Amount and focus of physical therapy and occupational therapy for young children with cerebral palsy

Area of Science:

• Pediatric Rehabilitation
• Neurology
• Developmental Pediatrics

Background:

• Cerebral palsy (CP) is a common childhood motor disorder requiring comprehensive therapeutic interventions.
• Understanding current physical therapy (PT) and occupational therapy (OT) service delivery is essential for optimizing care for young children with CP.
• Variations in service provision may exist based on geographical location and child's functional level.

Purpose of the Study:

• To describe the utilization of PT and OT services for a cohort of young children (2-6 years) with CP in the United States and Canada.
• To identify factors influencing the amount of PT and OT services received, including setting, Gross Motor Function Classification System (GMFCS) level, and country.
• To report on the focus of therapeutic interventions provided to children with CP.

Main Methods:

• A cohort of 399 children aged 2-6 years with CP was studied.
• Parents completed a services questionnaire via telephone interview.
• Children's GMFCS levels were classified by therapists.

Main Results:

• Children receiving PT and OT in both educational and clinic settings had greater service minutes per month.
• Children with higher GMFCS levels (IV-V) and those in the United States received more PT and OT minutes per month compared to lower GMFCS levels (I) and Canada, respectively.
• Interventions primarily focused on impairments, activity, and structured play, with moderate emphasis on environmental modifications and equipment, and less on self-care routines.

Conclusions:

• Service delivery for PT and OT in young children with CP is influenced by multiple factors.
• The findings highlight the importance of coordinated PT and OT services to address the diverse needs of children with CP.
• Further research into optimizing service delivery models across different settings and countries is warranted.