Revisiting therapy assumptions in children's rehabilitation: clinical and research implications.
OBJECTIVE
This commentary draws on a recent workshop hosted by the Canadian Children's Rehabilitation Research Network that brought together stakeholders to critically examine assumptions embedded in children's rehabilitation in order to advance current debates and suggest areas for further inquiry.


METHODS
Six issues are discussed: (1) the wisdom of dichotomising 'fix' versus 'function'; (2) the ethics of it might help and it won't hurt' therapy approaches; (3) the emphasis on early intervention rather than a lifespan approach; (4) the challenges of providing care for new rehabilitation populations; (5) discrepancies between performance outcomes and patient satisfaction; and (6) innovative partnerships to support care transitions of adolescents and their families.


RESULTS
Issues identified include: finding the right balance between therapies that focus on 'fixing' children versus enhancing function, judicious design of therapy programs as to not overburden children and families, adopting lifespan approaches to meet the needs of multiple 'paediatric' populations, cautious interpretation of measures and approaches that link well-being with physical performance, and the benefits of including parent and youth facilitators on children's rehabilitation teams.


CONCLUSIONS
Ongoing debate, discussion and research are needed in each of these areas to ensure that rehabilitation services are enhancing the well-being of children and families.
Gibson
Barbara E
BE
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada. barbara.gibson@utoronto.ca
Darrah
Johanna
J
Cameron
Deb
D
Hashemi
Goli
G
Kingsnorth
Shauna
S
Lepage
Céline
C
Martini
Rose
R
Mandich
Angela
A
Menna-Dack
Dolly
D
D000293:Adolescent; D002648:Child; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D004995:Ethics, Professional; D006801:Humans; D020380:Needs Assessment; D017060:Patient Satisfaction; D011788:Quality of Life; D012046:Rehabilitation / Q000639:trends