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Activity focused and goal directed therapy for children with cerebral palsy--do goals make a difference?

https://arctichealth.org/en/permalink/ahliterature150694
Source
Disabil Rehabil. 2009;31(22):1808-16
Publication Type
Article
Date
2009
Author
Kristina Löwing
Annmarie Bexelius
Eva Brogren Carlberg
Author Affiliation
Department of Woman & Child Health, Karolinska Institutet, Stockholm, Sweden. kristina.lowing@ki.se
Source
Disabil Rehabil. 2009;31(22):1808-16
Date
2009
Language
English
Publication Type
Article
Keywords
Cerebral Palsy - rehabilitation
Child, Preschool
Disability Evaluation
Female
Goals
Humans
Male
Motor Activity - physiology
Motor Skills
Prospective Studies
Rehabilitation - methods
Sweden
Abstract
To compare the effects of goal directed functional therapy (GDT) to activity focused therapy (AT) for preschool children with cerebral palsy (CP) on everyday activities and gross motor function. Another aim was to evaluate goal attainment in the GDT group.
A prospective intervention study comparing two types of intervention carried out in ecological settings. Forty-four children with CP, (25 boys, 19 girls; mean age 4 year 1 month [SD 1 year 5 month]), Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) levels I-IV participated. Twenty-two children were recruited to the GDT group and 22 to the AT group. Outcome measures were the Pediatric Evaluation of Disability Inventory (PEDI), and the Gross Motor Function Measure-66. Furthermore, goal attainment scaling (GAS) was used in the GDT group. The assessments were performed before and after an intervention period of 12 weeks.
The children in the GDT group improved more in most aspects of everyday activities measured by the PEDI than the children in the AT group (p
PubMed ID
19479520 View in PubMed
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Actual vs. best practices for young children with cerebral palsy: a survey of paediatric occupational therapists and physical therapists in Quebec, Canada.

https://arctichealth.org/en/permalink/ahliterature160768
Source
Dev Neurorehabil. 2008 Jan-Mar;11(1):60-80
Publication Type
Article
Author
M N Saleh
N. Korner-Bitensky
L. Snider
F. Malouin
B. Mazer
E. Kennedy
M A Roy
Author Affiliation
School of Physical & Occupational Therapy, Faculty of Medicine, McGill University and Centre de recherche interdisciplinaire en réadaptation du Montréal métropolitain, Montreal, Quebec, Canada. maysoun.saleh@mail.mcgill.ca
Source
Dev Neurorehabil. 2008 Jan-Mar;11(1):60-80
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Cerebral Palsy - rehabilitation
Child, Preschool
Cross-Sectional Studies
Female
Humans
Infant
Interviews as Topic
Male
Occupational Therapy - standards
Pediatrics - standards
Physical Therapy Modalities - standards
Quality of Health Care
Quebec
Treatment Outcome
Abstract
Cerebral palsy (CP) constitutes a substantial portion of paediatric rehabilitation, yet little is known regarding actual occupational therapy (OT) and physical therapy (PT) practices. This study describes OT and PT practices for young children with CP in Quebec, Canada.
This was a cross-sectional survey. All eligible, consenting paediatric occupational therapists (OTs) and physical therapists (PTs) were interviewed using a structured telephone interview based on vignettes of two typical children with CP at two age points--18 months and 4 years. Reported practices were grouped according to the International Classification of Functioning, Disability and Health (ICF).
91.9% of PTs (n=62; 83.8% participation rate) and 67.1% of OTs (n=85; 91.4% participation rate) reported using at least one standardized paediatric assessment. OT and PT interventions focused primarily on impairments and primary function (such as gait function and activities of daily living). Both professions gave little attention to interventions related to play and recreation/leisure. Clinicians reported the need for more training and education specific to CP and to the use of research findings in clinical practice.
Wide variations and gaps were identified in clinicians' responses suggesting the need for a basic standard of OT and PT management as well as strategies to encourage knowledge dissemination regarding current best practice.
PubMed ID
17943507 View in PubMed
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Adapting the Canadian Occupational Performance Measure for use in a paediatric clinical trial.

https://arctichealth.org/en/permalink/ahliterature163934
Source
Disabil Rehabil. 2007 May 30;29(10):761-6
Publication Type
Article
Date
May-30-2007
Author
Anne Cusick
Natasha A Lannin
Kevin Lowe
Author Affiliation
College of Social and Health Sciences, University of Western Sydney, New South Wales, Australia. a.cusick@uws.edu.au
Source
Disabil Rehabil. 2007 May 30;29(10):761-6
Date
May-30-2007
Language
English
Publication Type
Article
Keywords
Canada
Cerebral Palsy - rehabilitation
Child
Child, Preschool
Female
Humans
Male
Occupational Therapy - methods
Pediatrics
Psychometrics - methods
Randomized Controlled Trials as Topic
Abstract
The Canadian Occupational Performance Measure (COPM) is a commonly used outcome measure in rehabilitation. In this study it was adapted for very young children by deleting paid/unpaid work and household management categories and having parents act as proxies to rate child performance and their own satisfaction.
To assess the internal consistency reliability, content and construct validity, responsiveness, and impact of half scores (20 not 10-point scale) of the adapted COPM.
Parent proxies of subjects aged 2 - 8 (mean 3.9) years with spastic hemiplegic cerebral palsy (n = 41) participating in a clinical trial. There was a total of 214 occupational performance problems for analysis and an additional 56 which had used half score ratings. Internal consistency reliability and construct validity were evaluated using Cronbach alpha statistic. Proxy views explored content validity. Responsiveness was evaluated using pre-post intervention scores and a comparison with Goal Attainment Scaling scores which were assumed to be a suitable benchmark measure. The effect of half scores was assessed by two-sample t-tests.
The COPM adaptations did not have a negative impact on internal consistency reliability as this was acceptable for performance (0.73) and satisfaction (0.83). The high Cronbach alpha scores indicated good construct validity. Content of occupations and rating approach was considered valid by proxies. Use of half scores did not result in significantly different performance ratings, but mean satisfaction ratings were significantly higher when half scores were used (p = 0.0001). This suggests that half scores may provide more precise proxy satisfaction ratings, but at the cost of rigour as internal consistency with satisfaction half scores was lower (0.63 vs. 0.82). Responsiveness to change in clinical status was demonstrated by significant pre-post scores and moderate correlations with goal attainment scores.
The adapted COPM is a psychometrically robust tool and the use of half scores is not recommended.
PubMed ID
17457734 View in PubMed
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Amount and focus of physical therapy and occupational therapy for young children with cerebral palsy.

https://arctichealth.org/en/permalink/ahliterature120938
Source
Phys Occup Ther Pediatr. 2012 Nov;32(4):368-82
Publication Type
Article
Date
Nov-2012
Author
Robert J Palisano
Denise M Begnoche
Lisa A Chiarello
Doreen J Bartlett
Sarah Westcott McCoy
Hui-Ju Chang
Author Affiliation
Department of Physical Therapy and Rehabilitation Sciences, Drexel University, Philadelphia, Pennsylvania 19102, USA. robert.j.palisano@drexel.edu
Source
Phys Occup Ther Pediatr. 2012 Nov;32(4):368-82
Date
Nov-2012
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adolescent
Adult
Canada
Cerebral Palsy - rehabilitation
Child
Child, Preschool
Female
Humans
Male
Occupational Therapy - methods
Parents
Personal Satisfaction
Physical Therapy Modalities - statistics & numerical data
Questionnaires
United States
Abstract
The aims of this study were to describe physical therapy (PT) and occupational 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 services 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 impairments, 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.
Notes
Comment In: Phys Occup Ther Pediatr. 2012 Nov;32(4):383-723030607
PubMed ID
22954372 View in PubMed
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An analysis of reading and spelling abilities of children using AAC: Understanding a continuum of competence.

https://arctichealth.org/en/permalink/ahliterature140456
Source
Augment Altern Commun. 2010 Sep;26(3):191-202
Publication Type
Article
Date
Sep-2010
Author
Annika Dahlgren Sandberg
Martine Smith
Maria Larsson
Author Affiliation
University of Gothenburg, Sweden.
Source
Augment Altern Commun. 2010 Sep;26(3):191-202
Date
Sep-2010
Language
English
Publication Type
Article
Keywords
Achievement
Adolescent
Aptitude
Cerebral Palsy - rehabilitation
Child
Child, Preschool
Communication Aids for Disabled
Communication Disorders - rehabilitation
Comprehension
Education, Special
Female
Humans
Ireland
Language
Mainstreaming (Education)
Male
Memory, Short-Term
Phonetics
Reading
Retention (Psychology)
Sweden
Verbal Learning
Vocabulary
Abstract
The over-representation of reading and spelling difficulties in children with complex communication needs has been well documented. However, most of the studies reported have indicated that at least some children using augmentative and alternative communication (AAC) can achieve and demonstrate effective literacy skills, highlighting the heterogeneity of this group. This paper presents findings from a cross-linguistic study of 14 Swedish and 14 Irish children with cerebral palsy who use AAC, outlining their performance on a range of phonological awareness, reading, and spelling tasks developed for the purposes of the study. All participants were referred to the study as functioning in the average range of intellectual ability. Of the 28 participants, eight were classified as good readers, on the basis of their success on tasks involving connected text; while 10 presented with single-word reading skills; and 10 were categorized as non-readers. This paper explores the similarities and differences within and across these groups, in terms of associated skills and experiences. While analyses of group data suggests some common abilities and difficulties, exploration of individual profiles highlights the heterogeneity of the participants' profiles, suggesting a need for detailed individual assessment and interventions.
PubMed ID
20874081 View in PubMed
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Are family-centred principles, functional goal setting and transition planning evident in therapy services for children with cerebral palsy?

https://arctichealth.org/en/permalink/ahliterature139257
Source
Child Care Health Dev. 2012 Jan;38(1):41-7
Publication Type
Article
Date
Jan-2012
Author
J. Darrah
L. Wiart
J. Magill-Evans
L. Ray
J. Andersen
Author Affiliation
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada T6G 2G4. johanna.darrah@ualberta.ca
Source
Child Care Health Dev. 2012 Jan;38(1):41-7
Date
Jan-2012
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Attitude to Health
Cerebral Palsy - rehabilitation
Child
Child Health Services - organization & administration
Child, Preschool
Delivery of Health Care, Integrated - organization & administration
Family Health
Focus Groups
Health Services Research - methods
Humans
Interinstitutional Relations
Occupational Therapy - organization & administration
Parents - psychology
Patient Care Planning - organization & administration
Physical Therapy Specialty - organization & administration
Professional-Family Relations
Abstract
Family-centred service, functional goal setting and co-ordination of a child's move between programmes are important concepts of rehabilitation services for children with cerebral palsy identified in the literature. We examined whether these three concepts could be objectively identified in programmes providing services to children with cerebral palsy in Alberta, Canada.
Programme managers (n= 37) and occupational and physical therapists (n= 54) representing 59 programmes participated in individual 1-h semi-structured interviews. Thirty-nine parents participated in eleven focus groups or two individual interviews. Evidence of family-centred values in mission statements and advisory boards was evaluated. Therapists were asked to identify three concepts of family-centred service and to complete the Measures of Process of Care for Service Providers. Therapists also identified therapy goals for children based on clinical case scenarios. The goals were coded using the components of the International Classification of Functioning Disability and Health. Programme managers and therapists discussed the processes in their programmes for goal setting and for preparing children and their families for their transition to other programmes. Parents reflected on their experiences with their child's rehabilitation related to family-centredness, goal setting and co-ordination between programmes.
All respondents expressed commitment to the three concepts, but objective indicators of family-centred processes were lacking in many programmes. In most programmes, the processes to implement the three concepts were informal rather than standardized. Both families and therapists reported limited access to general information regarding community supports.
Lack of formal processes for delivery of family-centred service, goal-setting and co-ordination between children's programmes may result in inequitable opportunities for families to participate in their children's rehabilitation despite attending the same programme. Standardized programme processes and policies may provide a starting point to ensure that all families have equitable opportunities to participate in their child's rehabilitation programme.
PubMed ID
21083684 View in PubMed
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[A society for horse riding as therapy]

https://arctichealth.org/en/permalink/ahliterature35364
Source
Lakartidningen. 1995 Mar 15;92(11):1062
Publication Type
Article
Date
Mar-15-1995
Author
L. Svedberg
Source
Lakartidningen. 1995 Mar 15;92(11):1062
Date
Mar-15-1995
Language
Swedish
Publication Type
Article
Keywords
Animals
Cerebral Palsy - rehabilitation
Child
Child, Preschool
Horses
Humans
Societies
Sports
Sweden
PubMed ID
7700102 View in PubMed
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Becoming and staying physically active in adolescents with cerebral palsy: protocol of a qualitative study of facilitators and barriers to physical activity.

https://arctichealth.org/en/permalink/ahliterature138047
Source
BMC Pediatr. 2011;11:1
Publication Type
Article
Date
2011
Author
Aniek A O M Claassen
Jan Willem Gorter
Debra Stewart
Olaf Verschuren
Barbara E Galuppi
Lorie J Shimmell
Author Affiliation
CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, Ontario, Canada.
Source
BMC Pediatr. 2011;11:1
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Cerebral Palsy - rehabilitation
Child
Clinical Protocols
Data Collection
Female
Focus Groups
Humans
Male
Motor Activity
Multicenter Studies as Topic - methods
Ontario
Patient Selection
Videotape Recording
Abstract
Adolescents with cerebral palsy (CP) show a reduced physical activity (PA). Currently there are no interventions for adolescents with CP in this critical life phase that optimise and maintain the individuals' physical activity in the long term. To develop such a program it is important to fully understand the factors that influence physical activity behaviours in adolescents with CP. The aim of this study is to explore what makes it easy or hard for adolescents with CP to be and to become physically active.
A qualitative research method is chosen to allow adolescents to voice their own opinion. Because we will investigate the lived experiences this study has a phenomenological approach. Thirty ambulatory and non-ambulatory adolescents (aged 10-18 years) with CP, classified as level I to IV on the Gross Motor Function Classification System and 30 parents of adolescents with CP will be invited to participate in one of the 6 focus groups or an individual interview. Therapists from all Children's Treatment Centres in Ontario, Canada, will be asked to fill in a survey. Focus groups will be audio- and videotaped and will approximately take 1.5 hours. The focus groups will be conducted by a facilitator and an assistant. In preparation of the focus groups, participants will fill in a demographic form with additional questions on physical activity. The information gathered from these questions and recent research on barriers and facilitators to physical activity will be used as a starting point for the content of the focus groups. Recordings of the focus groups will be transcribed and a content analysis approach will be used to code the transcripts. A preliminary summary of the coded data will be shared with the participants before themes will be refined.
This study will help us gain insight and understanding of the participants' experiences and perspectives in PA, which can be of great importance when planning programs aimed at helping them to stay or to become physically active.
Notes
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PubMed ID
21214908 View in PubMed
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Children and youth with disabilities: innovative methods for single qualitative interviews.

https://arctichealth.org/en/permalink/ahliterature118456
Source
Qual Health Res. 2013 Feb;23(2):264-74
Publication Type
Article
Date
Feb-2013
Author
Gail Teachman
Barbara E Gibson
Author Affiliation
Department of Occupational Science & Occupational Therapy, University of Toronto, 160-500 University Ave., Toronto, ON, Canada. g.teachman@utoronto.ca
Source
Qual Health Res. 2013 Feb;23(2):264-74
Date
Feb-2013
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cerebral Palsy - rehabilitation
Child
Disabled Children - psychology
Female
Humans
Interview, Psychological - methods
Male
Ontario
Parents - psychology
Pilot Projects
Walking - psychology
Abstract
There is a paucity of explicit literature outlining methods for single-interview studies with children, and almost none have focused on engaging children with disabilities. Drawing from a pilot study, we address these gaps by describing innovative techniques, strategies, and methods for engaging children and youth with disabilities in a single qualitative interview. In the study, we explored the beliefs, assumptions, and experiences of children and youth with cerebral palsy and their parents regarding the importance of walking. We describe three key aspects of our child-interview methodological approach: collaboration with parents, a toolkit of customizable interview techniques, and strategies to consider the power differential inherent in child-researcher interactions. Examples from our research illustrate what worked well and what was less successful. Researchers can optimize single interviews with children with disabilities by collaborating with family members and by preparing a toolkit of customizable interview techniques.
PubMed ID
23208200 View in PubMed
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[Children with cerebral palsy referred to a multidisciplinary habilitation unit]

https://arctichealth.org/en/permalink/ahliterature7226
Source
Tidsskr Nor Laegeforen. 2004 May 6;124(9):1235-6
Publication Type
Article
Date
May-6-2004
Author
Kjersti Ramstad
Unni Sandaker Blom
Author Affiliation
Seksjon for habilitering, Barneavdelingen, Akershus universitetssykehus, 1474 Nordbyhagen. kjersti.ramstad@ahus.no
Source
Tidsskr Nor Laegeforen. 2004 May 6;124(9):1235-6
Date
May-6-2004
Language
Norwegian
Publication Type
Article
Keywords
Cerebral Palsy - rehabilitation
Child, Preschool
Denmark
English Abstract
Female
Follow-Up Studies
Humans
Infant
Male
Patient care team
Referral and Consultation
Abstract
BACKGROUND: At Akershus University Hospital a new multidisciplinary team was set up to serve neurologically impaired children. We investigated how many children with cerebral palsy were referred to the team and whether referral resulted in an associated diagnosis. MATERIAL AND METHODS: All children with a diagnosis of cerebral palsy referred up until the end of the team's first year of full service were included. Data on birth weight and mobility were retrieved from patient files. Additional diagnoses were registered at inclusion date and two years later and compared to prevalence studies. RESULTS: 182 children had a diagnosis of cerebral palsy. 41 out of 114 children (36%) in the age bracket 6-14 were described as walking without using aids. After a minimum of two years' follow-up, 80 children had no neurological or psychiatric diagnosis (except cerebral palsy). INTERPRETATION: Children with mild motor impairment were underrepresented, and associated impairments, except epilepsy, were diagnosed less often than expected.
PubMed ID
15131705 View in PubMed
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45 records – page 1 of 5.