Revisiting therapy assumptions in children's rehabilitation: clinical and research implications

Abstract

Purpose. This commentary draws on a recent workshop hosted by the Canadian Children's Rehabilitation Research Network that brought together stakeholders to critically examine assumptions embedded in children's rehabilitation in order to advance current debates and suggest areas for further inquiry.

Method. Six issues are discussed: (1) the wisdom of dichotomising ‘fix’ versus ‘function’; (2) the ethics of ‘it might help and it won't hurt’ therapy approaches; (3) the emphasis on early intervention rather than a lifespan approach; (4) the challenges of providing care for new rehabilitation populations; (5) discrepancies between performance outcomes and patient satisfaction; and (6) innovative partnerships to support care transitions of adolescents and their families.

Results. Issues identified include: finding the right balance between therapies that focus on ‘fixing’ children versus enhancing function, judicious design of therapy programs as to not overburden children and families, adopting lifespan approaches to meet the needs of multiple ‘paediatric’ populations, cautious interpretation of measures and approaches that link well-being with physical performance, and the benefits of including parent and youth facilitators on children's rehabilitation teams.

Conclusions. Ongoing debate, discussion and research are needed in each of these areas to ensure that rehabilitation services are enhancing the well-being of children and families.

Keywords:

• Children with disabilities
• rehabilitation
• quality of life
• ethics