Week 3: Pediatric Tests and Measures

what are the components of the subjective that should be taken in a pediatric setting?

• birth history, pregnancy

• medical history

• surgical history

• education level

• daily activities (dependent/independent)

• environmental information (assistive devices)

what are components of the objective that should be taken?

• pain (FACES, FLACC)

• range of motion (joint integrity)

• posture (structural vs musculature)

• muscle strength (functional positions)

• motor planning

• muscle tone (hypotonic vs hypertonic)

• balance (dynamic vs static)

• gait

• standardized testing

what scales are used in pediatrics for pain?

• FLACC

• Wong-baker FACES pain rating scale

• numeric rating scale

• visual analog scale

FLACC scale

most reliable pain rating scale for younger pts, based on observation of the child’s face, legs, activity, cry, or consolability

Wong-baker FACES pain rating scale

a pain assessment tool using facial expressions to indicate pain severity, often used with children

is goniometry very reliable or valid with pediatric patients?

can be less valid or reliable for ped patients, can be useful for contractures or with child athletes though

what needs to be taken into consideration with testing for MMTs?

• age

• developmental level

• cognitive level

• ability to follow instructions

• attention span

• motivation

• motor planning skills

• sensation

• proprioception

• pain

what are components of the pediatric assessment?

• strengths

• contextual factors (able to participate in therapy, caregiver support, follow through)

• impairments

• activity limitations

• goals

  • short/long term

what are details to consider in pediatric goal making?

• family/caregiver goals

• patient goals

• educational setting goals

also need to be achievable, measurable, time related, and specific to the child's needs and abilities. (short and long term goals)

what is the time frame for short and long term goals in outpatient peds?

typically 3 months short term, then 6 months

what should be included in the plan of care?

• frequency and duration of treatment

  • possible follow up with further standardized testing

• treatment interventions

  • forever changing, dep on pathology

• tool box of ideas

  • equipment, bracing, splinting, taping

  • suggested referrals

• home program

  • 1-3 exercises/ideas

what are the pros of standardized tests?

• ID infants at an early age that are at greater risk

• predictive of motor outcome

• ID a child in an educational setting that needs interventions

• determine eligibility/change over time

• plan a program

• determine efficacy/efficiency

• research

what are the cons of standardized testing?

• lengthy test

• limited knowledge about measures and measurement principles

• inadequate training

what is test selection based off of?

• primary complaint and family goals

• child’s age and dx

• current functional status

• history and systems review

• current evidence on the use of the tool

• therapist knowledge and experience

• purpose of testing

• ICF model

• integration of individualized outcome measures

what are the common screening assessments?

• Alberta Infant motor scale (AIMS)

• neuro-sensory motor developmental assessment (NSMDA)

what are the common motor assessments?

• test of infant motor performance (TIMP)

• peabody developmental motor scales (PDMS-2)

• Bruninks-Ostertsky Test and Motor proficiency (BOT 2)

what are the common functional assessments?

• gross motor function measure (GMFM-66)

• pediatric evaluation of disability inventory (PEDI)

• the functional independence measure for children (WeeFIM)

• the school function assessment (SFA)

what are some criterion referenced standardized tests?

GMFM-66 and the PEDI

what are some norm referenced standardized tests?

PDMS-2, Bayley

what age range is the PDMS-3 used for?

used for children from birth to 5 years of age, assessing fine and gross motor skills.

what are the advantages of the PDMS-3?

• easy to administer since has kit, instruction manual

• validated

• reliable

• scoring software

• norm-referenced

• well constructed

what are the disadvantages of the PDMS-3?

• basal level can be difficult to obtain

• limited age rang ein reliability studies

• cost

what age range is the PEDI used for?

6 mo to 7 years (also with children greater than 7.5 with significant functional delays)

what are the three domains assessed in the PEDI?

self care, mobility, social function

what are the advantages of the PEDI?

• assess functional skills over time

• norm-referenced AND

• criterion referenced

• judgement based

• scoring software

(parents can fill out the form too)

what are the disadvantages of the PEDI?

ceiling effect on mobility terms

which population is used for the BOT-3 test?

school age pop (4-21)

what are the 5 domains covered by the BOT-3?

fine motor control, manual coordination, body coordination, and strength and agility.

what are the advantages of the BOT-3?

• large age range

• contains photos for items

• face validity reflects typical childhood activity

• excellent test-retest reliability

• low sensitivity

• high specificity

• short form combines gross and fine motor items

what are the disadvantages of the BOT-3?

• time to score

• numerous charts to review

• difficulty of motor planning for 4 y/o

what is the SFA used for>?

used for children K-6, measures a student’s performance of functional tasks, gives support for his/her participation in the academic and social aspects of school, and designed to facilitate collaboration of program planning for students with a variety of disabling conditions

what are the 3 parts of the SFA?

participation, task supports, activity performance

what are the advantages of the SFA?

• completed by school professionals that know the student well

• determine eligibility for special ed services (IDEA)

• set specific goals

• criterion referenced

what are the disadvantages of the SFA?

• only used in educational settings '

• no norm reference

• takes into consideration many adaptations not just motor

• only standardized until 6th grade

what population is the GMFM-88/66 designed for?

for children with cerebral palsy and other motor impairments (also can be used for children with down’s syndrome), assessing their gross motor function. (6 mos to 16 years)

what are the 5 dimensions of the GMFM-88/66?

• lying/rolling

• sitting

• crawling/kneeling

• standing

• walking, running, jumping

GMFS levels I-V

are classifications of gross motor function in children with cerebral palsy, indicating their ability to perform various movements and activities independently. can get classification from the GMFM-66

what are the advantages of the GMFM-88/66?

• can perform with or without AD or orthotic

• validated and reliable with populations outside of CP

• GMFM-66 allows for missed responses

what are the disadvantages of the GMFM-88/66?

• CP only for GMFCS levels

what is the difference between corrected age and chronological age?

Corrected age is the age of a preterm infant based on their due date, while chronological age is the actual age since birth. This distinction helps assess development more accurately in premature infants. After 2 years of age chronological age becomes the primary measure for development (don’t do corrective anymore)