This is archived programming for CSM 2013. See current programming.
Browse Pediatrics sessions by day. Return to the main topic menu
Monday, January 21 | Tuesday, January 22 | Wednesday, January 23 | Thursday, January 24
* Should you choose to preselect sessions during the registration process, please be advised that preselection is not a guarantee of a seat. Attendees are asked to preselect to better determine room size and all efforts will be made to accommodate sessions in the largest rooms possible. All attendees are encouraged to show up to sessions early. Attendees are also encouraged to select alternative sessions in the event their first choice is full.
Location: San Diego Convention Center | 33C
Time: 8:00 am - 5:30 pm
Speakers: Margaret O' Neil, PT, PhD, MPH; Kristie F. Bjornson, PT, PhD, PCS; Nancy Lennon, PT, MS; Deborah Thorpe, PT, PhD, PCS
CEUs: 0.9 (9.0 contact hours/CCUs)
Preconference Pricing: Standard (1A)
Youth with cerebral palsy (CP) have decreased aerobic capacity, gross motor function, physical activity, and participation compared to peers with typical development. Aerobic fitness is critical for optimal health and functional mobility. Activity-based interventions may improve activity, fitness, and function in individuals with CP. "Dosing" exercise intensity using target heart rate may improve aerobic capacity and function in land and aquatic settings. The speakers will review the evidence on outcome measures and the effectiveness of "dosing" interventions to promote physical activity, fitness, and function in youth with CP. Recommendations on interventions will use the FITT principles (frequency, intervention, type, and time). The International Classification of Functioning, Disability, and Health (ICF) will be used to classify outcome measures for body function and structure, activity, participation, and personal and environmental factors. Attendees will work in small groups to design intervention and measurement protocols. A lab session will be conducted for attendees to get hands-on experience.
Upon completion of this course, you'll be able to:
Location: San Diego Convention Center | 33A
Speakers: Jill Heathcock, PT, PhD; Robyn Fuchs, PhD; Noelle Moreau, PT, PhD; Laura Prosser, PT, PhD; Mary Gannotti, PT, PhD; Andrew Gordon, PhD; Thubi H. Kolobe, PT, PhD, FAPTA; Jennifer B. Christy, PT, PhD
Level: Multiple Level
Rehabilitation strategies vary greatly due to vast differences in frequency, intensity, type of intervention, and timing (dosing). Intervention for children with brain injury provides an additional challenge to the pediatric physical therapist due to maturation during typical and atypical development. This course will explore the state of the science in dosing as it relates to children with cerebral palsy and includes 2 main topic areas: the musculoskeletal system and brain plasticity, which are both specific to dosing and early brain injury. Using the ICF (International Classification of Functioning, Disability, and Health) model, this course will familiarize attendees with the current research on the responses of muscle, bone, and brain to pediatric neurorehabilitation. The speakers will place an emphasis on strategies with established criteria for dosing—including frequency, intensity, type of treatment, and timing—with a focus on structural and functional changes in the context of lower- and higher-intensity protocols. Plasticity and recovery outcomes will guide the clinical discussion on how to use targeted interventions by applying best available evidence. Minimal and optimal dosing parameters will be discussed. The format for this session will include lecture and interactive discussions among presenters and attendees.
Time: 8:00 am–10:00 am (See Program for Room)
Speakers: Magdalena M. Oledzka, PT, PCS, MBA; Maureen C. Suhr, PT, DPT, PCS; Roger F. Widmann, MD
By combining the latest available evidence with clinical expertise, this program will discuss the etiology, incidence, differential diagnosis, developmental assessment, sensory implications, and therapeutic interventions for children diagnosed with congenital muscular torticollis. Plagiocephaly and its implications will be discussed. The speakers will present guidelines for examination, progression of treatment, and discharge, along with the clinical use of manual techniques, taping, and bracing.
Speakers: Lisa C. Drefus, PT, DPT; Sherry I. Backus, PT, DPT, MA; Melanie Buckland, PT, DPT, ATP, C/NDT
The musculoskeletal care of ambulatory children with cerebral palsy (CP) (GMFCS level I-III) is highly specialized and treatment is evolving. Gait deviations are common in children with spastic diplegia and hemiplegia, and it can be challenging to identify the primary versus secondary gait compensations. As a PT it is key to identify the cause of gait deviations in order to improve gait and functional mobility. This course will provide PTs who manage children with CP a better understanding of the principles of normal gait, gait deviations, CP clinical tests and measures, and musculoskeletal management. Observational gait analysis and an understanding of 3D gait analysis of kinematic and kinetic curves are needed in addition to the clinical examination to correctly identify areas of impairment. The gold standard for gait is 3-D motion analysis; however, this technology is not easily accessible in the clinic. Therefore, therapists need to be competent in visual and video gait analysis.
The purpose of this course is to review normal gait, identify common gait patterns, including classifications of hemiplegia and spastic diplegia, recognize clinical CP tests and measures, and discuss treatment strategies. Rehabilitation emphasis is on: fine tuning gait analysis skills, identifying musculoskeletal impairments, developing effective treatment strategies to work towards improving gait, motor development, and function in ambulatory children with CP.
Time: 11:00 am–1:00 pm (See Program for Room)
This is a joint program. See full description at Hand Rehabilitation programming.
Speakers: Connie Johnson, PT, DScPT; Maria Benedetto, PT, DPT; Deborah Rose, PT, DPT; Heather Atkinson, PT, DPT; Kim Nixon-Cave, PT, PhD, PCS
Outcomes are used to measure progress of children across pediatric physical therapist practice settings. This interactive forum will explore the utilization of a variety of outcomes methods for clinical reasoning and decision making across pediatric practice settings, including early intervention, hospitals, schools, and workplaces. Presenters will share information and facilitate discussion and shared learning for use of outcome measures relative to the ICF model, clinical decision making utilizing the Physical Therapist Clinical Reasoning Tool (PT-CRT), and professional partnerships with stakeholders. A case-study format will highlight the interpretation of outcomes measurement as part of collaborative clinical decision making with children and parents. Attendees will discuss the practical use of outcome measures relative to the ICF and communication of outcomes in a way that empowers families. Use of communication skills to build collaborative partnerships with families will be emphasized. By attending this course, physical therapists will have increased knowledge about how pediatric physical therapists can use and communicate outcomes measures across the lifespan.
Speakers: Nancy Ferreira, PT, DPT; Denise Coleman, PT, DPT; Elizabeth R. Alfonso, PT, DPT, PCS
Level: Multiple Level
Attendees will be instructed in Yoga, Pilates, and Zumba® techniques that can be used in play activities with children. The instructors will identify and discuss common musculoskeletal disorders seen in pediatric populations and identify how yoga, Pilates, and Zumba® can address these issues. This course will provide hands-on techniques to enhance therapeutic exercises to increase core stability, breathing, and posture. Clinicians will learn to identify postural mal-alignments that can affect core stability and breathing. Such manual application offers a unique way to achieve improvements in strength, aeration, and alignment in children.
By combining the available evidence with clinical expertise, this session will discuss the etiology, incidence, and differential diagnosis of congenital muscular torticollis (CMT). Ultrasonographic classification of the sternocleidomastoid muscle will be reviewed as a possible explanation for the failure of conservative treatment. The speakers will offer an in-depth explanation of surgical intervention for CMT, including subcutaneous tenotomy, Z lengthening, unipolar release, and bipolar release. Discussion will include postoperative rehabilitation guidelines including examination, assessment, treatment progression, orthotic management, and discharge criteria.
Time: 3:00 pm–5:00 pm (See Program for Room)
Speakers: Gay L. Girolami, PT, PhD, C/NDT; Takako Shiratori, PT, DPT, PhD
Anticipatory postural adjustments (APAs) and compensatory postural adjustments (CPAs) have been identified as components necessary to maintain balance when performing voluntary movement. Each of these postural strategies has a different yet significant role in postural control, and each is associated with a specific time frame in relation to a focal movement. APAs are feed-forward postural adjustments that are initiated approximately 100 ms prior to a movement and serve to minimize and offset the effects of the postural perturbation. APA research in adults is well-established, but until recently little was known about the organization of APAs in children with typical development and children with cerebral palsy. Recent research describing APAs in children deepens our knowledge concerning this component of postural control. Examining the evidence provides us with information to translate research into clinical practice. This purpose of this instructional course is to review the latest research on anticipatory postural adjustments (APAs) in children with typical development and cerebral palsy (CP), discuss translation of APA research findings into clinical practice and present ideas for management based on the research evidence.
Speakers: Eunice Y. Shen, PT, DPT, PhD, MS, PCS; Lora Woo, OTD
A large, multisite, outpatient pediatric therapy program embarked on evaluating its provision of therapy services. The program completed a strength-weakness-opportunities-threats (SWOT) analysis, developed a strategic plan, and created a new model for delivering services. The program made the commitment to be more family-centered by focusing on collaboration with patients and families to guide therapy, rather than one directed solely by the therapist. Staff training was provided on enhancing the collaborative process with patients and families that included the introduction of the Canadian Occupational Performance Measure (COPM) tool, and on leadership development for all supervisory staff. Two thousand and eighty-eight parents and caregivers completed the Measure of the Processes of Care for Families (MPOC-20) and the physical and occupational therapy staff completed the Measure of the Processes of Care for Service Providers (MPOC-SP). The extent of family-centered service provision was evaluated and the speakers will present the results.
This is a joint program. See full description at Cardiovascular and Pulmonary programming.
Speakers: Laurie Ray, PT, PhD; Carlo Vialu, PT
School-based physical therapist practice is a setting that, to date, has gotten little attention in the literature. In 2011 nearly 5,000 members of APTA's Section on Pediatrics, approximately 24%-30%, reported working primarily in public schools; however, a shortage of physical therapists for many school systems persists. This session will provide information from surveys from the practitioners that serve our public schools in 2 very different school systems: the New York City Department of Education and the North Carolina Department of Public Instruction.
This session will approach the interpretation of the survey results in 2 ways. First, the presenters will discuss obstacles that the public school systems face in retaining therapists expressed in the survey results, including, among others, salary discrepancy, the itinerant nature of the job, overwhelming workload, and a paucity of professional supports and opportunities for advancement. Through group discussions, the speakers will challenge attendees on how to best advocate in shrinking these barriers, or minimizing their effects. Second, data will be presented on the percentage of therapists surveyed who have expressed the desire to remain in their current position. What are the most influential factors in these PTs' decisions to remain? The speakers will facilitate an audience discussion on ways therapists and school administrators can further enhance the positive effects of these factors to enhance a school-based therapist's sense of job satisfaction.
Speakers: Jean Stout, PT, MS
This session will demonstrate the process of translating research into practice by applying Rasch Analysis measurement theory research to the Gillette Functional Assessment Questionnaire (FAQ) and the Pediatric Outcome Data Collection. The presenter will use case studies to describe the integration of skill difficulty, classification systems such as the GMFCS, and measures of gait impairment to explain the usefulness of the tool in a clinical or school setting in providing direction for therapies and in counseling families regarding expectations of skill abilities.
Speakers: Lisa Chiarello, PT, PhD, PCS; Tricia Catalino, PT, DSc, PCS
Providing services in early intervention requires the integration of the art and science of practice; it is complex and challenging, but rewarding. This session will provide practical recommendations and resources to foster best practice in early intervention. Based on research evidence and best practice guidelines, the presenters will link evaluation/assessment, program planning, and intervention with IDEA Part C legislation. You will be able to participate in discussions to promote a solution-focused, strength-based, and family-centered approach.
This is a joint program. See full description at Oncology programming.
Speakers: Linda Fetters, PT, PhD, FAPTA, Susan Knight, PT, PCS
In this session, the presenters will define successful communities to support knowledge translation (KT) and encourage you to identify behaviors that are barriers to KT in your environment. With help from the presenters, you also will identify behaviors that would enhance KT and build successful KT communities. The session will include presentations of successful strategies that have been used by clinician/researcher teams to build KT communities.
Speakers: Shelley Mannell, BHScPT; Julie W. Wiebe, PT, MPT, BSc
The concept of trunk control as necessary support for distal mobility, movement quality, and efficiency has been widely discussed in the treatment of children with motor challenges. More recently, the term "core stability" has been introduced in pediatrics, modeling the research and programming with adult populations. However, children with motor challenges, including coordination issues, sensory processing deficits, and muscle tone impairments, cannot perform a standard core program and struggle to reap benefit from this approach. They still have the need for core stability, so how can pediatric therapists address this challenge? Part 1 of this session will provide an overview of how the core functions based on the literature for both adults and children. This will include an understanding of the interconnection between core function and motor development from birth to 12 months. Presenters will introduce relevant core assessment tools, which will enable you to examine core function in a variety of diagnoses. A brief overview of an evidence-based clinical model for the treatment of core stability in children will be provided.
This is a joint program. See full description at Neurology programming.
Speakers: Donna Cech, PT, DHS, PCS; Deborah Anderson, PT, MS, PCS
Children with developmental coordination disorder (DCD) are frequently referred for physical therapy services due to movement dysfunction that interferes with their ability to participate in age-appropriate play and recreational activities. Often the factors contributing to the motor limitations displayed by these children stem from sensory motor issues, poor organization of movement, postural control and balance difficulties, and poor motor planning.
This session will focus on evidence-based decision making related to the evaluation and physical therapy intervention of children with DCD. The presenters will review screening and assessment tools, and individual and group intervention models incorporating task-oriented approaches such as neuromotor task training and cognitive orientation to daily occupational performance. Additional topics include: development of the sensory systems; descriptions of sensory motor development and dysfunction in children with DCD; and the impact of sensory motor dysfunction, postural control, balance, and motor proficiency on the level of physical fitness and participation of the child with DCD.
Joint Program: Sports Physical Therapy
Speakers: Gabriel P. Brooks, PT, DPT, MSPT, MTC
The session presents new strategies for evidence-based care of the pediatric athlete. Emphases include biomechanics, manual therapy, advances in surgical techniques, and outcomes assessment tools. Evaluation and treatment skills are presented for immediate application in the clinic. The pediatric athlete is complex; the presenters will demystify the numerous aspects of sports physical therapy treatment for this special population.
Speakers: Joseph Schreiber, PT, PhD, PCS, Brooke Racicot, PT, PCS, Ellen Kaminski, PT, MPT
Pediatric physical therapists face many challenges related to the application of research evidence into clinical practice. An outpatient pediatric facility implemented a multi-component knowledge translation (KT) program to support practice change related to the integration of standardized tests and measures into routine practice. This program included the use of a knowledge broker/change agent, setting of individual and department-wide goals, multiple interactive workshops, online and hard copy materials, an online discussion board, monthly reminders, and program evaluation activities. The presenters at this session will share their perspectives—those of the change agent, department administrator, and clinical staff—on the successes and challenges of this KT program, along with baseline and follow-up data on knowledge and frequency of use of standardized tests and measures. The department director will speak to administrative challenges related to the program, and the clinical staff member will discuss specific cases that illustrate individual and clinic-wide practice changes related to the KT program.
Although the term "core stability" has been introduced in pediatrics, modeling the research and programs in adult populations, children with motor challenges often cannot perform a standard core program and struggle to reap benefits from this approach. Yet they still have the need for core stability. How can pediatric PTs address this challenge? Part 1 of this 2-part session provided an overview of core function, core development in the first year of life, and clinical tops for assessment. Part 2 will draw on this expanded understanding of core function to present an alternative clinical model designed for the pediatric population. Combining alignment interventions with the use of the respiratory diaphragm as the access point for the inner core system will give practitioners new tools for core recruitment within movement, function, and play. Demonstrations, activities, and patient scenarios will give you ample opportunity to interact with the material. Finally, a case study will demonstrate the use of the clinical model for treatment of posture and function in a child with cerebral palsy.
Joint Program: Cardiovascular and Pulmonary
Speakers: Robin C. Rae, PT, MS
The use of ventricular assist devices (VADs) is becoming increasingly prevalent within the pediatric population as a bridge to transplant and for overall recovery. As such, it is essential that physical therapists remain current on the associated information and research in order to provide evidence- based quality care. Physical therapists play a crucial role in the medical management of these patients prior to, during, and post implantation, with a goal of improving the overall quality of life throughout their hospital experience. This session will cover the most common pediatric diagnoses that necessitate the implantation of a VAD and the physical therapy goals/interventions associated with these patients. The presenters will discuss specific physical therapy interventions and goals across the spectrum of the pediatric population. A brief overview of age-appropriate VADs, including but not limited to Berlin Heart, HeartMate II, and HeartWare, as well as their impact on rehabilitation, will be provided.
Speakers: Ann VanSant, PT, PhD
This session will focus on the writing of systematic reviews for publication. The presenter will use the PRISMA statement to describe the organizational structure of manuscripts incorporating a systematic review, and will discuss the necessary elements to be included in the review. The session will conclude with an overview of the process of preparing your work for publication.
Speakers: Robert Barnhart, PT, ScDPT, PCS, Peter C. Panus, PT, PhD
Your practice is affected by the drugs your patients take. The administration of these drugs may or may not be related to the physical therapy activities of the patient. However, these drugs have the potential to either enhance or impede your physical therapy activities. The purpose of this course is to identify 3 separate pediatric populations in which polypharmacy may affect physical therapy outcomes. These pediatric populations are children with seizures and spasticity. A review of the pathophysiologies will precede a discussion of the pharmacologic treatment, identifying major pharmacologic classes with mechanisms of action and clinically relevant pharmacokinetics. The speakers will discuss the potential benefits and limitations of these drugs to physical therapy activities. The application of this information will be reinforced by case studies at the end of each section.
Speakers: Mary Gannotti, PT, PhD; Ian Cannon; Matt Phinney
Individuals with chronic disability, such as cerebral palsy, who use wheelchairs are at greater risk than their peers for secondary conditions associated with a sedentary lifestyle, including decreased muscle mass, poor aerobic conditioning, low bone mineral density, and depression. Innovative programs to address the unique physical abilities of individuals who use wheelchairs and severe motor disability are lacking. This session will review the importance of physical therapists incorporating health and wellness activities in care plans for individuals with severe motor limitations, review the current state of the science on strengthening and conditioning principles for individuals with cerebral palsy, and describe an innovative exercise program: "Roll With the Punches."
"Roll With the Punches" was developed by an individual with nonambulatory spastic quadriplegia cerebral palsy in collaboration with trainers from combat sports, such as boxing and mixed martial arts. "Roll With the Punches" training program includes progressive resistive exercise training, core strengthening, flexibility, and functional skill training. A case study will highlight the impact of this exercise program on bone density, flexibility, strength, activity level, and participation in society. Attendees will be instructed in the principles of the training program and be exposed to ways to apply these principles to individuals with varying levels of physical ability.
Joint Program: Education
Speakers: Kathy Martin, PT, DHS; Joseph Schreiber, PT, PhD, PCS; Mary Jane Rapport, PT, DPT, PhD; Jennifer Furze, PT, DPT, PCS
The Section on Pediatrics held an Education Summit in July of 2012 that brought together various stakeholders to discuss best practices in professional pediatric physical therapy education. This session will focus on sharing and discussing some of the key concepts and products that resulted from the summit, including what should be taught, how should it be taught, how should teaching and learning be assessed, pediatric clinical education issues, and strategies to develop and maintain qualified pediatric faculty.
Speakers: Frances Baratta-Ziska, PT, MS, PCS; Cathleen L. Raggio, MD
There are over 350 distinct types of skeletal dysplasias—a heterogenous group of genetic disorders characterized by differences in the size and shape of the limbs, trunk, and/or skull that often affect stature in a significant number of individuals. Although individually rare, collectively there are a significant number of individuals with the various dysplasias. It is estimated that 14,000 to 27,000 babies in the United States are born each year with some form of skeletal dysplasia. Skeletal dysplasias are frequently associated with a range of orthopedic problems. These may include joint dislocation and scoliosis. Other health concerns may include respiratory, neurological, otolaryngologic, rheumatologic, gastroenterologic, endocrine, and/or cardiac issues. Specific topics that need to be addressed are genetic diagnosis, medical management, surgical intervention (when is surgery needed and how can it be done as safely as possible), morbidities of obesity, and psychosocial impact.
This presentation will highlight the orthopedic physical examination, the relevance of various diagnostic testing in the diagnosis, and treatment recommendations for a patient with skeletal dysplasias. Recommendations regarding exercise will vary depending on the individual's medical diagnosis and precautions (eg, osteogenesis imperfecta, Marfans, achondroplasia).The multidisciplinary approach (ie, the orthopedist, geneticist, pathologist/radiologist, physical therapist, nutritionist, social worker, and patient) of The Kathryn O. and Alan C. Greenberg Center for Skeletal Dysplasias at the Hospital for Special Surgery works to design an individualized treatment plan for the individual with a specific skeletal dysplasia. As a result of participation in this course, attendees will be given the skills to provide appropriate multidisciplinary care for patients with skeletal dysplasia.
Speakers: Colleen Peyton, PT, DPT, PCS
Cerebral palsy (CP) is not usually diagnosed until late in the first or second year of life. Early prediction of CP is important for identifying children who need close monitoring and follow-up. However, early identification of children with CP is difficult, and the accuracy of different assessment methods varies. Analysis of general movements (GMs), observable at less than 5 months post term, has been shown to predict the development of CP with a high degree of certainty. At this age, the characteristics of GMs change if there has been an injury to the nervous system. General movement assessment (GMA) has been described in several studies, and it has been suggested that the method also may predict the development of neurological disorders other than CP. Emerging evidence suggests that a computerized software tool also has the ability to predict cerebral palsy through video analysis of GMs. This session is intended for clinicians and researchers with the goal of understanding the current evidence and concepts surrounding analysis of infant spontaneous movement and the prediction of neurological dysfunction. Video examples of normal and abnormal infant general movements will be presented. The session is not intended as a general movement assessment course, but as an introduction to current concepts and research.
Joint Program: Neurology
Speakers: Kathy Martin, PT, DHS; Patricia Scheets, PT, DPT, NCS; Edelle Field-Fote, PT, PhD; Sally Westcott McCoy, PT, PhD; Barbara J. Norton, PT, PhD, FAPTA
Success in achieving Vision 2020 depends, at least in part, on physical therapists being able to diagnose conditions that are within the scope of their practice and consistently using commonly understood terminology for describing the conditions that affect the movement system of their patients. Specialists have the expertise needed to lead the profession in defining, labeling, and cataloging the diagnoses that are relevant to physical therapists’ practice. The primary purpose of this session is to engage specialty section members in a collegial dialogue about what "labels" should be used for the conditions that physical therapists diagnose. An introduction to some of the issues will be provided in a brief summary of 9 prior meetings about diagnosis. Case descriptions of 4 patients will be presented to provide the context for dialogue with members of the audience.
Time: 3:00 pm–5:00 pm (See Program for Room)
Speakers: Mary E. Parker, PT, PhD, NCS, PCS
Physical therapists accept referrals of individuals with a variety of descriptive diagnoses that do not define the underlying etiology of the disorder. Failure to thrive, developmental delay, and hypotonia are all descriptive, but not definitive. To optimize treatment outcomes, physical therapists must research and employ a variety of tools to determine the most effective treatments for their patients. While models of disability and frameworks for evaluation and treatment exist, there are few tools that assist physical therapists in differential diagnosis, especially with complex multisystem disorders. The goal of this course is to provide physical therapists with tools for differential diagnosis of patient with complex multisystem disorders. Included in this review will be mitochondrial disorders and leukodystrophies.
Speakers: Catherine Maher, PT, DPT; Genevieve Pinto Zipp, PT, EdD; Susan Simpkins, PT, EdD
In today's market place, you can stand out by marketing your skills and accomplishments via the development of your professional portfolio. As a descriptive of professional's strengths and accomplishments, a portfolio is based upon facts, evidence, and self-reflection. It reveals the scope and quality of a professional’s performance within clinical practice, teaching, service, management, publications, grants, and collegial recommendations. A portfolio is a selection of items that offer a boarder picture of a professional's contributions than curriculum vitae or reference letters. The portfolio may be used for initial employment opportunities or professional advancement. What should be included in your portfolio? Strong portfolios should begin with a statement that describes your philosophy regarding the focus of the portfolio. It should reflect the author's professional development, whether it is teaching, management, research, or clinical practice. Portfolios should end with goal developments that outline what direction the author plans to take to develop their skills. The process involved in the development of a portfolio is an engaging one, and it enables you to reflect upon your journey and design a future both professionally and personally rewarding. This presentation will explore the "how to" and "why" regarding portfolio development and allow you to showcase yourself no matter where you are professionally.