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A touchy topic: tactile assessment among pediatric therapists
Megan Louise Auld1,2, Leanne Marie Johnston1
1a Division of Physiotherapy, School of Health and Rehabilitation Sciences , The University of Queensland , Brisbane , Australia.
Insights
Pediatric therapists rarely perform tactile assessments in children with cerebral palsy (CP) due to barriers like lack of knowledge and equipment. Developing targeted strategies is crucial to improve these essential assessments for CP patients.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Occupational therapy
Background:
- Tactile impairments are prevalent in over 77% of children with unilateral cerebral palsy (CP).
- Current evidence-based practices for tactile assessment in CP are not consistently applied by therapists.
- Understanding therapist practices and barriers is vital for improving pediatric rehabilitation outcomes.
Purpose of the Study:
- To investigate current pediatric therapist practices regarding tactile assessment in children with CP.
- To identify the barriers and facilitators influencing the implementation of tactile assessments in clinical settings.
- To inform the development of effective knowledge translation strategies for tactile assessment in CP.
Main Methods:
- A two-part study involving pediatric therapists (n=35) using questionnaires on tactile assessment knowledge and usage.
- A second questionnaire utilizing the Theoretical Domains Framework to explore barriers and facilitators in clinical practice (n=12).
- Quantitative and qualitative data collection to comprehensively assess therapist perspectives and practices.
Main Results:
- Over 90% of therapists conduct tactile assessments in less than 25% of children with CP treated.
- Key barriers identified include insufficient knowledge, skills, confidence, and lack of equipment.
- Therapists suggested organizational guidelines, templates, and improved training as facilitators for tactile assessment.
Conclusions:
- A significant gap exists between recommended and actual tactile assessment practices in pediatric CP care.
- Addressing therapist-identified barriers through multi-faceted knowledge translation is essential.
- Facilitators like equipment, standardized procedures, and training can enhance the implementation of tactile assessments, improving rehabilitation for children with CP.
Purpose:
Tactile impairments affect over 77% of children with unilateral cerebral palsy (CP). This study aimed to examine the current practices of pediatric therapists in relation to tactile assessment and the barriers to carrying out tactile assessment in children with CP.
Method:
The study was in two parts. In part one, pediatric therapists (n = 35) completed a questionnaire detailing their current knowledge and the use of tactile assessments in children. In part two, therapists (n = 12) completed a questionnaire based on the Theoretical Domains Framework examining the barriers and facilitators to completing tactile assessments in clinical practice.
Results:
Most therapists (over 90%) carry out tactile assessments in the minority (less than 25%) of children with CP that they treat. Therapists reported the need for improved knowledge/skills (n = 24) and confidence (n = 19) in carrying out tactile assessments, alongside the provision of necessary equipment (n = 17). Qualitative reports also suggested that organizational assessment guidelines and templates may facilitate the implementation of tactile assessment.
Conclusions:
A multi-faceted knowledge translation strategy to address the barriers to tactile assessment among pediatric therapists needs to be developed. Implications for rehabilitation Pediatric occupational therapists and physiotherapists may not be completing tactile assessments according to current evidence-based recommendations. Therapists identified five main barriers, including a lack of knowledge, skills, belief in their capabilities (confidence), behavioral regulation (organizational procedures), and environmental context (e.g., equipment). Therapists recommended several potential facilitators, including access to necessary equipment, procedures, record sheets, training in tactile assessments, and research supporting related interventions. Service providers are encouraged to develop multi-faceted knowledge translation strategies that address these barriers and maximize facilitators.