Standardized Assessments for Pediatrics PDF

Standardized Assessments for Pediatrics October 28, 2024 Rebecca Pendino, PT, DPT, CNT, PCS GOAL: choose and implement appropriate physical therapy standardized tests and measures for patients with neuromuscular conditions, based on their age, diagnosis for physical therapy and...

Standardized Assessments for Pediatrics October 28, 2024 Rebecca Pendino, PT, DPT, CNT, PCS GOAL: choose and implement appropriate physical therapy standardized tests and measures for patients with neuromuscular conditions, based on their age, diagnosis for physical therapy and other evaluative findings. Program in Physical Therapy Objectives utilize evidence-based practice principles in every-day clinical practice outline and efficiently organize a basic physical therapy examination of a patient who displays a neuromuscular condition and perform appropriate examination procedures correctly describe and perform the examination techniques needed to assess mental status, memory, perception, visual fields, cranial nerve function, sensation, developmental reflexes, deep tendon reflexes, fractionation of movement, movement control and strength, muscle tone, postural control (balance), coordination, vestibular system, function and gait for patients with neurological deficits. Program in Physical Therapy Objectives (con’t) identify the presence or absence of essential components of the following tasks: turning in bed; sitting up and lying down; moving from bed to chair; standing up and sitting down; balanced sitting and standing; and walking list examples of standardized functional and developmental assessment tools and be able to a) discuss how decisions about what test to use are made, b) discuss the value of using standard assessments, and c) select (reliability, portability, time, ceiling effect, etc.) and administer an appropriate tool for given patients analyze a patient’s examination results verbally and/or in written form, according to the positive and negative findings Program in Physical Therapy Objectives (con’t) given a patient condition, apply the International Classification of Functioning Disability and Health (to identify the effects on a patient’s body function and structure, activity, and participation) and intra- and intervening factors use a classification scheme to determine a movement system diagnosis for neurologically involved patients compose appropriate short and long term goals based on examination results that are obtainable, relevant to patient prognosis, evidence-based, and person specific Program in Physical Therapy  68 year old s/p right CVA 3 days ago IP setting 75 year old s/p left CVA 4 weeks ago OP setting 35 year old newly diagnosed with MS OP setting Newborn s/p intrauterine CVA IP setting 4 year old s/p CVA due to clotting disorder/ heart defect OP setting 10 year old with diagnosis of CP OP setting Program in Physical Therapy THE WHY, WHAT AND HOW Background information: Ages: birth to 21years Developmental Level Repeated measures testing Pediatric Tests and Measures by ICF Microsoft Word - FactSheet_ListofPediatricAssessmentToolsCategorizedbyICFModel_2013.doc x (pediatricapta.org) Program in Physical Therapy Value of Pediatric Standardized Assessment Objective information (test score) + descriptive evaluation= more complete picture of child Common Language for parents/providers/payors Eligibility for services Highlights areas of strength/opportunities Guide intervention Progress Research Program in Physical Therapy How to use the test score Prioritize treatment Track progress Plan for frequency of services Predictive value/ follow up planning Advocate for additional services Program in Physical Therapy Terms Pediatric: birth to 21 years Screening Tool: a general assessment covering a variety of domains such as gross motor, fine motor, language, social. Screening tools provide information about need for evaluation by specific services. Program in Physical Therapy 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 American College of Obstetrics and Gynecology Program in Physical Therapy Age Calcuation Chronological Age: amount of time (days, months, years) since the child was born (birth date) Corrected age (weeks or months): chronological age reduced by the number of weeks born early (pre-term) ; it should be used only for children up to 3 years of age who were born pre-term. The American Academy of Pediatrics suggests correcting age for children born preterm up to age 3. Some facilities/organizations may correct up to age 2. Example: infant born at 30 weeks gestation (10 weeks before due date) who is now 12 weeks chronological age would have a corrected age of 2 weeks. *Corrected age and adjusted age may be used interchangeably, however corrected age is preferred Program in Physical Therapy  Corrected age (weeks or months): chronological age reduced by the number of weeks born early (pre-term) **should used only for children up to 3 years of age who were born pre-term. ( American Academy of Pediatrics recommendation). Some facilities/organizations may correct up to age 2. Example: infant born at 30 weeks gestation (10 weeks before due date) who is now 12 weeks chronological age would have a corrected age of 2 weeks. *Corrected age and adjusted age may be used interchangeably, however corrected age is preferred Program in Physical Therapy Assessment Terms: Age equivalent: this score provides an estimate of the chronological age at which a typically developing child demonstrates the skills displayed by the child being assessed Criterion Referenced: this type of test compares a person’s performance to a set of standards. This type of test allows the person to be compared to themself over time to see if they are at/above/below the set level Norm Referenced: this type of test compares a person's performance to others who are similar by age. For example, comparing a child’s mobility skills to a group of peers of the same age. A norm- referenced test compares a person's performance to what is typical for other people like them. Program in Physical Therapy Assessments- special considerations Cost Training Copyright/Intellectual Property Program in Physical Therapy Pediatric Assessments Program in Physical Therapy Alberta infant Motor Skills (AIMS) Description of the measure: This test measures the motor development for infants at risk for motor delay, focusing on attaining motor milestones and components necessary to attain the milestones weight distribution posture movement against the force of gravity Age and types of diagnoses: infants ages 0-18 months or until walking independently This test is best suited to infants who are delayed but have relatively normal movement patterns. Criterion or norm-referenced: norm -referenced Program in Physical Therapy Alberta infant Motor Skills (AIMS) (con’t) Reliability: Interobserver reliability found intraclass correlation coefficients of 0.76 to 0.99 of infants 0-18 months Validity: Content validation of the instrument was accomplished through a mail survey of Canadian pediatric physical therapists and consultation with an international panel of experts. Cost of test: $96 testing manual $50 testing 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, toys appropriate for ages 0 to 18 months, stable wood bench or chair to observe some of the pull to stand, standing, and cruising items Program in Physical Therapy Alberta infant Motor Skills (AIMS) (con’t) Time it takes to administer: 20 minutes When/how often the test would be administered: Inpatient or outpatient setting, may be repeated monthly or less often depending on purpose of testing/ intervention Setting(s) in which this would be performed: inpatient (potentially at evaluation more likely closer to discharge for planning purposes), outpatient, developmental clinic Program in Physical Therapy Alberta infant Motor Skills (AIMS) (con’t) AIMS Sample Assessment Prone 9-12 months Program in Physical Therapy Bayley Scales of Infant Development (Bayley 4) Description of the measure: This test covers multiple domains of child development. Cognitive Language Motor Social-Emotional Adaptive Behavior Format: Child-examiner interaction, parent interview Program in Physical Therapy Bayley Scales of Infant Development (Bayley 4) (con’t) Age and types of diagnoses: 16 days-42 months. May be used for a variety of 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 (