Increased Intensity of Physical Therapy for a Child with Gross Motor Developmental Delay

Abstract

Background and Purpose. The intensity of physical therapy provided for children in early intervention (EI) programs may be influenced by a number of factors. In an individualized program, however, some children and families may benefit from an increased frequency of services. The purpose of this case report was to systematically document and describe an increase in physical therapy frequency over a 4-week time frame for a child receiving EI physical therapy services.

Case Description. The child was a 31-month-old girl with a diagnosis of 18p-, a chromosomal abnormality of the short arm of the 18th chromosome. Physical therapy services were increased from once every two weeks to four times a week for four weeks.

Outcomes. Improvement was noted on the Gross Motor Function Measure and Goal Attainment Scaling. Her age-equivalent scores on the Peabody Gross Motor Scales did not change.

Discussion. A targeted increase in physical therapy frequency may be appropriate for some children receiving EI services. Careful consideration of the readiness of a child, along with use of appropriate measurement tools, may be important for determining whether an increase is appropriate and successful.

Key Words:

• Clinical decision-making
• dosage
• early intervention
• frequency
• physical therapy

Additional information

Notes on contributors

Joe Schreiber

Michael Lepp, PT, is in private practice, Associate Instructor of the Upledger Institute, and Clinical Instructor, Case Western Reserve University School of Dentistry, Cleveland, OH.

Marie McKenzie, MS, OTR, is in private practice. She was Coordinator of Occupational Therapy at Scottish Rite Hospital at the time of this study.

Heather Miller, MS, OTR/L, is currently employed by Madison County Educational Service Center, providing therapy services to the county's pre-schools. This research was completed in partial fulfillment of the requirements of an MS degree at Ohio State University.

Linda Viscardis, BA, is Team Leader and Community Development Worker, Peterborough Family Enrichment Centre. She is Co-Founder of P.R.O.S.P.E.C.T.S., a support and advocacy group for families who have children with special needs.

Debra Stewart, BSc, OT(C), is Occupational Therapist, Erinoak, Serving Young People with Physical Disabilities, Mississauga, ON, and Clinical Lecturer, School of Rehabilitation Science, McMaster University.

Janette McDougall, MA, was Project Coordinator

Kip Husted, BEd, was a parent representative on the study team.

Aviva Yochman, MA, OTR, was a student in the School of Occupational Therapy, Faculty of Medicine, The Hebrew University of Jerusalem, Israel at the time of this study.

Imelda Burgman, MA OTR/L BCP, completed her MA in Movement Sciences at Teachers College, Columbia University, and was an Occupational Therapist at The Shield Institute, Bronx, NY. She is currently Lecturer, Habilitation, School of Community Health, Faculty of Health Studies, Charles Sturt University, Albury, N.S.W., Australia.

Barbara J. Steva, OTWL, BCP, is Occupational Therapist, University of New England Community Occupational Therapy Clinic, Saco, ME. She was Director of Occupational Therapy and Therapeutic Recreation, Franciscan Children's Hospital and Rehabilitation Center, Boston, MA, when this work was completed.