Pediatric Physical Therapy Assessments

Standardized Assessments for Pediatrics

• This document focuses on using standardized assessments for physical therapy in pediatrics.

Goals

• Implement age-appropriate standardized physical therapy tests for neuromuscular conditions.

Objectives

• Utilize evidence-based practice in daily clinical practice.
• Conduct basic physical therapy examinations for patients with neuromuscular disorders.
• Assess mental status, memory, perception, visual fields, cranial nerves, sensation, developmental reflexes, deep tendon reflexes, fractionation of movement, movement control and strength, muscle tone, postural control, coordination, vestibular system, function, and gait in neurological patients.
• Indentify presence/absence of essential components of tasks like turning in bed, sitting up and lying down, moving from bed to chair, standing up and sitting down, balanced sitting and standing, and walking.
• Discuss the value of standardized assessments.
• Select and administer appropriate assessments based on reliability, portability, time constraints, and ceiling effects.
• Analyze patients' examination results verbally and in writing based on positive and negative findings.
• Utilize the International Classification of Functioning, Disability, and Health (ICF) to identify the effects of a patient's condition on body function, activity, and participation.
• Use a classification scheme to determine a movement system diagnosis for neurological patients.
• Compose appropriate short and long-term goals based on examination results that are obtainable, relevant to patient prognosis, evidence-based, and person-specific.

The Why, What, and How

• Focuses on children from birth to 21 years old.
• This section highlights developmental levels and repeated measures testing.
• Uses the International Classification of Functioning, Disability, and Health (ICF) as a framework.

Value of Pediatric Standardized Assessment

• Provides objective information (test scores) and descriptive evaluations.
• Establishes a common language for parents, providers, and payers
• Assesses eligibility for services.
• Identifies areas of strength and opportunity.
• Guides intervention strategies.
• Tracks patient progress.
• Supports research.

How to use the test score

• Prioritize treatment.
• Track progress.
• Plan service frequency.
• Determine predictive value and follow-up planning.
• Advocate for additional services.

Terms

• Pediatric: individuals from birth to 21 years of age
• Screening Tool: a general assessment covering various domains like gross motor, fine motor, language, and social skills. Provides information regarding the need for specialized evaluations.

Preterm/Term

• Pre-Term: 36 6/7 weeks or earlier.
• Early term/Late pre-term: 37 0/7 weeks through 38 6/7 weeks.
• Full term: 39 0/7 weeks through 41 6/7 weeks.
• Post term: 42 0/7 weeks and beyond.

Age Calculation

• Chronological Age: The time elapsed (days, months, years) since birth.
• Corrected Age: Chronological age reduced by the number of weeks born early (pre-term). Used for children up to 3 years of age who were born preterm.

Assessment Terms

• Age Equivalent: Provides an estimate of the chronological age at which a typically developing child exhibits the skills displayed by the child being assessed.
• Criterion Referenced: Compares an individual's performance to a set of predetermined standards.
• Norm Referenced: Compares an individual's performance with others of similar age.

Assessments- special considerations

• Cost of assessment tools.
• Training requirements.
• Copyright and intellectual property considerations.

Pediatric Assessments

• Alberta Infant Motor Skills (AIMS)
• Bayley Scales of Infant Development (Bayley 4)

Alberta infant Motor Skills (AIMS)

• Measures motor development in infants at risk for motor delay, focusing on attaining motor milestones and components necessary to achieve these milestones, including weight distribution, posture, and movement against gravity.
• For infants ages 0-18 months or until walking independently.
• Best suited for infants with developmental delays but relatively normal movement patterns.
• Norm-referenced assessment tool.

Alberta Infant Motor Skills (AIMS) (con’t)

• Reliability: Interobserver reliability found intraclass correlation coefficients of 0.76 to 0.99 for infants 0-18 months.
• Validity: Content validation was achieved through a survey of Canadian pediatric physical therapists and consultation with an international panel of experts.
• Cost: 96forthetestingmanualand96 for the testing manual and 96forthetestingmanualand50 for scoring sheets (package of 50).
• Additional materials needed: Examining table for younger infants (0 to 4 months), firm mat or carpeted area for older infants, age-appropriate toys, stable wood bench or chair for observing pull-to-stand, standing, and cruising activities.
• Administration time: Approximately 20 minutes.
• Administration settings: Inpatient or outpatient settings, may be repeated monthly or less often depending on the treatment goals.
• Suitable for: Inpatient (potentially at evaluation but more likely closer to discharge for planning purposes), outpatient, and developmental clinics settings.

Alberta Infant Motor Skills (AIMS) (con’t)

• Prone example: AIMS assessment for a 9-12 month old child in prone position.

Bayley Scales of Infant Development (Bayley 4)

• Comprehensive test covering multiple domains of child development: Cognitive, language, motor, social-emotional, and adaptive behavior.
• Format: Child-examiner interaction and parent interview.

Bayley Scales of Infant Development (Bayley 4) (con’t)

• Age range and types of diagnoses:
  • 16 days-42 months.
  • May be utilized for various diagnoses:
    • Autism Spectrum Disorder
    • Language Delay
    • Developmental Delay
    • Motor Impairment
    • Prenatal Drug/Alcohol Exposure
    • Moderately or Late Preterm (32-36 weeks)
    • Extremely or Very Preterm (<32 weeks).

This quiz explores standardized assessments in pediatric physical therapy, focusing on neuromuscular conditions. Participants will learn about conducting comprehensive examinations to evaluate a range of physical and mental status indicators. The goal is to enhance evidence-based practices in clinical settings.