Phys Occup Ther Pediatr. 2008 May; 28(2): 191-206
Ketelaar M, Russell DJ, Gorter JW

Once a measure has been developed and validated, it may take years for implementation into clinical practice. The purpose of this paper is to describe strategies used to increase knowledge translation and use of the Gross Motor Function Measure (GMFM) and the Gross Motor Function Classification System (GMFCS) in clinical practice in the Netherlands and reflect on the process. Knowledge translation strategies included peer-reviewed publications, workshops, and posting information on Web sites. The impact of several of these strategies was evaluated using questionnaires focusing on therapists' self-reported familiarity and use of the measures. Peer reviewed publications did not appear to impact clinical practice. Interactive workshops were more successful at increasing use, but a gap remained between knowledge and use; the transfer into clinical practice was not optimal. A stages of change model proposed by Grol and colleagues (2007) was a helpful framework for reflecting on the process, planning, and evaluation of strategies for facilitating change in clinical practice. ...»

Phys Occup Ther Pediatr. 2008 May; 28(2): 171-89
Stoffel A, Berg C

Few standardized assessments exist for children living in the United States who are Hispanic/Latino. This study reports the Spanish translation process for the Preschool Activity Card Sort (PACS), which is a measure of participation in preschool children, and examines content, construct, and concurrent validity. Methods of verifying accuracy of translation included expert review and back translation and supported content validity of the Tarjetas de Actividades Preescolares (TAP). Subsequently, a sample of 37 parents of children between 3 and 6 years of age completed the PACS/TAP by structured interview. Twenty-six parents were Spanish speaking, and 11 were English speaking. A comparison of reported participation by Spanish- and English-speaking children provides initial construct validity of the TAP. Results indicate that the TAP differentiates among children of recent immigrants as compared to preschoolers who were born in the United States on domains of self-care, high and low demand leisure, and educational activities. Results emphasize the importance of considering sociocultural influences when assessing participation. PACS/TAP scores were moderately correlated with Pediatric Evaluation of Disability Inventory scores for the self-care domain, but did not correlate with the mobility or social function domains. The PACS/TAP appears to provide a useful means of understanding preschoolers' participation. Future research is needed to further establish the validity of this assessment. ...»

Phys Occup Ther Pediatr. 2008 May; 28(2): 155-69
Shikako-Thomas K, Majnemer A, Law M, Lach L

Children and youth with cerebral palsy (CP) experience difficulties in their ability to move, problem solve, socialize, and communicate, associated with limitations in activities in all environments. They are at risk for lower participation in social and leisure activities critical in fostering friendships, developing interests, and promoting well-being. Little is known about involvement in leisure activities and their determinants. This systematic review aims to describe participation in leisure activities by children with CP and identify personal and environmental factors that influence participation. The following databases were reviewed--CINAHL, Medline, Cochrane, Web of Science, OT-seeker, and REHABDATA--using the keywords participation, cerebral palsy, leisure, and recreation. The literature to date suggests that children with physical disabilities are less involved in leisure activities than their peers; activities are more passive, home based, and lack variety. Several factors influence participation in leisure activities, including age, gender, activity limitations, family preferences and coping, motivation, and environmental resources and supports. ...»

Phys Occup Ther Pediatr. 2008 May; 28(2): 141-54
McNamara P, Humphry R

This study obtains a deeper understanding of the processes supporting the formation of young children's routines in a child care classroom. Eight infants and toddlers and their teachers from two child care classrooms were observed for 4 to 6 months during periods of regularly occurring activities. Detailed, moment-to-moment descriptions of their behaviors and interactions were analyzed. Eleven processes supported the development of children's routines. Teachers structured and guided the children's experiences in learning routines, and children initiated requests to do routines. The study also identified three processes where children invited, coached, and modeled, supporting one another in learning routines. Finally, familiar objects used in routines elicited the children's engagement. ...»

Phys Occup Ther Pediatr. 2008 May; 28(2): 137-40
Dunn W

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Phys Occup Ther Pediatr. 2008 May; 28(2): 117-36
Jirikowic T, Olson HC, Kartin D

This study described sensory processing behaviors and sensory-motor abilities in children with fetal alcohol spectrum disorders (FASD) and explored their relationship to home and school function. A clinic-referred sample of 25 children with FASD, ages 5 to 8 years, was compared with 26 children with typical development, balanced for age, gender, and race/ethnicity, on standardized tests examining sensory processing, sensory-motor performance, school performance, and adaptive behavior. Children with FASD scored significantly more poorly on sensory processing, sensory-motor, adaptive, and academic achievement measures, and demonstrated more problem behaviors at home and school. Correlations were significant between measures of sensory processing and sensory-motor performance, adaptive behavior, and some aspects of academic performance. Sensory processing and related foundational sensory-motor impairments should be considered when determining the developmental needs of children with FASD. These impairments may co-occur with and contribute, at least in part, to decreased adaptive and school function. ...»

Phys Occup Ther Pediatr. 2008 May; 28(2): 109-16
Cameron D

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Phys Occup Ther Pediatr. 2008 May; 28(2): 105-8
Bartlett D

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Phys Occup Ther Pediatr. 2008; 28(1): 79-98
Baranek GT, Roberts JE, David FJ, Sideris J, Mirrett PL, Hatton DD, Bailey DB

BACKGROUND AND PURPOSE: No longitudinal study on sensory processing in children with fragile X syndrome (FXS) exists. This study examined developmental trajectories and correlates of sensory processing from infancy through preschool years in 13 boys with FXS. METHOD: Participants were assessed using observational and parent-report measures 2-6 times between 9 and 54 months of age. RESULTS: Over time, an increasing proportion of boys displayed sensory processing that differed significantly from test norms. Observational measures were more sensitive than parent-reports early in infancy. Age and developmental quotient significantly predicted levels of hyporesponsiveness; there was a trend for hyperresponsiveness to increase with age. Baseline physiological and biological measures were not predictive. CONCLUSIONS: Sensory processing problems are observable early and grow increasingly problematic from infancy through the preschool ages. Early identification and intervention may attenuate long-term difficulties for children with FXS. ...»

Phys Occup Ther Pediatr. 2008; 28(1): 59-77
Arnold SH, McEwen IR

The School Outcomes Measure (SOM) is a minimal data set designed to measure outcomes of students who receive school-based occupational therapy and physical therapy. The purpose of this study was to determine item test-retest reliability and the responsiveness to change of the SOM. Thirty-two occupational therapists and physical therapists collected data on 73 students, age 3-21 years, stratified into two groups based on the Gross Motor Function Classification System: those with mild/moderate functional limitations (Levels I, II, III) and those with severe functional limitations (Levels IV, V). Weighted kappa statistics (0.68-1.0) indicate good to excellent item test-retest reliability. Repeated measures analysis of variance indicated that the SOM is responsive to change in children with mild/moderate functional limitations but is less responsive to change in children with severe functional limitations. The findings support the use of the SOM to measure outcomes for students with mild/moderate functional limitations as well as enabling program evaluation of therapy services provided in school settings. More research is needed to evaluate responsiveness in students with severe functional limitations. ...»

Phys Occup Ther Pediatr. 2008; 28(1): 41-57
Maher CA, Olds T, Williams MT, Lane AE

Health Related Quality of Life (HRQOL) is an important outcome in the delivery of health care. Research on the HRQOL in young people with cerebral palsy (CP) has relied on proxy-reports from parents. The purpose of this study was to investigate the self-reported HRQOL of young people with CP. A survey was mailed to 229 adolescents with CP in South Australia, of which 118 responded (51.5%). Seventy-one participants 11 to 17 years of age, self-reported HRQOL on the Pediatric Quality of Life Inventory 4.0 (PedsQL). Thirty-eight youth were deemed by their parent/guardian as having insufficient cognitive ability to self-report HRQOL and nine respondents returned their surveys incomplete. The mean PedsQL Physical Function score was 57.3 (SD = 24.3), the mean Psychosocial Function score was 64.5 (SD = 15.9), and the Overall PedsQL score was 62.0 (SD = 16.7). Compared to norms for children without disabilities, 67% of participants had an Overall PedsQL score greater than 1 SD below the mean. PedsQL scores were related to gross motor function classification level (Spearman's rho = -0.54), number of health issues (rho = -0.51), and socioeconomic status (rho = 0.28), but not age, gender, quality of sleep, or whether parent assistance was needed to complete the PedsQL. The results have implications for policy and efforts to identify and address barriers to full and satisfying participation in mainstream schools and community activities. ...»

Phys Occup Ther Pediatr. 2008; 28(1): 25-39
Ziviani J, Macdonald D, Ward H, Jenkins D, Rodger S

Inadequate physical activity in children is a major health concern. The purpose of this study was to examine changes in physical activity of boys and girls, between 6-8 and 8-10 years of age and how activity patterns correlated with selected family, child, and environment factors. The sample included 59 children without motor delays (26 boys and 23 girls) between 8 and 10 years of age. Twenty-two of the children participated in a previous study at 6-8 years of age. Parents completed a questionnaire on their children's non-physical and physical activities. Children wore a pedometer during two weekdays and two weekend days. The results indicate that girls spent more time on homework and reading and on crafts and indoor play than boys. Girls spent more time on musical and cultural activities and boys spent more time on screen-based activities at 8-10 years of age. Children spent significantly less time on physical activity at 8-10 years of age. Boys took more steps per day than girls on weekends. The average number of steps taken per weekday increased for boys, but not girls, at 8-10 years of age. There was an inverse relationship between body mass index and number of steps taken per day (weekdays r = -.28; weekend r = -.32). Socioeconomic status was associated with the number of steps taken by children on weekends (r = .34). The results have implications for physical activities for girls and school and community programs for children. ...»

Phys Occup Ther Pediatr. 2008; 28(1): 5-23
Klein S, Erickson L, James K, Perrott C, Williamson H, Zacharuk L

Word processing using a keyboard is an option for children with Developmental Coordination Disorder (DCD) who have printing/ handwriting difficulties. A five-replication single-subject ABA design was used to explore the ability of 6 children with DCD (entering Grades 3-5) experiencing problems with printing/handwriting to learn computer skills. Following a two-week intervention all children were familiar with basic computer functions and showed improved word processing skills. Touch-keyboarding speed increased for the five children entering Grades 4-5, but only one child acquired a speed (letters/minute) comparable to printing/ handwriting. Four children demonstrated increased text production when generating a story, but none achieved speeds comparable to printing/handwriting. Five-finger touch-keyboarding proficiency was better for children in Grades 4-5. Therapists observed improved legibility and increased motivation. Results suggest that the child's grade, program support, and program length should be considered when making decisions about keyboarding. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 87-102
Deitz JC, Kartin D, Kopp K

The Bruininks-Oseretsky Test of Motor Proficiency (Bruininks, 1978) is a standardized, norm-referenced measure used by physical therapists and occupational therapists in clinic and school practice settings. This test recently was revised and published as the Bruininks-Oseretsky Test of Motor Proficiency, Second Edition (BOT-2; Bruininks & Bruininks, 2005). The BOT-2 is an individually administered measure of fine and gross motor skills of children and youth, 4 through 21 years of age. It is intended for use by practitioners and researchers as a discriminative and evaluative measure to characterize motor performance, specifically in the areas of fine manual control, manual coordination, body coordination, and strength and agility. The BOT-2 has both a Complete Form and a Short Form. This review of the BOT-2 describes its development and psychometric properties; appraises strengths and limitations; and discusses implications for use by physical therapists and occupational therapists. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 67-85
Bowyer PL, Kramer J, Kielhofner G, Maziero-Barbosa V, Girolami G

The purpose of this study was to examine the reliability and validity of the Short Child Occupational Profile (SCOPE; version 2.0). The SCOPE is an occupation focused, client-centered, theory driven assessment developed out of a practice/academic partnership. In this study, twenty practitioners from occupational therapy, physical therapy, speech therapy, and social work completed thirty-five SCOPE assessments with clients' ages two years, four months to twenty-one years with both physical and intellectual disabilities. All therapists rated one common client. Rasch analysis using Facets was used to analyze the items. Results reveal that the SCOPE items coalesce to represent the construct of occupational participation in a valid manner and that most clients can be measured in a valid way by those items. Therapists used the SCOPE in a similar way and analysis demonstrated there was limited variability among therapists. The SCOPE discriminated between clients who had varying levels of occupational participation. The results indicate a need to do minor revisions to the assessment in order to maximize the psychometric properties and enhance clinicians' understanding of the items and rating scale terms. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 43-65
Crompton J, Imms C, McCoy AT, Randall M, Eldridge B, Scoullar B, Galea MP

This pilot study examined the feasibility of a 6-week group-based, task-related training program in children 6 to 14 years-old with spastic diplegia. Eight children were randomized to lower limb training and seven to an upper limb dexterity training program. There were no statistically significant differences in lower limb outcomes between children who received the lower limb training and children who received the upper limb dexterity training after completion of the interventions or at a 6-week follow-up. Children who received the upper limb training demonstrated a greater improvement on measures of manual dexterity compared with children who received the lower limb training program. Children who received the lower limb training demonstrated a trend toward walking a longer distance in 10 minutes immediately following intervention, that was not sustained at the 6-week follow-up. The group setting appeared to motivate the children and enhance their participation in the training programs. The pilot study provides data for the calculation of effect size and sample estimates for future studies. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 23-42
Hamill D, Washington KA, White OR

The purpose of this single subject research study was to examine the effects of a once weekly, 10-week hippotherapy program for three children, ages 27-54 months, with cerebral palsy. Participants were rated as Level V on the Gross Motor Function Classification System. The Sitting Dimension of the Gross Motor Function Measure was used to establish a baseline of sitting abilities, and was administered every 2 weeks during intervention. The Sitting Assessment Scale and the Gross Motor Function Measure were administered before, after, and 4 weeks postintervention. Parental perceptions of the hippotherapy intervention were assessed using questionnaires. None of the children made gains on any of the standardized outcome measures. Parental perceptions were very positive, with reported improvements in range of motion and head control. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 7-22
Rodger S, Springfield E, Polatajko HJ

Cognitive Orientation for daily Occupational Performance (CO-OP) is a client-centred, cognitive approach to acquisition of occupational skills. Children are taught a global problem solving framework and are guided to discover Domain Specific Strategies to enable mastery of their child chosen skills. A major focus of CO-OP is on the generalization and transfer of learned strategies and skills to everyday life. Two case studies are reported that provide preliminary evidence of the effects of CO-OP on the everyday lives of two siblings (aged 9 years and 11 years) with Asperger's Syndrome. The data were drawn from the detailed diary kept by the children's mother from the start of intervention and for two months after intervention ceased. Thematic analysis of the diary entries revealed multiple detailed accounts of the children's spontaneous use of the global problem solving framework to assist with acquisition of new motor skills, to overcome organizational and social-emotional difficulties, as well as numerous examples of generalization and transfer of skills. This case report provides preliminary support for CO-OP as an intervention for children with Asperger's Syndrome that supports both skill acquisition and generalization and transfer of skills and strategies. ...»

Phys Occup Ther Pediatr. 2007; 27(4): 1-5
Palisano RJ

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Phys Occup Ther Pediatr. 2007; 27(3): 73-90
Case-Smith J, Sainato D, McQuaid J, Deubler D, Gottesman M, Taber M

IMPACTS project was a master's level graduate program that prepares occupational therapists, physical therapists, speech and language pathologists, nurses and special educators for early intervention practice. The purpose of this descriptive report is to explain the conceptual framework for the graduate program and to identify themes in students' learning from the portion of the program focused on professional-family relationships-the family practicum. In the family practicum, each student spent 50 hours over 6 months with one family who had a young child with significant disabilities. The students wrote reflective journals during the practicum that revealed how they interpreted their experiences for application to their own practices. Through qualitative analysis of the students' journals, four themes emerged: (1) Acknowledge that parenting a child with a disability is a 24/7 job; (2) Recognize that internal and external resources are essential to family adaptation; (3) Respect parents as the experts on their child; and (4) Accept the family's values. These themes were validated by the families' evaluation of the practicum and provide evidence that students grew in their appreciation of and competence in relationship-centered early intervention. ...»