Abstracts of the Academy of Pediatric Physical Therapy Poster Presentations at the Combined Sections Meeting

EASE OF CAREGIVING FOR CHILDREN: A MEASURE OF PHYSICAL CAREGIVING FOR PARENTS OF CHILDREN WITH CEREBRAL PALSY Alghamdi M, Chiarello L, Palisano R (Physical Therapy and Rehabilitation Sciences, Drexel University), Avery L (Avery Information Systems, Orillia, Ontario) PURPOSE/HYPOTHESIS: The Ease of Caregiving for Children has been validated to measure physical caregiving by parents of children with cerebral palsy (CP) aged 1.5-5 years. The purpose of this study was to re-validate psychometric properties for parents of children with CP up to 11 years of age. NUMBER OF SUBJECTS: 611 parents of children with CP from two studies (Move and PLAY, n = 407; On Track, n = 204). Children were 1.5-11 years old and 56% were boys. Parents had a mean age of 36 (8.17) years and 90% were mothers. MATERIALS/METHODS: Parents rated their physical caregiving using Ease of Caregiving for Children at the initial data collection point of both studies. Parents and therapists identified children's level of function using the Gross Motor Function (GMFCS), Manual Ability (MACS), and Communication Function (CFCS) classification systems. Partial Credit Model of the Rasch analysis was used to examine stability and hierarchal ordering of items, (n = 611). Intraclass correlation coefficient (ICC2,1) was used to examine test retest reliability, (n = 55). Three 2-way ANOVAs were used to establish known groups validity by examining effect of child's age, gross motor, manual and communication functions on ease of caregiving, (n = 204). Known groups were child's level of function in GMFCS, MACS, and CFCS (higher functioning: Levels I-II; lower functioning: Levels III-V) and child's age group (younger: 1.5-5.9; older: 6-11-). RESULTS: Rasch analysis indicated a stable item calibration (ICC = 0.98) and hierarchical ordering by difficulty (logits varied from −0.88 to 0.78) and acceptable fit of items (infit values <2.0). The measure had moderate test retest reliability, ICC = 0.69. No significant interactions were found between child's age and manual or communication function on ease of caregiving, p > 0.05. A significant interaction was found between child's age and gross motor function level on ease of caregiving, p = 0.02. Analysis of simple main effects indicated that parents of older children with higher functions had higher ease of caregiving than parents of younger children with higher functions, p = 0.01. There were significant main effects for child's level of gross motor, manual and communication functions on ease of caregiving, p<0.001, parents of children with higher functioning had higher ease of caregiving scores compared to parents of children with lower functioning. No main effect was found for child's age on ease of caregiving, p > 0.05. CONCLUSIONS: Findings support reliability and validity of the Ease of Caregiving for Children completed by parents of children with CP 1.5-11 years of age. Rasch analysis supported the unidimensionality of the measure, appropriateness of the rating scale, and logical ordering of items based on difficulty of the tasks. CLINICAL RELEVANCE: Therapists are encouraged to have parents of children with CP complete the Ease of Caregiving for Children and engage parents in discussion to identity needs and concerns pertinent to physical caregiving, to develop individualized plans of care and to objectively document and monitor physical caregiving. PROGRESSION OF OBJECT PERMANENCE IN RELATION TO SITTING DEVELOPMENT IN INFANTS WITH MOTOR DELAYS An M, Harbourne R (Physical Therapy, Duquesne University), Hsu L (University of Washington), Stankus J (Department of Education, Duquesne University) PURPOSE/HYPOTHESIS: Object permanence as a cognitive construct is thought to be grounded in infants' everyday perceptual-motor experience such as sitting, object interaction, self-mobility. Adequate postural control in sitting allows infants to process visual information and use their hands freely to manipulate objects, which links to understanding of object properties. However, it is not clear how sitting development relates to object permanence in infants with motor delays. The purpose of this study is to examine the progression of object permanence over 6 months as sitting skills advanced in infants with motor delays. NUMBER OF SUBJECTS: Fifty-six infants with motor delays (mean age = 10.3 months, SD = 2.7) were involved in the study. Infants were recruited between 7-16 months of corrected age if they were able to sit propped on their arms for at least 3 seconds but unable to get in and out of sitting by him/herself. MATERIALS/METHODS: The Object Permanence Scale (OPS) and the Gross Motor Function Measure-88 Sitting dimension (GMFM-SD) were administered 4 times over 6 months, at baseline, 1.5 months, 3 months and 6 months. The GMFM-88 is a reliable and valid outcome measure designed to evaluate changes in gross motor skills over time. The OPS was developed to measure object permanence from minimal to advanced skills, in which the child has an opportunity to earn a score from 0-10. Items were extracted from studies on the progression of object permanence. The correlations between OPS and GMFM-SD scores were calculated using the Spearman rho statistic. To examine the influence of sitting ability on object permanence progression, infants were divided into 2 groups based on GMFM-SD score at baseline and a mixed analysis of variance (ANOVA) was performed. RESULTS: The results of Spearman rho statistic showed significant correlations between OPS and GMFM-SD scores with rranging from 0.584 to 0.715 (p < 0.001) at all 4 assessment visits. The results of mixed ANOVA indicated significant main effects of time (F(2.63, 118.50) = 7.23, p < 0.001) and sitting group (F(1, 45) = 22.90, p < 0.001), but no interaction between group and time (F(2.63, 118.50) = 0.38, p > 0.05). The results indicate that the OPS score increased over time in both sitting groups and infants with better sitting skill at baseline showed significantly higher object permanence scores across time. CONCLUSIONS: Our findings suggest that object permanence of infants with motor delays develops with the improvement of sitting skill. This expands previous research showing the linkage between early motor skills and cognitive development. Infants with limited perceptual-motor experience such as sitting and object interaction are at risk for delays in aspects of cognitive object permanence. CLINICAL RELEVANCE: physical therapists and early the influence of sitting skills on development of object permanence and that motor and cognitive development. OF IN CHILDREN WITH (Physical Therapy, of for of for of Therapy, of of for PURPOSE/HYPOTHESIS: There is a of outcome to the of in children with The Scale is a valid and reliable outcome measure that was developed to the motor of children with The purpose of this study was to examine the reliability of the Scale to motor in children with of NUMBER OF SUBJECTS: children with years of mean age of were recruited from and support groups a of two physical therapists and two therapists as the for the study. had an of years of and 11 years of MATERIALS/METHODS: child with was on the two and child was by two and reliability was using correlation for items and the RESULTS: The score reliability (ICC = the items, reliability was for items and and and (ICC = for to sit of sit of and sit to and (ICC = and moderate for of the items had The score had reliability across age and groups by There was no in the scores all at = p = CONCLUSIONS: were able to and score the on children with a of and CLINICAL RELEVANCE: This is the of the use of the in children with This study to the the psychometric properties of the and the use of this outcome measure as an to motor in children with MOTOR for The purpose of the is to the between motor and control and in to and of A analysis was on the and at for to the between motor and control and Children to have motor were to if they had a or of for for the purpose of this OF of children from the of months to 6 years from the and at for were This the at the for a motor and control A was and the of have a or of and age of to by had a significant for based on physical This that of the at with in motor and control had a of are data on the at in to the between motor and of to the of physical therapists on motor and risk for motor delays and TO The results of this of children with motor and control and of at the for early and and of The for early physical for infants with has been to have results in of of and on and is to of and The correlation the of and of physical for and and the it the for for physical therapists to motor and risk for motor delays and The of this study is assessment of the at to the for an to OF OBJECT OF INFANTS (Physical Therapy, of PURPOSE/HYPOTHESIS: Infants with delays in the development of and object their risk of delays in cognitive This study and effects of the on and object in infants at was the infants' ability a and with the infants' ability across time NUMBER OF SUBJECTS: MATERIALS/METHODS: infants age, = SD = with a 4 cerebral at the of the study was months. Infants were using a baseline, with a and and the was used the parents infants with of using the Infants were all with and the and for their ability to for and at and level was used for and object visual to objects, of of and were using in RESULTS: The infants' for and object and object the The and object across time the with of in the CONCLUSIONS: The infants' for objects, and of objects, which for information and effects were the effects were with in function across time from with the CLINICAL RELEVANCE: The is a that as an and to early and object for infants at risk for motor and cognitive delays. early and object in the of skills be for infants at risk but are for information to cognitive development. A FOR OF IN CHILDREN WITH (Physical Therapy, of PURPOSE/HYPOTHESIS: function and in gross and motor children's in and of The purpose of this study was to evaluate the of the designed to use of the and for children with The has the on the to the of the by of and manual of the the allows for with the was compared to and with a of the use of the and but not use of the compared to and use of both hands and compared to the NUMBER OF SUBJECTS: 2 MATERIALS/METHODS: children with to in this a old with and a old with child was 2 for visits. gross motor on the and motor at a across a with the and with a on the use and time and were using were used to test the study RESULTS: the and use of the and increased use of the gross and motor the children using the in gross motor and showed of both hands in motor This use of the hands was not with the the was not in gross motor and was in motor minimal of were in the CONCLUSIONS: The use of the and object with the CLINICAL RELEVANCE: data suggest that the an for for with use of the as as to of the an for in the is an outcome of physical The of and as in and an of child and in and children to and get with and develop skills and they to in their and The purpose of this is to a and that an opportunity for children with to in their and The and in the in of the physical for is a and with on and skills and with and for is an that is to all of their previous or The is limited to to and use and physical therapists their time to with this OF The has in two years. the the This a in the and with with support that but was not limited to support with the and and not The were and with their with all on and The for and TO Children with be in their compared to children This a that how between and is to and the of children with The children and their and to to develop for the of children with with the of their and MOTOR OF FOR INFANTS WITH TO CEREBRAL PALSY R of Therapy, of and Rehabilitation and Sciences, The University), J University) PURPOSE/HYPOTHESIS: palsy (CP) is a that children and Motor skills are it for the child to a motor skill for interaction with the and object is The purpose of this study was to of and the between motor and ability to in and complete of in infants with moderate to NUMBER OF SUBJECTS: MATERIALS/METHODS: Infants with CP in aged months corrected age, in this study. infants were a of a control Infants were in a and with and for 2 of was in a at the and The were were using a and gross motor skills were using the of and gross motor and of were using the of a outcome The of was compared to motor development and as by the outcome assessment analysis was completed using RESULTS: The of for infants in level was for level was and for level was had a and with the and = p = = the = p = = and = p = = had a and with the child's in = p = = CONCLUSIONS: Infants had CP had lower lower motor and ability to in infants with higher or had ability and opportunity to with and their This study of is a of motor function and as by outcome CLINICAL RELEVANCE: results suggest an of that for to motor skill development and A FOR M, M, M, (Department of Therapy and and of of PURPOSE/HYPOTHESIS: To the used to a for an child to for children with and to on function and of and are NUMBER OF SUBJECTS: parents in for MATERIALS/METHODS: A was developed using a child with as a to a for an child This child used the for 4 Parents completed a groups their child's and the group were using and time to complete the were calculated to of RESULTS: of using an with of Analysis of groups the in to on postural child and ease of use on time to and the of the it child in such as and at the an of and and concerns were not CONCLUSIONS: Parents identified on ease of and time to as needs of that be by the the that a for their child's The the for and which were identified as needs of research and groups to better of using this process in the CLINICAL RELEVANCE: for children with be a and to to for the is significantly than time and are by of and OF IN A M, of of has been in the to care of at and and of on an increased risk to the of the and the of the There is limited research on The purpose of this is to experience in on and were for or in a 36 care were by physical at least of and as were and able to in of were for by the were to the sitting by the of the 6 were into sitting in 4 on the of the and up by the of the the 6 to at least sitting, had an with a a The was with and by the the in the early a physical an and the A was to all their and was The of was individualized for based on stability and their for There were no early by of of or or a significant in their or in the of the as by the research is to for but it be as it be and on the A is to the of the is OF MOTOR R University), of and Rehabilitation Sciences, University), J University), L, L PURPOSE/HYPOTHESIS: analysis is a used to study in infants and This of analysis on and of and how they over time. to have been no studies that how influence the development of motor skills as outcome The of and Motor and the Motor Scale are used outcome to evaluate motor development in the The purpose of this study was to the between as by and motor skill as by the and the NUMBER OF SUBJECTS: = infants in this study. MATERIALS/METHODS: were study were on the hands and was in with a at for 6 to and and The gross motor and motor of the and the were RESULTS: were to the between and the and was as a in all significantly by all p = p = p = significantly by all p = p = p = not significantly by significantly by the (p = CONCLUSIONS: This study on how of the to assessment used to motor development. score was significantly with and score was significantly with of increased and CLINICAL RELEVANCE: The results of this study be used to designed to Our study that on to skills and to of the effect of based on the results from this study be changes in skills an and of and changes in skills an of OF A OF M, M, M, (Physical Therapy, of than of the risk of with this is The significantly increased risk for results in and and is of physical in The purpose of this is to the and of an physical The of the and of the was a on ability to in and to as a A of with a of of the and with of both was for physical in motor control and of The were to an and to The was for the 6 months the initial and was from physical administered by physical visits. Scale and and of in A in and was by the to able to all an and using the were and the was completed at time were at of physical and up to This the use of the and the that this ability to to and pertinent as a that to and age. IN WITH CEREBRAL PALSY A J (Physical Therapy, of PURPOSE/HYPOTHESIS: The effects of The of this was to evaluate the effects of on in children with cerebral NUMBER OF SUBJECTS: MATERIALS/METHODS: and were in using with cerebral and of of all study with CP at or on or the age of and the use of the of as a outcome measure at least months were if they were not in A was used to the research for of was with the RESULTS: the for group scores in the and of the showed significant improvement years compared to baseline scores were in all years. in from baseline were were the years in Levels and and no in were of the studies used the GMFM-88 to evaluate the in gross motor function over time. score changes were significant from baseline years for and for CONCLUSIONS: is on children have it has the to in years and the in in CLINICAL RELEVANCE: has been to in and skills in years studies with of up are to the data PHYSICAL FOR A A (Physical Therapy, of for and are for with to the stability of the and in with the of and early The purpose of this was to the and of physical in an to in and and The was a in was with and a for years which limited in and for years to The a and and at The completed a of over the of The of care and were designed to and motor control the lower and were to and the risk of to and as as with visual and to and The improvement in all outcome at rated on the Scale for increased by minimal and Scale increased by of with and time on an and and to to on a but was unable to the of the the time of the was able to to of and in and for control of the have a significantly the not the of the an with for with significant to and have a of and have of level of function is in stability and the to the risk of early and in the IN A R (Physical Therapy, of is but in than of age than and are with increased is in the The purpose of this is to in a child with was a and was with at the by and no to and and with and and for and from was the was on and was to have and a 6 on the the was of physical was increased to at this time to increased for at this time on and a the was to times sit to and scores were The simple and on with on and for the time on with 36 On score was and with in and with The was to The child in this had a significant and The of were with and and and of to and have the ability of the to evaluate and The was significant and in a time with minimal of from score 6 to in the significant is and and plans for with CLINICAL OF IN M, The University), PURPOSE/HYPOTHESIS: for a in children at risk for increased risk for in early of is for early early of a of are not of skills over time is for to if data a to early of by this data across for infants were with NUMBER OF SUBJECTS: This study infants age identified a of which were with and and MATERIALS/METHODS: completed a of data from to to scores from the of Motor and of and months and were in to and using and RESULTS: indicated no significant group in The group had significantly lower and scores for at both time mean scores were the for both groups at the time of the indicated that the group had significantly lower scores at months compared to for all scores were in the for all at this time The control group had significantly lower scores at months compared to for all the in scores between time was significantly for the group CONCLUSIONS: The results of this study indicate are in early development between were with and were are and significant at 2 years. Infants are with a in scores in the 2 years of in to early gross motor was not with a of CLINICAL RELEVANCE: This study the of for at risk of between months of age. research is to develop for OF IN CHILDREN WITH CEREBRAL PALSY R (Department of Therapy, University), Therapy, University), (Physical Therapy, University) PURPOSE/HYPOTHESIS: To the of on be The of are a to research in has and this data to the of to to by the to across and NUMBER OF SUBJECTS: MATERIALS/METHODS: Children with a of CP completed of with a of on the was divided into 3 of and 4 of were completed and assessment and completed which on a times from were extracted to time over the of and the in time between and of were calculated for RESULTS: time significantly for all from to p = and from to p = time were found between the of (p = significant were found between the two which to the of (p = and the and of the previous (p = No main effect was found for changes in time over CONCLUSIONS: children in their time motor that was by the motor the the of and cognitive This previous studies have been to the of not are children able to complete have an increased motor CLINICAL RELEVANCE: is a used Children in this study from a of as by their motor over the of a higher of be which the to to the of to in IN A WITH CEREBRAL A L, (Physical Therapy Education, University) Children with cerebral palsy (CP) experience or on the of the which has been to cognitive skill development as it the ability to has been to be to of in children with CP with The purpose of this is to the effect of and in a old child with CP level The was that physical on and control in of and the to The was a 3 years months old physical and The with increased lower and in lower and of to up to in for on and and postural Gross Motor Function and of and in time from 2 to and over from to with a from to moderate with dimension from to and dimension at at at and increased from to of in from to of in increased from to and of in from to and in this in to and no significant were in over a of time have in and be in in children with CP are and research is to if a in on the OF OF Chiarello L, Palisano R (Physical Therapy Rehabilitation Sciences, Drexel University), of Sciences, PURPOSE/HYPOTHESIS: The was developed based on the that of child and for is a process in which information is are and on of the and The purpose of this study was to evaluate construct and of the of NUMBER OF SUBJECTS: 11 and children MATERIALS/METHODS: The of is a to the and needs of a and and to develop an to a child's for The of of the 6 of the and 4 of the with to discussion of the of the and for the were rated the of and of and the and of the assessment on a therapists the for completed the and parents and therapists were to RESULTS: for group and group of the the for construct and and indicated that the assessment are from and is a development of and to the the time to complete the the process was and and use of CONCLUSIONS: The findings of construct and and of the of for use in and to child and for and in and the and of the have been and a to in the research is to examine if changes with are for use of the assessment in CLINICAL RELEVANCE: The is a to and on a child's for in their The a and the of a and children and in the FOR INFANTS IN of Therapy, University), for The purpose of this is to an to in the Information in the was from a at the in The of has been in the in the as research has that of infants age which be at a risk in a of care to of the of to the of and the development of delays in motor skill OF The of this is to with to support The that was developed that a at risk for of and using and that be to with early of and and to and for for a in the and TO this a to with and for to to the in the is to which infants be at risk as as the that be the is in the in to the to the is A FOR A for L J The purpose of this is to the to the that to in from an in to is a of are research that are a in that is a higher of in compared to findings suggest that the of is The and are of in or of to the of are to therapists such as the developed by to the of as a of a are no that the and over OF An was to in To better the of the the classification of

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