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How are actual needs recognized in the content and goals of written rehabilitation plans?
Ira Jeglinsky1, Eva Brogren Carlberg, Ilona Autti-Rämö
1Arcada, University of Applied Sciences , Helsinki , Finland .
Insights
Rehabilitation plans for children with cerebral palsy (CP) often lack clear goals aligned with needs and functional difficulties. Utilizing the International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) can improve goal setting and documentation.
Area of Science:
- Pediatrics
- Rehabilitation Medicine
- Developmental Disabilities
Background:
- Cerebral palsy (CP) presents diverse functional challenges requiring tailored rehabilitation.
- Individualized rehabilitation plans are crucial for addressing the specific needs of children with CP.
- Effective goal setting in rehabilitation plans is essential for optimizing outcomes.
Purpose of the Study:
- To examine the relationship between identified needs, functional difficulties, and therapeutic goals in children with CP.
- To assess the quality and content of written rehabilitation plans for children with CP.
- To explore the utility of the International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) in documenting rehabilitation plans.
Main Methods:
- Retrospective cross-sectional register study analyzing 77 children and adolescents with CP.
- Utilized the International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) as a framework for content analysis.
- Included children across various age ranges and Gross Motor Function Classification System (GMFCS) levels.
Main Results:
- Rehabilitation plans for 70 children (ages 1-16) showed a disconnect between stated needs/difficulties and therapeutic goals.
- Goals primarily focused on body functions and activity/participation, with limited reflection of individual needs.
- Parental involvement was noted in half the plans, and multidisciplinary collaboration was present.
Conclusions:
- Written rehabilitation plans for children with CP exhibit deficiencies in content and goal alignment.
- The ICF-CY framework can enhance the identification of needs and the targeting of rehabilitation goals.
- Collaborative goal setting focused on meaningful daily activities, guided by the ICF-CY, is recommended for effective rehabilitation planning.
Purpose:
The primary aim of the study was to investigate the interrelation between needs and functional difficulties and the therapeutic goals in children with cerebral palsy (CP) as documented in individual written rehabilitation plans.
Method:
The study was a retrospective cross-sectional register study. The data consisted of randomly chosen register documents for 77 children and adolescents with CP in different predetermined age ranges. The International Classification of Functioning, Disability and Health-Child and Youth version (ICF-CY) was used as a reference for analyzing the content of the written statements.
Results:
The rehabilitation plans for 70 children, 1-16 years of age, representing all GMFCS levels were analyzed. Goals were not well reflected in the children's needs and functional difficulties. The needs, functional difficulties and goals mainly encompassed the components of body functions and activity/participation. In half of the plans the presence of the parents was mentioned, and the plans were made in multidisciplinary collaboration.
Conclusions:
The results of this study indicate deficiencies in the content and goals of the written rehabilitation plans. The ICF-CY could serve as a framework to help professionals and parents identify the child's needs and those areas where the goals should be targeted. Implications for Rehabilitation Documenting the child's and family's needs in relation to activity and participation preferences is critical to rehabilitation and intervention planning. Goals, based on the child's needs, should be identified in collaboration with all parties involved, and focus on the child's functioning in meaningful everyday activities. The ICF-CY could serve as a framework for the family and professionals to identify needs and to communicate rehabilitation goals.
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