Pediatric Physical Therapy:
The Editor declares no conflicts of interest.
This issue brings to light the level of judgment that readers of the journal need to bring to their practice of our increasingly complex profession. Within the issue are examples of research that expand our knowledge in a variety of practice areas, and challenge our thinking as we seek to translate research to practice.
Glanzman and his colleagues1 have been working to establish a new test instrument for children with spinal muscular atrophy type I (SMA I), which addresses the need to document the motor skills of children with severe neuromuscular disorders. This article presents information on the validity of their Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND) and demonstrates the validity of using the test with children with SMA I, but also the promise it may hold for documenting motor skills and change in children with other severe neuromuscular disorders. I believe we need to take up the challenge of applying the CHOP INTEND to other disorders and would suggest that clinicians with experience working with children with severe neuromotor disorders examine the usefulness of using this instrument for children with other conditions and document its applicability in case reports. That work is fundamental to continuing research on the CHOP INTEND, and represents opportunity for clinicians to help in driving our knowledge forward.
In another article in this issue Camy and Mezzacappa2 report on a study to examine the effect of an intervention designed to increase expiratory flow on acid reflux in infants born premature with bronchopulmonary dysplasia. Here we face a need for very careful judgment. In the United States chest therapy with this fragile population has been largely discontinued as other ventilatory techniques are available to address the respiratory problem, which pose less risk to the infant. But we recognize that there are practice differences throughout the world. This study was not carried out in the context of neonatal care typically provided in the United States but we need to respect and learn from these differences and come to understand why they might exist. I recommend that everyone read the clinical bottom line that accompanies this article. When we consider the concept of translating research to practice, we cannot forget contextual factors that influence the application of study findings to our own practice environments.
Finally, I would like to point out the work by Hanson and colleagues3 documenting the motor developmental problems of children in an urban child welfare system. Here is a study that should alert us to the fact that children who have faced difficult family circumstances are likely to need and benefit from our services. This research should be quickly incorporated into our practice. To translate these findings into practice we need to begin to examine how child welfare systems operate in our various locales and begin to advocate for screening and referral of children in need of our services. We should remember that the sooner the child begins to receive service the better the long-term prognosis will be.
We have a responsibility to translate research to practice, but with that responsibility comes the need for exercising careful judgment and taking up the challenges that new findings bring to us.
Ann F. Van Sant, PT, PhD, FAPTA
1. Glanzman AM, McDermott MP, Montes J, et al. Validation of the Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP INTEND). Pediatr Phys Ther. 2011;23:322–326.
2. Camy LFS, Mezzacappa MA. Expiratory flow increase technique and acid esophageal exposure in infants born preterm with bronchopulmonary dysplasia. Pediatr Phys Ther. 2011;23:328–334.
3. Hansen H, Jawad AF, Ryan T, Silver J. Factors influencing gross motor development in young children in an urban child welfare system. Pediatr Phys Ther. 2011;23:335–346.