Collaborative Developmental Monitoring Part 1

Overview

This introductory online physiotherapy course focuses on the overall results of the Move & PLAY and On Track Studies, which are both cohort studies that were conducted with large samples of children with cerebral palsy and their families living in both Canada and the United States.

The two major products of the Move & PLAY study are:

1. A comprehensive toolbox of measures that are brief and clinically feasible to administer, as well as reliable and valid. 
2. Testing of a conceptual model of child, family and service determinants and their relationships to outcomes of motor function, self-care performance, and leisure participation.

In the On Track Study, we produced longitudinal curves and reference percentiles for all measures produced in Move & PLAY, which assist with understanding children’s prognoses, relative strengths and limitations, and interpretation of change over time.

These overall results assist in obtaining a more comprehensive understanding of individual children than has previously been possible, which assists with tailoring interventions. A weakness is that the Move & PLAY study was limited to children 18 months to 5 years of age.

The On Track Study included children 18 months to 12 years of age. The major barrier to implementing these results into practice is therapists’ need for TIME to learn how to administer, interpret, and use these research outputs. We have purposefully worked hard to ensure that each therapist- and parent-administered measures can be completed in a timely manner, once learned.

Relevance to physiotherapy practice

Children with cerebral palsy are heterogeneous and complex. This precludes the exclusive use of evidence from randomized controlled trials (RCTs) to inform clinical decisions about services for individual children. We propose an evidence-based approach to complement RCTs using results from the Move & PLAY and On Track studies.

We advocate for a thorough comprehensive annual assessment of children with cerebral palsy, along with interpretation of scores over time, to contribute to intervention planning in collaboration with children and families as a means to contribute to more effective and efficient rehabilitation care.

Learning objectives

Upon completion of this workshop, and completion of online training materials alluded to in this introductory session, participants will be able to:

1. Administer and score brief, psychometrically sound, and clinically feasible measures of balance, strength, range of motion, endurance, the impact of associated health conditions, gross motor function, and participation in self-care and leisure activities for use with children with cerebral palsy across all motor function ability levels.
   
   
2. Understand how to use the results of the Move & PLAY study (i.e. relationships between determinants of primary impairments (balance), secondary impairments (impairments of strength, range of motion and endurance), the impact of associated health conditions, adaptive behaviour, and family and service factors on outcomes of motor function, self-care performance and participation in recreation and leisure activities) to inform intervention planning.
   
   
3. Understand how longitudinal curves and percentiles (products of the On Track Study) of all measures described in the first two objectives can assist with intervention planning by assisting with understanding:
   1. An individual child’s prognosis.
   2. A child’s relative strengths and limitations relative to other children of similar functional level.
   3. The interpretation of changes in scores taken over a period of a year.
      
      
4. Understand how enablement frameworks, family priorities, family-centredness, and collaborative approaches contribute to optimal care.

This course is brought to you by the Paediatric Division of the Canadian Physiotherapy Association. You can find Part 2 of this course here.

Audience

This introductory online course is appropriate for all physical therapists working with children with cerebral palsy and their families. Although the measures and their scoring might not be familiar to participants at the outset, the constructs measured and methods of the examination will be understood by all physical therapy practitioners, regardless of experience.

Practitioners who have served as assessors in either or both of the Move & PLAY and/or On Track studies will already be very familiar with the measures. The section on our approach to ‘collaborative developmental monitoring’ is new.  

Presenter

Doreen Bartlett, MSc, PhD, graduated from Queen’s University with her entry-to-practice physical therapy degree in 1979. After 10 years of clinical pediatric physical therapy practice in Newfoundland, Ontario and British Columbia, she embarked on graduate training and completed her MSc in Physical Therapy and Ph.D. in Rehabilitation Sciences with Martha Piper at the University of Alberta in 1992 and 1997, respectively.

Since completing post-doctoral training in Epidemiology and Biostatistics at Western in 1998 she has been a faculty member in the School of Physical Therapy. She is currently a Professor Emerita of the School of Physical Therapy at Western and Scientist Emerita with CanChild Centre for Childhood Disability Research at McMaster University. Most of her research program over the past 20 years has focused on understanding the development and function of children with cerebral palsy.