TL;DR: The themes of experience, barriers, and supports, and tradeoffs supported the current view of participation as a dynamic interaction between person and environment and the unique challenges facing adolescents with CP in terms of deciding what was most important and meaningful to them now and in their future.
Abstract: This article reports on the findings of a qualitative study about the experiences and perceptions of adolescents with cerebral palsy (CP) in relation to social participation. A phenomenological approach was used to interview 10 adolescents with CP, 17 to 20 years of age, selected using purposeful sampling. An iterative process of data collection and analysis resulted in four themes about social participation. The themes of experience, barriers, and supports, and tradeoffs supported the current view of participation as a dynamic interaction between person and environment. The fourth theme of making choices described the unique challenges facing adolescents with CP in terms of deciding what was most important and meaningful to them now and in their future. Health care professionals can support adolescents as they develop the capacity to make their own decisions during the transition to adult living by ensuring that assessments and interventions address social participation.
38 citations
TL;DR: This study evaluated the applicability, representativeness, and comprehensiveness of the Daily Activity, Social/Cognitive, and Responsibility domains for children and youth with an ASD through in-person or virtual focus groups and cognitive interviews.
Abstract: The use of current adaptive behavior measures in practice and research is limited by their length and need for a professional interviewer. There is a need for alternative measures that more efficiently assess adaptive behavior in children and youth with autism spectrum disorders (ASDs). The Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT) is a computer-based assessment of a child's ability to perform activities required for personal self-sufficiency and engagement in the community. This study evaluated the applicability, representativeness, and comprehensiveness of the Daily Activity, Social/Cognitive, and Responsibility domains for children and youth with an ASD. Twenty professionals and 18 parents provided feedback via in-person or virtual focus groups and cognitive interviews. Items were perceived to represent relevant functional activities within each domain. Child factors and assessment characteristics influenced parents' ratings. In response to feedback, 15 items and additional directions were added to ensure the PEDI-CAT is a meaningful measure when used with this population.
36 citations
TL;DR: Children offer a unique perspective which should be integrated with other sources of information to gain a more holistic perspective of their motor skill performance, and several significant moderate-to-large correlations were found between scores for parent-report and scores for performance-based assessments.
Abstract: Client-centered practice requires therapists to actively seek the perspectives of children and families. Several assessment tools are available to facilitate this process. However, when evaluating motor skill performance, therapists typically concentrate on performance-based assessment. To improve understanding of the information provided by the different approaches, the study investigated correlations between performance-based, child-report, and parent-report measures of children's motor skill performance. A sample of convenience of 38 children 8–12 years of age with no history of motor or intellectual impairments and their parents was recruited from Victoria, Australia. Scores for the Bruininks–Oseretsky Test of Motor Proficiency (performance-based, administered by a therapist), Physical Self-Description Questionnaire (child report), and Movement Assessment Battery for Children Checklist (parent report) were analyzed using Spearman's rho correlation. Several significant moderate-to-large correla...
TL;DR: Among children with CP, there were significant reductions in range with increasing functional limitation (higher GMFCS level) and variations based on unilateral or bilateral involvement, particularly the case for the hamstrings and hip adductor musculature, where PROM varied considerably acrossGMFCS Levels I to IV.
Abstract: While passive range of motion (PROM) is commonly used to inform decisions on therapeutic management, knowledge of PROM of children with spastic cerebral palsy (CP) is limited. A population-based sample of 178 children with spastic CP (110 male; unilateral, n = 94; bilateral, n = 84; age range 4–17 years) and 68 typically developing children (24 male; age range 4–17 years) were recruited to the study. All children were able to walk a minimum of 10 m over a straight flat course, with or without assistive devices. Gross Motor Function Classification System (GMFCS) levels of participants with CP were: Level I = 55, Level II = 88, Level III = 21, and Level IV = 14. Ankle dorsiflexion, knee extension, popliteal angle, hip abduction, hip internal rotation, and hip external rotation were measured using a goniometer. The results indicate that the children with CP had significantly reduced PROM compared to the children with typical development. Children with CP demonstrated reduced length in the hamstrings,...
TL;DR: Avenues for future research include randomized controlled trials that specifically target hip flexor muscles, as this has not previously been done, and determining factors other than strength that are likely related to locomotor capacity of children and adolescents with CP.
Abstract: This study aimed to quantify relationships between lower limb muscle strength and locomotor capacity for children and adolescents with cerebral palsy (CP) to identify key muscle groups for strength training. Fifty 6- to 16-year-olds with CP (Gross Motor Function Classification System level I or II) participated. Isometric muscle strength of hip flexor and abductor, knee flexor and extensor, and ankle dorsiflexor muscles was measured using hand-held dynamometry. Ankle plantar flexor concentric muscle strength was assessed as the maximal number of unilateral heel rises. Locomotor capacity was evaluated by the 6-min walk test (6MWT), 10-meter Shuttle Run Test (10mSRT), and Timed Up and Down Stairs Test (TUDS). With control for age, sex, and height, hip flexor and ankle plantar flexor strength explained 47.8% of the variance in the 6MWT and 32.9% of variance in the TUDS and hip abductor isometric strength explained 43.5% of the variance in the 10mSRT. Avenues for future research include randomized controlled trials that specifically target hip flexor muscles, as this has not previously been done, and determining factors other than strength that are likely related to locomotor capacity of children and adolescents with CP.
TL;DR: The results support the effectiveness of CIMT provided through a center-based program and Statistically significant gains were made on the Melbourne Assessment of Unilateral Upper Limb Function, Quality of Upper Extremity Skills Test, Assisting Hand Assessment, and the Canadian Occupational Performance Measure.
Abstract: A single-group pre- and post-test design was used to evaluate functional outcomes of a constraint-induced movement therapy (CIMT) protocol implemented in an outpatient therapy center. The participants were 29 children with hemiplegia, ages 1.6–19.1 years old. The less-involved upper limb was placed in a cast that was worn 24 hr a day, 7 days a week. Individual therapy sessions took place 5 days/week. Children received 3 or 6 hr therapy sessions for 16–19 days followed by 2–5 days in which bimanual tasks were performed. Outcomes were assessed at baseline and following CIMT. Statistically significant gains were made on the Melbourne Assessment of Unilateral Upper Limb Function, Quality of Upper Extremity Skills Test (except the Protective Extension subtest), Assisting Hand Assessment, and the Canadian Occupational Performance Measure. The effect sizes varied from 0.46 to 0.70 indicating a moderate effect size. The results support the effectiveness of CIMT provided through a center-based program.
TL;DR: Perceptions related to increased utilization of group interventions as a part of the service reorganization within a pediatric rehabilitation program are explored to explore perceptions related to service quality in groups.
Abstract: Objectives. To explore perceptions related to increased utilization of group interventions as a part of the service reorganization within a pediatric rehabil- itation program. Methods. Individual interviews with program administrators (n = 13) and focus groups with therapists (n = 19) and parents of children with disabilities (n = 5) were conducted. Data were analyzed using a coding grid inspired by the organized action systems theory. Results. Administrators and therapists identified several issues in- cluding the need to improve the referral process for groups and the coordination across services. Groups considerably modified practice and required substantial efforts from therapists. Administrators felt groups contributed to increased service accessibility. Al- though therapists had some doubts about service quality in groups, especially in regard to the reduced attention to individual needs, they reported positive benefits on children's social participation. Generally, parents were satisfied with group interventions. Conclu- sion. Groups appear to be a promising method of service delivery, but organizational- related issues should be considered.
TL;DR: It is very difficult to draw firm conclusions from the literature about the optimal intensity of pediatric therapy, and the vast variations in practice and the major shifts in underpinning theories that have evolved over time make it difficult to do so.
Abstract: Parents seek sustained intense “hands-on” therapy for their children based on a belief that “more is better” (Aarts, Jongerius, Geerdink, van Limbeek, & Geurts, 2010; Arpino, Vescio, De Luca, & Cur...
TL;DR: Although many families described their adoptive child as having challenges with multiple daily life activities, parents reported being able to create effective strategies to address many of these challenging behaviors.
Abstract: The purpose of this study was to describe reflections of nine American parents on the strengths, challenges, and strategies in parenting young children newly adopted from another country. Eight mothers and one father with an adopted child aged <3 years and home for <3 months completed standardized assessments measuring the child's social emotional development, sensory processing, and parental stress. Each parent participated in qualitative interview to discuss challenges and strategies helpful in addressing their children's needs. All parents reported challenges addressing their child's needs in the areas of sleep, feeding, attachment and self-regulation, and soothing. Parents reported similar strategies to address their child's behavioral concerns. Parents also reported on family factors and community resources that supported the success of the adoption. Although many families described their adoptive child as having challenges with multiple daily life activities, parents reported being able to create effective strategies to address many of these challenging behaviors.
TL;DR: Suggestions for improvement in the provision of family-centered care are provided based on the findings, indicating parents and therapists differed in their ratings of the focus of therapy interventions.
Abstract: The purpose of this study was to determine whether parents and therapists have similar perceptions of therapy services provided to young children with cerebral palsy (CP), reflecting collaboration and provision of family-centered care. Forty-six parents of young children with CP and 40 therapists providing services for those children participated. Parents and therapists independently completed the same Services Questionnaire, indicating their perceptions of the focus and extent of the children's therapy services. For data analysis, answers to survey questions were combined into seven categories of items with a similar focus. The Spearman rho correlations and Wilcoxon signed-rank tests were used to explore relationships and differences between the ratings of parents and therapists. No significant correlations were found for the seven categories. Significant differences between ratings for five of the seven categories were identified, indicating parents and therapists differed in their ratings of the focus of therapy interventions. Based on the findings, suggestions for improvement in the provision of family-centered care are provided.
TL;DR: If the ICF-CY can be further integrated into occupational therapy systems, it holds promise for shifting practice patterns and creating professional opportunities and further clarity and development is warranted around activity and participation categories and functional profiles.
Abstract: Classifying disability for children and youth has typically meant describing a diagnosis or developmental lag. The publication of the International Classification of Functioning, Disability and Health: Child & Youth version (ICF-CY) marks a global paradigm shift in the conceptualization and classification of childhood disability. Knowledge and awareness of the ICF-CY has been slow to diffuse within occupational therapy. Purpose. The purpose of this paper is to foster the integration of the ICF-CY into occupational therapy practice with children and youth. Key issues. Research describes positive trends in using the ICF-CY for cross-disciplinary communication; further clarity and development is warranted around activity and participation categories and functional profiles. Implications. Occupational therapy can contribute to the evolution of the ICF-CY, but must clarify its complementary perspective and knowledge base. If the ICF-CY can be further integrated into occupational therapy systems, it hol...
TL;DR: The results support the importance of motion cues in evaluating the social skills of individuals with DS and demonstrate the lowest accuracy for recognition of scared.
Abstract: Research on facial expressions in individuals with Down syndrome (DS) has been conducted using photographs. Our goal was to examine the effect of motion on perception of emotional expressions. Adults with DS, adults with typical development matched for chronological age (CA), and children with typical development matched for developmental age (DA) viewed photographs and video clips of facial expressions of: happy, sad, mad, and scared. The odds of accurate identification of facial expressions were 2.7 times greater for video clips compared with photographs. The odds of accurate identification of expressions of mad and scared were greater for video clips compared with photographs. The odds of accurate identification of expressions of mad and sad were greater for adults but did not differ between adults with DS and children. Adults with DS demonstrated the lowest accuracy for recognition of scared. These results support the importance of motion cues in evaluating the social skills of individuals wit...
TL;DR: With the passage of the “No Child Left Behind” legislation in 2001, Congress enacted comprehensive revisions to the Elementary and Secondary Education Act of 1965, which increased accountability for schools.
Abstract: With the passage of the “No Child Left Behind” legislation in 2001, Congress enacted comprehensive revisions to the Elementary and Secondary Education Act of 1965, which increased accountability fo...
TL;DR: No main effects of age or gender were found, but an interaction effect of age by gender was found in Modulation of Sensory Input Affecting Emotional Responses, in which older females presented with the lowest scores.
Abstract: This study systematically assessed sensory processing in 34 children, aged 3-14 years, with Smith-Magenis syndrome (SMS) using the Sensory Profile Caregiver Questionnaire. Scores for the SMS cohort were significantly different from scores of the national sample of children with and without disabilities in all Sensory Profile categories and quadrants (p < .001). No main effects of age or gender were found, but an interaction effect of age by gender was found in Modulation of Sensory Input Affecting Emotional Responses, in which older females presented with the lowest scores. A significant decline over time was found in the Seeking pattern, reflecting increased vulnerability (p < .05). Nonsignificant trends suggest more vulnerabilities for older versus younger children, especially older females. The neurobehavioral phenotype in children with SMS is expanded by this description of sensory processing. How children with SMS experience and respond to everyday sensations informs multidisciplinary team decisions.
TL;DR: Evidence from this study does not support use of this particular splint for decreasing pain and increasing handwriting speed and endurance for ninth grade students with joint hypermobility syndrome.
Abstract: Purpose: Pain associated with hypermobility of wrist and hand joints can contribute to decreased handwriting output. This study examined the effectiveness of a neoprene wrist/hand splint in reducing pain and increasing handwriting speed and endurance for students with joint hypermobility syndrome. Methods: Multiple baseline, single system design (SSD) methodology was used. Four ninth grade students with handwriting difficulties because of joint hypermobility syndrome participated in this study. Results: Visual and statistical (two standard deviation band method) analyses indicated a significant decrease in handwriting speed when using the splint for three out of four participants. No significant change in pain or endurance was noted during intervention. There was a significant decrease in pain following withdrawal of the splint for three participants. Conclusion: Evidence from this study does not support use of this particular splint for decreasing pain and increasing handwriting speed and enduran...
TL;DR: The MLSRI quantifies the extent to which motor learning strategies (MLS) are used within physiotherapy (PT) interventions and intra- and inter-rater reliability was excellent, and moderate inter- rater reliability may be due to inconsistent item interpretation between raters.
Abstract: Purpose: To evaluate reliability and feasibility of the Motor Learning Strategy Rating Instrument (MLSRI) in children with acquired brain injury (ABI). The MLSRI quantifies the extent to which motor learning strategies (MLS) are used within physiotherapy (PT) interventions. Methods: PT sessions conducted by ABI team physiotherapists with a convenience sample of children with ABI (4–18 years) were videotaped and independently scored later by two raters trained in MLSRI use. Intraclass correlation coefficients (ICCs) and 95% confidence intervals (CIs) estimated intra- and inter-rater reliability. Results: Eighteen PT sessions were evaluated. Intra- and inter-rater reliability ICCs for total score were 0.86 (95% CI: 0.66–0.94) and 0.50 (95% CI: 0.08–0.78), respectively. MLSRI category ICCs were 0.56–0.86 (intra-rater) and 0.16–0.84 (inter-rater). Conclusions: Intra-rater reliability of MSLRI total score was excellent. Moderate inter-rater reliability may partially be due to inconsistent item interpre...
TL;DR: A new tool designed to summarize the most up-to-date evidence in an easily readable format, in order to provide clinically useful answers within minutes for assisting decision-making and determining next steps is introduced.
Abstract: The core intention of evidence-based practice (EBP) is: to do the right things, for the right child, at the right time, to optimize intervention outcomes. Translating research evidence into clinica...
TL;DR: School-based practitioner perceptions of competency were, for the most part, mainly similar to those in other primary practice settings.
Abstract: Objective. The primary purpose of this study was to identify the practitioner competencies that occupational therapists perceive as important for handwriting evaluation and intervention in school-aged children. A secondary purpose was to compare the practitioner perceptions of those in school-based practice with those from other primary practice settings. Method. A stratified random sample of 376 occupational therapists recruited from a national professional organization database participated by completing a survey instrument containing 80 competency items. Results. A majority of the 80 practitioner competency items were perceived to be of high importance to the respondent groups. A significance difference in perception when comparing the school-based practitioners to all other practitioners was revealed in only 3–12 competency summary categories. Conclusion. Practitioner competency survey items were perceived to be of high importance to the participants. School-based practitioner perceptions of c...
TL;DR: It is important for therapists to engage in health promotion strategies to support participation in active, healthy lifestyles for CYSHCN and their families.
Abstract: Pediatric physical and occupational therapists are in the unique position to provide therapeutic and health promotion interventions to children and youth with special health care needs (CYSHCN) inc...
TL;DR: The modified instructions and scoring patterns from this study can assist in using the CB&M in children of ages 8–11 years and suggest that other factors contribute to variation in balance and mobility proficiency.
Abstract: This study describes the performance of children 8–11 years of age on the Community Balance and Mobility Scale (CBM 9: 72.8 (68.7, 76.8); 10: 79.2 (76.6, 81.7); and 11: 82.9 (79.2, 86.5). None of the children achieved the maximum score. Scores increased with age, and overweight/obese children had relatively lower scores. There were no significant differences between males and females. A regression analysis found 28.1% of the variation in the CB&M total scores was explained by age (p < .001), BMI (p < .01), and sex (p = .25) suggesting that other factors contribute to variation in balance and mobility proficiency. The modified instructions and scoring patterns from this study can assist in using the CB&M in children o...
TL;DR: The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.
Abstract: The Ages and Stages Questionnaires (ASQ) are parent-report screening tools to identify infants at risk of developmental difficulties. The purpose of this study was to examine validity and internal reliability of the fine motor developmental area of the ASQ, 2nd edition (ASQ2-FM) for screening 12-month-old infants following major surgery. The ASQ2-FM was completed by caregivers of 74 infants who had cardiac surgery in the first 90 days of life, 104 infants who had noncardiac surgery in the first 90 days of life, and a control group of 154 infants. The Rasch item response analysis revealed that the ASQ2-FM had poor ability to discriminate among levels of fine motor ability. Sensitivity was poor (20%) and specificity was good (98%) when compared with the scores for the fine motor subscale of the Bayley Scales of Infant and Toddler Development. The ASQ2-FM under-identified infants at risk for fine motor delay; internal reliability and construct validity do not support use as a screening tool of fine motor development of infants aged 12 months who have undergone major surgery.
TL;DR: Five generic fidelity measures are described and examined for their applicability to pediatric rehabilitation and common characteristics of nonspecific attributes with pediatric rehabilitation are discussed, and investigator plans to conduct future testing.
Abstract: To increase the rigor of pediatric rehabilitation research, there is a need to evaluate the degree to which an intervention is conducted as planned (i.e., fidelity). Generic fidelity measures evaluate more than one intervention and often include nonspecific attributes of the therapy process common to both interventions. The objective of this study was to describe the characteristics of generic fidelity measures and examine how these attributes fit with pediatric rehabilitation. A review of generic fidelity measures was conducted utilizing health and education databases. Five generic fidelity measures are described and examined for their applicability to pediatric rehabilitation. The measures were used in nine studies meeting the inclusion criteria, involving people ages from 11 years to >65 years undergoing psychotherapy. From the 76 nonspecific items, 37 items were judged to be applicable to pediatric rehabilitation. Common characteristics of nonspecific attributes with pediatric rehabilitation a...