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The Child in Front of You -A Case Study Approach for Pediatric Motor Therapists by Michelle Fryt Linehan,
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Faculty:: Michelle Fryt Linehan
Duration:: 5 Hours 44 Minutes
Format:: Audio and Video
Copyright:: May 01, 2013

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.

Handouts

Outline

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

Faculty

Michelle Fryt Linehan, MSPT, PCS, MEd, Related seminars and products: 3

Michelle Fryt Linehan, MSPT, PCS, MEd, is a licensed physical therapist and APTA Pediatric Certified Specialist with over 26 years of experience working with children in both rehab and educational settings. Currently she works in an outpatient facility in Spokane, Washington, and owns her own practice, Kinetic Kids Physical Therapy, treating children in Idaho. Ms. Linehan previously worked in the field of education, both in the United States and in Africa, as a teacher and state-level administrator for a total of 13 years. She has spent the last 18 years working as a pediatric physical therapist in a variety of settings: hospital acute care, outpatient, school systems, and early intervention programs. Ms. Linehan also previously owned a pediatric physical therapy practice in Georgia, seeing children in their natural environments.

Ms. Linehan received a bachelor’s degree in Elementary Education from the University of Colorado at Colorado Springs in 1980, obtained a master’s degree in Early Childhood Special Education from the University of Washington in Seattle in 1987, and in 1993 she earned her MSPT from Boston University. Ms. Linehan completed the NDT/Bobath 8-week Pediatric course in 1999 and became a Pediatric Certified Specialist through the American Physical Therapy Association in 2002. She has also earned certifications in Threshold Electrical Stimulation and Infant Behavior Assessment. Ms. Linehan views “Evidence-Based Practice” as a necessary aspect of her clinical practice and continually strives to seek effective ways to provide physical therapy services to all of her patients.

Speaker Disclosures:

Financial: Michelle Fryt Linehan maintains a private practice. She receives a speaking honorarium from PESI, Inc.

Non-financial: Michelle Fryt Linehan is a member of the American Physical Therapy Association.

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