Clinical Bottom Line
“How could I apply this information?”
Størvold and Jahnsen have provided us with research that presents an alternative method to provide intensive therapy using a combination of groups and individualized therapy. What is clearly seen from the research is that with extensive planning and coordination of care by several professionals, it is possible to combine children of different ages and Gross Motor Function Classification System levels into groups and expect progress toward individual functional goals. They provide a clinically useful description of the design of group sessions and the alterations and creativity needed to meet each individual child's needs within the group context. The use of Goal Attainment Scaling is a clinically useful method to organize each child's individual goals and provides a reminder to professionals and parents as to their child's progress toward these individual goals. With limited resources or in rural areas, this creative approach to provide short-term intensive therapy services might be an effective solution. In addition, combining group and individual therapy into an intensive model may be feasible in several pediatric practice settings including, but not limited to, inpatient rehabilitation, outpatient, and early intervention. As the authors indicated from preliminary results, parents preferred intensive periods compared with low-frequency therapy sessions spread over a longer time. Further information on the interpretation of the parent interviews, logs, and questionnaires from this study would provide more information on this important perspective.
“What should I be mindful about in applying this information?”
The interpretation of the results of this exciting approach would be strengthened if the authors had added a statistical analysis to the visual inspection. A statistical analysis can be used to remove the trend in changes that would occur without intervention. Reliability among the therapists measuring the outcomes would also strengthen the interpretation of results. Coordination of care across professionals seemed crucial to the implementation of this program with each professional knowledgeable and willing to include individual goals into a group program. Although this type of coordination may be challenging, this report supports the importance of preparation and flexibility by the professionals for children to achieve functional successes through therapy.
Susan Knight PT, PCS
Rehabilitation Services, Children's Hospital of Los Angeles, Los Angeles, CA
Linda Fetters PT, PhD, FAPTA
Division of Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, CA