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Transparency and tuning of rehabilitation care for children with cerebral palsy: a multiple case study in five
R C Siebes1, M Ketelaar, J W Gorter
1Langeveld Institute for the Study of Education and Development in Childhood and Adolescence, Utrecht University, TC Utrecht, the Netherlands.
Insights
Transparency and tuning in pediatric cerebral palsy (CP) rehabilitation need improvement. Parent-identified problems, treatment goals, and activities showed limited alignment, indicating a need for better communication and documentation in CP care.
Area of Science:
- Pediatric Rehabilitation
- Child Neurology
- Developmental Disabilities
Background:
- Limited understanding exists regarding the alignment of parent-identified problems, treatment goals, and activities in pediatric cerebral palsy (CP) care.
- Assessing the transparency and tuning within the rehabilitation process is crucial for effective intervention.
Purpose of the Study:
- To determine if parent-identified problems and treatment goals are documented in pediatric CP rehabilitation.
- To examine the relationship and alignment between parent-identified problems, treatment goals, and therapy activities.
Main Methods:
- Detailed observation of five school-aged children with CP during physical, occupational, and speech therapy sessions.
- Analysis of written reports, linking parent problems, goals, and activities to the International Classification of Functioning, Disability and Health (ICF) framework.
- Quantification of agreement through code comparison.
Main Results:
- Documentation of parent-identified problems was minimal (six problems across two children).
- Forty-five treatment goals and 72 treatment activities were identified.
- While some alignment was observed, only four treatment activities perfectly matched both treatment goals and parent-identified problems.
Conclusions:
- The transparency and tuning of the pediatric rehabilitation process for children with CP require significant enhancement.
- Suggestions for improving documentation and alignment within the treatment process are discussed.
Purpose:
Generally, there is a lack of knowledge whether and how parent-identified problems, treatment goals and treatment activities are tuned in the treatment of children with cerebral palsy. This study aimed to observe whether parent-identified problems and treatment goals were documented ('transparency' of the rehabilitation process), and to examine the relationship ('tuning') of parent-identified problems to treatment goals and to treatment activities of children with cerebral palsy in pediatric rehabilitation in the Netherlands.
Method:
Five school-aged subjects with cerebral palsy were observed in detail during physical, occupational, and speech therapy, and their written reports were studied. Parent-identified problems, treatment goals, and treatment activities were linked to the ICF components, domains and categories and the amount of agreement was determined by code comparison.
Results:
Only two children with a total of six parent-identified problems could be documented. Forty-five treatment goals were identified and 72 treatment activities were observed. The analyses indicated some tuning of parent-identified problems, goals and activities in all subjects, but only four of the treatment activities were perfectly tuned to treatment goals as well as to parent-identified problems.
Conclusions:
We conclude that transparency and tuning of the pediatric treatment process described in the present study could be improved substantially. Several suggestions for improving the transparency and tuning of the treatment process are discussed.
