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  • Physical Therapy for Children-Module 8: Special Settings and Educational


    Course Description: This course was adapted from the textbook: Physical Therapy for Children, 4th Edition. It provides the essential information needed by PTs, both student and professional, when working with children. Like the previous bestselling editions, the 4th edition follows the practice pattern categories of the Guide to Physical Therapist Practice and uses the IFC model of the disabling process as it presents up-to-date evidence-based coverage of treatment. In this latest edition, Suzann Campbell DeLapp, PT, PhD, FAPTA, Robert J. Palisano, PT, ScD and Margo N. Orlin, PT, PhD, have added more case studies and video clips, additional chapters and Medline-linked references online, and Evidence to Practiceboxes to make it easy to find and remember important information.

    Module 8: Special Settings and Educational Environments covers chapters 27, 28, and 30. Chapter 27: The Environment of Intervention Chapter 28: The Special Care Nursery Chapter 30: The Educational Environment

    Methods of Instruction: Online course available via internet

    Target Audience: Physical Therapists, Physical Therapy Assistants and Athletic Trainers.

    Educational Level: Intermediate

    Prerequisites: None

    Course Goals and Objectives: At the completion of this course, participants should be able to: 1. Recognize the core concepts of child development2. Identify Barnard's four features of successful parent-child interactions3. Recognize the importance that culture plays in successful interventions4. Differentiate between Stewart's five social support theories5. Identify strategies to help families engage in the intervention process6. Recognize the history of the neonatal intensive care environment7. Recognize the incidence of prematurity and low birth weight8. Differentiate between neonatal pulmonary conditions

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  • 9. Identify common signs and symptoms of neonatal seizures 10. Differentiate between the stages of retinopathy of prematurity 11. Identify the eight core concepts of family-centered care 12. Recognize the purposes of the neonatal physical therapy examination 13. Recognize the current physical therapy evaluation and examination tools for the

    neonatal patient 14. Recognize current federal legislation in the educational environment 15. Identify federal definitions of children with disabilities 16. Recognize Section 504 of the Rehabilitation Act 17. Recognize areas that have prompted due process hearings involving physical therapy

    services 18. Identify the least restrictive environment 19. Identify models of team interaction 20. Recognize requirements of the IEP document under IDEA 2004 21. Recognize successful components of educational based physical therapy goals and

    outcomes Criteria for Obtaining Continuing Education Credits: A score of 70% or greater on the written post-test

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    1. This course is offered in conjunction with and with written permission of Elsevier Science Publishing.

    2. Review the goals and objectives for the module. 3. Review the course material. 4. We strongly suggest printing out a hard copy of the test. Mark your

    answers as you go along and then transfer them to the actual test. A printable test can be found when clicking on View/Take Test in your My Account.

    5. After reading the course material, when you are ready to take the test, go back to your My Account and click on View/Take Test.

    6. A grade of 70% or higher on the test is considered passing. If you have not scored 70% or higher, this indicates that the material was not fully comprehended. To obtain your completion certificate, please re-read the material and take the test again.

    7. After passing the test, you will be required to fill out a short survey. After the survey, your certificate of completion will immediately appear. We suggest that you save a copy of your certificate to your computer and print a hard copy for your records.

    8. You have up to one year to complete this course from the date of purchase.

    9. If you have a question about the material, please email it to: and we will forward it on to the author. For all other questions, or if we can help in any way, please dont hesitate to contact us at or 405-974-0164.

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    Physical therapy for children relies on parents and other caregivers to positively infl uence the children s func-tional outcomes and well-being. Consequently, changes in the profi le and aspirations of any contemporary society shapes the demand for specifi c types of services. Since the 1980s, the role of pediatric physical therapists in the provi-sion of services for children with disabilities has expanded to address the demands for enhancing the capacity of the caregiving environment. More recently, the concept of par-ticipation , proposed in the International Classifi cation of Functioning and Health model (ICF) by the World Health Organization, 159 has challenged professionals to consider how individuals function in their environment as the ulti-mate outcome of intervention. Participation is defi ned by the ICF as being involved in life situations and activities. 159 Although planning and providing services that enhance chil-dren s participation continues to be a challenge, designing services that enhance both children s participation and the capacity of the caregiving environment is a monumental task.

    A better understanding of how physical, social, and atti-tudinal elements in the environment mediate children s functional skills and participation is critical for effecting change. Simply acknowledging that the caregiving environ-ment is a crucial element in child development is not enough. Neither is accepting the role of the family. Understanding of environmental determinants entails synthesis of informa-tion from current research fi ndings on (1) environmental factors that contribute to optimal or nonoptimal functional outcomes in children, (2) how factors interact and directly or indirectly infl uence outcomes, and (3) the types of inter-vention programs or approaches that infl uence the caregiv-ing environment and child outcome directly and indirectly. Also needed are studies, particularly by pediatric physical therapists, on the environment of intervention as it relates to service delivery and motor outcomes in children. Until there are more studies on the impact of physical therapy, literature from psychology, anthropology, and family therapy offers a sizable body of knowledge that can be useful to physical therapists.

    This chapter synthesizes the literature with focus on envi-ronmental factors as they relate to child development and participation, family functioning, and physical therapy interventions. First, we briefl y review theoretic frameworks and fi ndings that support targeting the child s caregiving environment and also may inform intervention strategies. Next, we analyze characteristics of the physical and social environments that have been closely linked to child out-comes and that could form the basis for service delivery models for children with disabilities. In the last section, we offer suggestions for how therapists can plan interventions that are informed by and infl uence the environment (con-textual interventions). Because physical therapists focus their interventions on motor development and its ability to promote participation whereas research on environmental factors has focused on social and cognitive development, the chapter concentrates on environmental factors that we believe (1) may affect or be affected by physical therapy, (2) are important for children s activity and participation in daily life, and (3) are likely to contribute to the differ-ences in the outcomes of children based on family background.

    DEFINITIONS The environment in this chapter is used to describe the physical and social settings in which children develop, grow, and function. The physical environment may be a home, day care center, school, or neighborhood. It encompasses struc-tural conditions such as space, equipment, and material resources (e.g., toys and books), and relates to safety and access. The social environment conveys interactions and relationships that nurture development and shape behavior. It includes relationships, starting with interactions with parents, siblings, extended families, and extending to peers and other adults in the community. The social environment also relates to emotional wellness and the quantity and quality of support. For children and their families, these two environments are inextricably intertwined as they constitute

    SECTION V Special Settings and Special Considerations SECTION EDITOR: ROBERT J. PALISANO, PT, ScD

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  • 880 SECTION V Special Settings and Special Considerations

    authors and researchers in early interventionist study have expanded the defi nition to include both the setting where children actively participate in their everyday lives and natu-rally occurring routines or rituals. 98,121,129 This defi nition, which regards the natural environment as contextual, is sub-sumed in the broader defi nition of the caregiving environ-ment and incorporated in information that will be discussed in this chapter.



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