Physical & Occupational Therapy in Pediatrics最新文献

Aim: The aim of the study was to examine children's lived experiences of the therapeutic relationship with their occupational therapist.

Methods: A hermeneutic phenomenological design was used. Fourteen children aged 2 to 10 were recruited through occupational therapists at various sites within a healthcare institution in Quebec (Canada). Individual art-based interviews were conducted with children. A hermeneutic phenomenological analysis was used to identify themes emerging from their experiences.

Results: Children's experiences of the therapeutic relationship reflected four main themes. First, trust-building emerged as central, with children highly attuned to nonverbal cues such as empathic gaze and active listening. Second, children highlighted the importance of feeling genuinely heard and understood in their therapeutic journey. Third, the learning process, with its progress and challenges, was shaped by the therapist's responsiveness. Finally, a shared understanding of therapeutic activities fostered a strong connection, especially when the activities held personal meaning for the children and reflected their own goals.

Conclusions: This study showed that children value being heard, understood, supported, and engaged in meaningful therapy activities that reflect their goals and interests. Their experiences emphasize the importance of recognizing children as active participants and integrating their voices into the co-construction of therapeutic relationships.

Aims: This cohort study aimed to evaluate the test-retest reliability, responsiveness, and interpretability of the Participation Questionnaire for Preschoolers (PQP), a tool for assessing participation in preschool children with autism spectrum disorder (ASD).

Methods: Caregivers of children with ASD aged 51-75 months completed online surveys at four time points over six months. Test-retest reliability was examined using intraclass correlation coefficients (ICCs) for 275 participants. Responsiveness was examined by analyzing correlations between changes in PQP scores and the Strengths and Difficulties Questionnaire and the Family Outcomes Survey based on four predefined hypotheses. To assess interpretability, the Global Rating of Change (GRC) Scale was used as an anchor to analyze receiver operating characteristic curves and estimate minimal important change (MIC).

Results: ICCs ranged from 0.80 to 0.92 for individual subscales and reached 0.93 for the total score. Three of four hypotheses for responsiveness were supported. However, the correlation between the GRC Scale and changes in PQP scores was below 0.3, preventing MIC calculation.

Conclusion: Although the MIC could not be calculated, the PQP's strong test-retest reliability and responsiveness provide a foundation for future research.

Aim: This exploratory study examined evidence for emerging humility and appreciation of the benefits of listening, as shown in students' reflections on their use of listening stances.

Methods: 135 Occupational Therapy, Physical Therapy, Speech-Language Pathology and Audiology students completed a written reflection on their experience practicing a self-selected listening stance (receptive, exploratory, consensus-oriented, or action-oriented listening). A chi-square analysis examined the number of students' humility-related comments as a function of students' discipline and chosen listening stance. Types of benefits arising from listening practice were determined by extracting and grouping quotes in students' reflections.

Results: More Occupational Therapy students chose to practice exploratory listening than expected by chance and they made more humility-related comments when choosing this stance, whereas more Physical Therapy students chose to practice action-oriented listening and they made more humility-related comments when choosing this stance. There was evidence for various positive benefits, including deeper understanding for the self, deeper sharing by the other person, and more meaningful and productive conversations.

Conclusions: This study provides important findings regarding the preparation of healthcare students for clinical practice. There was preliminary evidence of associations between clinical listening practice and emerging humility, as well as greater awareness of the benefits of listening.

Aims: This pilot study provides preliminary insights into pediatric physical therapist (PT) current use and perceived value of telerehabilitation services, identifying key barriers and benefits associated with its implementation.

Methods: An electronic survey was sent to pediatric physical therapy clinical sites from three universities. Multiple-choice and open-ended questions focused on PT use and perception of telerehabilitation, patient characteristics, interventions and assessments utilized, and perceived barriers and benefits.

Results: Data from 68 surveys were analyzed. Pediatric PTs reported an average of 15.5 years (SD = 10.5) of practice experience. Since the conclusion of the COVID-19 pandemic, 42 participants (61.8%) indicated they have continued to provide telerehabilitation services. There was a small-to-moderate positive association between value of delivering telehealth and the frequency of delivering pediatric physical therapy via telehealth (r_s=0.29, p = 0.015). Perceived barriers included socioeconomic, child/caregiver engagement, child characteristics, administrative barriers, and limited hands-on care/reduced clinical effectiveness. Perceived benefits included increased access to services, family empowerment, opportunity for home programming, opportunity for continued services, and family involvement/engagement.

Conclusions: Study findings in this small sample support the perceived value of telerehabilitation as a pediatric physical therapy service delivery model and highlight the ongoing need for its continued use.

Aims: Person-level engagement, though well studied in counseling, mental health, and adult rehabilitation, is also critical in pediatric rehabilitation, yet it remains underexplored in motor learning interventions for children with unilateral spastic cerebral palsy (USCP). This study investigated how individual characteristics, including age and mastery motivation, influenced person-level engagement and examined how engagement affected motor outcomes.

Methods: A retrospective analysis was conducted involving 49 children with USCP aged 6-17 years who participated in either constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive therapy (HABIT). Engagement was assessed through video coding and behavioral questionnaires, while hand function was evaluated using three standardized tests.

Results: Findings indicated that age was significantly related to engagement. Engagement measures correlated with improvements in hand capacity as measured by the Jebsen-Taylor Hand Function Test, but not with performance on the Assisting Hand Assessment.

Conclusion: The results highlighted the relationship between age and engagement, emphasizing the importance of age-appropriate intervention strategies. Engagement played a role in improvements observed on capacity-based hand function tests, suggesting that engagement during therapeutic camps may be more critical for capacity-based than for performance-based motor activities. These insights support the design of targeted, age-appropriate interventions that optimize therapeutic outcomes for children with USCP.

Aims: This study aimed to examine how motor skills, sensory processing, and visual perceptual abilities predict self-care performance in typically developing preschool children.

Methods: Eighty-six children aged 4-6 years were included in this cross-sectional study. Self-care performance was assessed by teachers using the Assessment of Self-Care Skills, which evaluates children's functional independence in daily routines. The Bruininks-Oseretsky Test of Motor Proficiency- Brief Form (BOT-2-BF) was used to assess motor proficiency. The Sensory Processing Measure (SPM) evaluated sensory responsiveness and regulation across sensory domains. The Motor-Free Visual Perception Test (MVPT-3) measured visual discrimination, memory, and spatial processing. Data were analyzed using ANOVA, Pearson correlation, and multiple regression analysis.

Results: Significant age-related differences were found in motor proficiency, visual perceptual skills, and self-care performance (p < .05). Manual dexterity, visual accuracy, and figure completion emerged as significant predictors of self-care. Sensory processing difficulties, particularly in the visual domain, were negatively associated. The final regression model accounted for 80.9% of the variance in self-care scores (p < .001).

Conclusions: Motor proficiency, sensory processing, and visual perceptual abilities significantly influence self-care performance in preschool children. Early identification and intervention targeting these developmental domains may support children's independence and participation in daily routines.

Aims: To explore key components and describe the areas of online learning programs for caregivers of children and youth with neurodevelopmental disabilities (NDDs, e.g. autism, cerebral palsy), examine their impact, and highlight gaps in current knowledge.

Methods: A scoping review, guided by the Arksey and O'Malley framework, was performed in six steps including a comprehensive search across six databases, rigorous study selection, detailed data extraction, synthesis of findings through content analysis, and consultation with five stakeholders (caregivers of children with NDDs).

Results: From 1701 citations, 36 studies were included, over half of which were randomized controlled trials (n = 20, 55.6%). Most programs focused on caregivers of children with autism spectrum disorder, and nearly three-quarters targeted early childhood (0-5 years). Parental knowledge was the most frequently addressed outcome, with 86.1% (n = 31/36) studies reporting significant improvements. Caregiver consultations underscored limited integration of online programs into practice, and emphasized unmet needs related to transition to adulthood, single parent support, and flexible delivery.

Conclusions: Online learning shows strong potential to enhance caregiver outcomes. However, future development should broaden to include diverse NDD populations, adolescence and adulthood transitions, and strategies to embed structured programs into routine clinical practice.

Background: Children with autism spectrum disorder (ASD) have difficulties in social communication and sensory processing. This study examined how these challenges affect daily living activities (ADLs) in young children with ASD.

Methods: In this cross-sectional descriptive study, we assessed 60 Brazilian children aged 3-5 years with ASD. The primary outcome, ADL performance, was assessed using the Pediatric Evaluation of Disability Inventory - Computer Adaptive Test (PEDI-CAT/ADL). The Autism Classification System of Functioning: Social Communication (ACSF:SC) and the Sensory Profile, Second Edition (SP2), were employed to examine the influence of social communication abilities and sensory processing on ADL performance. We used correlation and regression analyses to identify interrelationships.

Findings: While most children scored within age-expected values on the PEDI-CAT, only a few (8/13.3%) scored within the typical range on the SP2. Regression analysis revealed that while ACSF:SC-performance, age, and gender significantly influenced the PEDI-CAT score (p < .001), sensory processing did not.

Conclusion: The importance of social communication for daily activities was reaffirmed. While functional performance declined with age, sensory processing issues did not affect daily function in young children with ASD. Cultural expectations may have influenced parents' ratings of ADLs, especially for girls. Longitudinal cross-cultural studies are needed to clarify gender and sensory processing roles in daily functioning of children with ASD.

Aims: To develop a multicriteria index with the main factors associated with high risk of cerebral palsy (CP).

Methods: Exploratory cross-sectional study. Ninety-two infants, mean age 94.8 (±13.5) days, discharged from neonatal intensive care units (NICU) in Brazil, were included, and assessed using the General Movements (GMs) and Hammersmith Infant Neurological Examination (HINE). The multicriteria index incorporated factors such as infections from the toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, and zika virus (TORCHSZ), prematurity, birth asphyxia, Apgar score, seizures, duration of mechanical ventilation, corticosteroid and magnesium sulfate medications, therapeutic hypothermia, and caffeine. Validation included the Pearson correlation, simple linear regression analysis, and one-way analysis of variance (ANOVA), with Tukey's post hoc test.

Results: The multicriteria index showed a positive and moderate association with high risk of CP (R²=0.20, p < 0.0001), indicated by abnormal GMs and HINE results. Significant differences between the low- and high-risk groups (p < 0.0001) and between the medium- and high-risk groups (p = 0.005) of CP were found.

Conclusions: The multicriteria high risk CP index, developed by combining clinical factors, enabled the identification of high-risk infants with CP and a history of NICU admission. These findings can support healthcare professionals in making more precise referrals for early intervention.

Aims: Identify occupational therapy service models in Chilean schools and explore the factors that influence these models, and how they align with inclusive practices.

Methods: This was a mixed-methods study that included a cross-sectional survey that obtained 241 valid responses from Chilean OTs working in schools, which were analyzed using descriptive statistics. Eighteen of these participants subsequently participated in four online focus groups, discussions that were analyzed using a thematic approach.

Results: Participants provided more frequent direct pull-out services (68.3%) with weekly 45 min sessions, conducted mainly in an OT room or mainstream classroom. Five factors were perceived to influence services: institutional constraints, the educational community's perspectives on OTs, characteristics of students, a persistent structural demand for a deficit-based approach, and the impact of the COVID-19 pandemic.

Conclusions: The service model of OTs in Chilean schools was characterized by difficulty aligning with inclusive practices. This reveals a praxis with a markedly medical focus, making it difficult to distinguish it from clinical practice, an essential aspect for the development of OT services in schools.