Pediatric Physical Therapy: Family-Centered Care

Family-Centered Care (FCC)

An approach to healthcare that considers the child, family, and natural environments, recognizing families as central to a child's life. family works with service providers to make inform decisions

IFSP

Individualized Family Service Plan, developed by the family and early intervention team for children birth to 3.

What is the main principle of Family-Centered Care (FCC)?

The family is the expert on the child's abilities and needs, and the strengths and needs of all family members should be considered.

What are 3 major characteristics of Family-Centered Care?

Lifespan approach (not restricted to peds), best practice (includes EI, hospital and community based services), and holistic approach (considers child, family, and natural env)

What should be the FIRST strategy when implementing family-centered care?

Address basic family needs.

What are the 3 family-centered factors?

Structure, Function, Culture.

What does Structure mean in Family-Centered Care?

Who makes up the family and what resources are available (parents, grandparents, socioeconomic resources, etc.).

What does Function mean in Family-Centered Care?

The roles and responsibilities of family members in daily routines and caregiving.

What does Culture mean in Family-Centered Care?

The beliefs and values that influence expectations, decisions, and actions.

How should a PT approach cultural differences in pediatric care?

Observe the family and follow their lead, recognizing that beliefs and customs influence how a child is raised.

What law provides the legal basis for pediatric PT services?

IDEA — Individuals with Disabilities Education Act.

What does FAPE stand for?

Free Appropriate Public Education.

What age range is Early Intervention?

Birth-3 years old.

Which part of IDEA covers Early Intervention?

IDEA Part C.

What document is used for Early Intervention?

IFSP — Individualized Family Service Plan.

Who develops the IFSP?

The family and Early Intervention team.

What age range does school service cover?

PreK-12.

Which part of IDEA covers school services?

IDEA Part B.

What document is used for school-based services?

IEP — Individualized Education Program.

How should PTs involve families during an evaluation?

Allow families to decide how they want to participate—observing, assisting, or practicing strategies—using a coaching approach.

What should a PT ask the family during evaluation?

Family concerns and goals, what has/hasn't worked, and information about the child's typical behavior and routines.

Where should pediatric PT assessments ideally occur when possible?

In natural settings, such as during family-child interaction, play, or snack time.

Why is coaching important in pediatric PT?

It empowers families to integrate PT strategies into daily routines.

During an evaluation, should a PT only focus on problems?

No. The PT should also acknowledge what is going well and the child's strengths.

At what 2 levels should pediatric PT outcomes be measured?

Body structure/function and activity/participation.

What is the Top-Down approach?

Start with the desired participation goal, then identify strengths/obstacles and develop strategies to achieve the goal.

What is the order of the Top-Down approach?

Participation goal → strengths/obstacles → strategies → intervention plan.

What should pediatric PT goals be based on?

Functional outcomes and the desires of the child/family.

Matthew was born at 28 wks gestation and is 8 mths old now. what is his corrected age?

40-28=12 wks

8 mths x 4 wks (one mth) = 32 wks

Subtract the prematurity from his chronological age:

32 weeks − 12 weeks = 20 weeks

32 - 12 wks= 20 wks/4= (5 mths old)

his developmental skills should be expected as a 5 mth old instead of 8 mths.

What 3 things should be included when writing a functional goal?

Behavior + Conditions + Criteria.

What is the major shift from a deficit-based model to an enablement model?

Instead of trying to fix the child's disability, focus on what the child wants to do in meaningful contexts.

What does the bidirectional nature of the ICF model mean?

Changes in one area can affect other areas; a linear relationship cannot be assumed.

Example: Does quadriceps weakness automatically mean a child will have difficulty walking?

No. The ICF is interactive, so an impairment does not necessarily cause an activity limitation.

Why is pediatric PT considered a team sport?

Children with complex needs require expertise from multiple disciplines, including family and school personnel.

What is a transdisciplinary team?

A team that shares knowledge and skills and participates together in decision-making about assessments, performance, goals, and objectives.

Why must pediatric PTs teach parents and teachers?

Weekly therapy alone is insufficient; parents and teachers need to reinforce PT strategies throughout daily activities.

What are the 5 models of pediatric PT service delivery?

Direct, Integrated, Consultative, Monitoring, Collaborative.

What is Integrated service delivery?

PT works together with teachers/aides, and direct service and consultation may be blended.

What is Consultative service delivery?

The team implements the activities, while the PT provides consultation rather than directly implementing everything.

What is Monitoring service delivery?

The PT keeps in contact with the child and monitors progress or deterioration.

What is Collaborative service delivery?

A mode of working with the team/family, including coaching or role release.

What are 4 reasons pediatric PT may be terminated?

Goals/objectives met; Child/family declines to continue; Unable to progress toward anticipated goals/outcomes; PT determines services no longer provide benefit.

What does periodic vs episodic care relate to?

Transitioning to different levels of service throughout the continuum of care.

Which document is developed for children receiving early intervention services from birth to age 3?

A. Individualized Education Program (IEP)

B. Individualized Family Service Plan (IFSP)

C. Plan of Care (POC)

D. Individualized Health Plan (IHP)

B

A child is 10 months old and was born at 34 weeks of gestation. What is the child's adjusted age?

Assume a full-term pregnancy is 40 weeks.

A. 7 monthsB. 8.5 monthsC. 10 monthsD. 11.5 months

B

40 weeks − 34 weeks = 6 weeks premature10 months − 1.5 months = 8.5 months adjusted age

School-based services for children from prekindergarten through Grade 12 are provided under which section of IDEA?

A. Part AB. Part BC. Part CD. Part D

B

Which statement best describes a family-centered approach to pediatric physical therapy?

A. The physical therapist independently determines the child's goals.

B. Treatment focuses only on the child's physical impairments.

C. The child and family collaborate with the therapy team in decision-making.

D. Therapy is provided only in a clinical setting.

C

Which action best demonstrates a family-centered evaluation?

A. Conducting all assessments without family participation

B. Asking the family about its concerns, priorities, and goals

C. Using only standardized test scores to determine the child's needs

D. Selecting interventions before interviewing the family

B

In a top-down approach to planning intervention, what should the physical therapist identify first?

A. The child's muscle strength

B. The available standardized assessments

C. The desired participation goal

D. The frequency of therapy sessions

C

Which outcome is measured at the activity and participation level?

A. Increased ankle range of motion

B. Improved lower-extremity strength

C. Improved standing balance

D. Walking with classmates at school

D

C is not the best answer because "improved standing balance" is primarily a body function outcome in the ICF model. It describes the child's physical ability but does not indicate how that ability is used in a daily activity or life situation. To make C an activity-level outcome, you could revise it to: "Standing independently while participating in classroom activities."

What is an important characteristic of a transdisciplinary team?

A. Each professional works independently and avoids overlapping responsibilities.

B. One professional makes all decisions for the team.

C. Team members share knowledge and integrate strategies across settings and activities.

D. Families receive information only after the team makes its decisions.

C