title: Exploring physical therapy clinical decision making for children with spastic diplegia: survey of pediatric practice.
abstract: OBJECTIVE
  The purpose of this special interest report is to describe the outcomes of a research round table discussion regarding the physical therapy management of mobility for children with spastic diplegia.
  
  
  METHODS
  Sixty-two pediatric physical therapists and physical therapists assistants participated in focus groups during the Research Round Table at the American Physical Therapy Association (APTA) 1999 Combined Sections Meeting. A case description of a child with spastic diplegia and guiding questions were used to facilitate discussion.
  Common practices in patient management across the child's life-span emerged from the discussion. Practices in examination, evaluation and prognosis, and intervention differed depending on the age and function of the child and the family's needs. In general, therapists reported that younger children receive examinations that include standardized tests of development and ongoing intervention with a frequency of one to five times per week. In contrast, older children receive therapy services on an episodic basis that address their specific needs. The elements of patient management served as a useful framework for exploring decision making.
  The information compiled from this project needs to be validated through systematic inquiry. Therapists may, however, use the practices reported here to reflect on their clinical decision making and to identify questions for further exploration. This descriptive document is the first step in the development of a guideline for evidence-based practice. The development of such a clinical guideline could serve as an education tool for novice therapists, a program evaluation tool to ensure quality care, and a foundation for future research to promote evidence-based practice.
authors.affiliation: Drexel University, Philadelphia, PA 19102, USA. lc38@exchange1.drexel.edu
authors.forename: Lisa Ann
authors.initials: LA
authors.lastname: Chiarello
authors.forename: Margaret
authors.initials: M
authors.lastname: O'Neil
authors.forename: Carol Gildenberg
authors.initials: CG
authors.lastname: Dichter
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Westcott
authors.forename: Margo
authors.initials: M
authors.lastname: Orlin
authors.forename: Victoria Gocha
authors.initials: VG
authors.lastname: Marchese
authors.forename: Beth
authors.initials: B
authors.lastname: Tieman
authors.forename: Rachel Unanue
authors.initials: RU
authors.lastname: Rose
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001291:Attitude of Health Personnel; D002547:Cerebral Palsy / Q000175:diagnosis / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010372:Pediatrics; D026741:Physical Therapy Modalities / Q000592:standards* / Q000639:trends; D011786:Quality Control; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States