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PTs should understand:
- Pathology
- Etiology
- Impairments in body structure and function
- Restrictions in activities
- All domains of child development
- Behavior
- Family functioning
PT working with pediatrics
- Identify infants at an early age that are at greater risk
- Predictive of motor outcome
- Identify a child in an educational setting that needs intervention
- Determine eligibility/change over time
- Plan a program
- Determine efficacy/efficiency
- Research
The Why/Pros
- Pain (FACES, FLACC)
- ROM
- Joint integrity
- Posture
- Structural vs. musculature
- Muscle strength
- Functional positions
Objective -- Examination
Based off:
- Primary complaints and family goals
- Childs age and diagnosis
- Current functional status
- History and systems review
- Current evidence on the use of the tool
- Therapist knowledge and experience
- Purpose of testing
- ICF model
- Integration of individualized outcome measures
Test selection
Name the type of test:
- AIMS
- NSMDA
Screening tests
1. Consider purpose of testing, dx, screening, document progress, plan intervention, research, program evaluation
2. Consider the outcome that you desire: eligibility for services, achievement of skills
3. Consider the population that is most representative of the individual that you are testing, dx, age, culture, setting
4. Consider the qualities of the test and characteristics of the tester, time needed, reliability, validity, experience with the test
test selection
- Birth history, pregnancy
- medical history
- surgical history
- educational level
- daily activities
- dependent/independent
- Environmental information
- AD
Subjective -- Examination
- Tests are often lengthy
- Therapist may have limited knowledge about measures and measurement principles
- inadequate training
CONS of standardized testing
Type of standardized tests:
- GMFM-66
- PEDI
- WeeFIM
- SFA
Functional
Type of standardized tests:
- TIMP
- PDMS-2
- BOT 2
Motor
Test selection:
Distinguish between individuals with and without a particular characteristic or function
To discriminate or determine difference/diagnosis: eligibility
ICF Model in context: health condition cerebral palsy
- Impairment: decreased control of selective muscle function; increased resistance to movement
- Measure used: Tardieu scale
Body function/structure
Test selection purpose:
Classify individuals into categories based on what is believed or expected will be their future status
To predict
ICF Model in context: health condition cerebral palsy
- Activity limitation: difficulty with independent mobility
- Measure used: GMFM
Activity
Test selection purpose:
Document change with subjects over time; measure magnitude of longitudinal change, evaluate effectiveness of intervention
To evaluate
- Compares child to same child's performance over a period of time
- GMFM-66, PEDI
Criterion referenced
What is the age range for PDMS-2?
Birth-5 yo
- Child is compared to peers at specific point in time to determine performance
- PDMS2, Bayley
Norm referenced
- Kit, instruction manual, easy to administer
- Validated
- Reliable
- Scoring software
- Norm - referenced
- Well constructed
Advantages of the PDMS-2
ICF Model in context: health condition cerebral palsy
- Participation restrictions: inability to access school and playground settings independently
- Measure used: SFA
Participation
- Basal level can be difficult to obtain
- Limited age range in reliability studies
- Cost
Disadvantages of the PDMS-2
What is the age range for the PEDI test?
6 months - 7 yo
- Assess functional skills over time
- Norm referenced
- Criterion referenced
- Judgement based
- Scoring software
Advantages of PEDI
- Ceiling effect on mobility terms
Disadvantages of the PEDI
3 domains
- Self care
- Mobility
- Social function
- 197 functional skills
Structured interview
- parents or observation
- 20-30 minutes
*** Can be used with children > 7.5 yo with significant functional delay ***
PEDI