How are actual needs recognized in the content and goals of written rehabilitation plans?

Abstract

Purpose: The primary aim of the study was to investigate the interrelation between needs and functional difficulties and the therapeutic goals in children with cerebral palsy (CP) as documented in individual written rehabilitation plans. Method: The study was a retrospective cross-sectional register study. The data consisted of randomly chosen register documents for 77 children and adolescents with CP in different predetermined age ranges. The International Classification of Functioning, Disability and Health – Child and Youth version (ICF-CY) was used as a reference for analyzing the content of the written statements. Results: The rehabilitation plans for 70 children, 1–16 years of age, representing all GMFCS levels were analyzed. Goals were not well reflected in the children’s needs and functional difficulties. The needs, functional difficulties and goals mainly encompassed the components of body functions and activity/participation. In half of the plans the presence of the parents was mentioned, and the plans were made in multidisciplinary collaboration. Conclusions: The results of this study indicate deficiencies in the content and goals of the written rehabilitation plans. The ICF-CY could serve as a framework to help professionals and parents identify the child’s needs and those areas where the goals should be targeted.

Implications for Rehabilitation

• Documenting the child’s and family’s needs in relation to activity and participation preferences is critical to rehabilitation and intervention planning.

• Goals, based on the child’s needs, should be identified in collaboration with all parties involved, and focus on the child’s functioning in meaningful everyday activities.

• The ICF-CY could serve as a framework for the family and professionals to identify needs and to communicate rehabilitation goals.

• Cerebral palsy
• functional needs
• goals
• ICF-CY
• rehabilitation plan

Acknowledgements

The authors thank the Social Insurance Institution of Finland, Department of Rehabilitation and Department of Research for financial support, Nigel Kimberley for his help in polishing the language and Peter Mildén for his help with the statistics.