Meeting the Physical Therapy Needs of Children

Abstract

In this second edition of Meeting the Physical Therapy Needs of Children, Dr. Susan Effgen of the University of Kentucky once again offers a broad overview of paediatric physical therapy. This edition is set up in much the same way as the first, taking a systems approach and using the International Classification of Functioning, Disability and Health, Version for Children and Youth (ICF-CY) model as a guide to physical therapy intervention. Abundant photographs and diagrams help to explain skills development, assessment, and a variety of disabilities. Throughout, the text emphasizes the value of a team approach to intervention and the importance of culturally sensitive, family-centred care. The author recommends a systematic approach to intervention that includes goal-directed therapy as well as discharge criteria. Unfortunately, the text does not include strategies for supporting families when therapy is discontinued before the child's goals are reached. This edition includes several updates. A comprehensive new chapter titled “Child Development” examines typical development, biomechanics, and gait development in detail; the progression of gross motor skills such as running and jumping is described, from initial appearance through to mature performance. This chapter also includes details on the development of manipulation, cognition, language, and social–emotional milestones, which may assist therapists in designing age- and skill-appropriate treatment plans. The timelines provided may also help physical therapists to recognize instances of skill deficit for which referral to another rehabilitation professional is appropriate. A second new chapter, “Child Appraisal: Examination and Evaluation,” lists tests and measures in five categories—developmental, functional, sensory integration, pain, and quality of life—detailed versions of which are found in the appendix at the end of the chapter. These charts are an easy reference tool for identifying the appropriate test or measure with respect to age range, primary use, ICF-CY Classification tested, and area or areas of skill tested. Also included in this chapter is a figure titled “Clinical Decision-Making Algorithm for Paediatric Physical Therapy—Examination,” which provides a pictorial view of the assessment process and could be a helpful tool both for students and for therapists new to paediatric practice. Information on assessing impairments is not included in this chapter; every system-specific chapter, however, does include information on assessing impairments related to that system. Meeting the Physical Therapy Needs of Children features several disease-specific case studies demonstrating the complexity and multisystem involvement of paediatric disorders. These cases have been updated from the first edition, and two new cases—“Developmental Coordination Disorder” and “Myelodysplasia”—have been added. Each case includes a history, systems review, and tests and measures across the paediatric age range, as well as examples of goals, treatment, and client/family education. Combined with discussion questions at the end of each chapter, these cases may facilitate therapists' critical thinking and clinical decision making. In addition, these tools are detailed enough to be used by physical therapy students for self-study. Also new to this edition is a narrated DVD featuring video of children with various diagnoses receiving physical therapy treatment. While it effectively shows the dramatically different presentations of children with different disability types and diagnoses, the video component would need to be significantly expanded to be truly useful in designing physical therapy treatment plans. This text would be a good reference for students and therapists looking for case studies to help them with their studies or with treatment planning. It would also be a satisfactory reference for those wishing to examine paediatric physical therapy from a systems perspective.