Pediatric Physical Therapy:
Abstracts: Abstracts of Platform and Poster Presentations for the 2006 Combined Sections Meeting: Platform Presentations
1Program In Physical Therapy, The George Washington University, Washington, DC, USA
The purpose of this study was to compare the developmental gains in six domains of development in children attending a home-based versus center-based early intervention program while controlling for the developmental quotient (DQ) or initial level of delay. The six domains of development included: gross motor, fine motor, language, self-help, cognition and social.
Number of Subjects:
The records of 134 children with a variety of diagnoses contributing to developmental delay were reviewed. Of the participants whose records were reviewed, 86 children received center-based intervention, 48 received home-based services, 37% were girls, 63% were boys and 67% qualified for Medicaid. Children's ages ranged from three to 44 months. The record was considered for inclusion if the child participated in the program for one continuous year and had developmental scores based on the administration of the Early Intervention Profile (EIP) for the year under consideration.
Developmental gains were calculated for one year using the scores from the EIP in each of the domains described above. Controlling for variances in DQ, A Multivariate Analysis of Covariance (MANCOVA) was performed to determine whether a significant difference existed between the mean gains in each developmental domain for children attending the center-based versus home-based program.
The comparison of the two groups on the mean developmental gains in the six domains while controlling for the DQ was significant (Hotellings Trace = 0.190; P = 0.001). A comparison of the groups on the covariate DQ was also significant (Hotellings Trace = 0.260; P = 0.001) substantiating the need to control for initial delay in the group comparisons. Children attending center-based programs made more gains in gross motor, fine motor, and language development. Children attending home-based programs made more gains in self-help and social development. No differences were noted in cognitive development based on intervention site. The only univariate comparison that was statistically significant was the gross motor gains (F = 7.686; P = 0.006). Children attending the center-based program made significantly more gross motor gains than children participating in the home-based program.
Developmental gains in the above domains may be influenced by program site placement. In this population, children made greater developmental gains in gross motor, fine motor and language skills if attending a center-based program and greater gains in self-help and social skills if attending a home-based program.
Intervention site appears to have a variable influence on each domain of development. Site decisions should be based on a family and team's assessment of each child's relative strengths and needs.