Special Education

For a child with disabilities, few transitions are as fraught as the passage from youth to adult, usually around age 21. While the Individuals with Disabilities Education Act (IDEA) makes some provision for transitional services for youth as they prepare to move out of the school system for “further education, employment or independent living,” these services are often poorly defined and...

Because bone is dynamic and responds to positive stresses and forces placed on it through weight-bearing activity, the authors of a recent study set out to examine the effects of early upright supported stepping on bone mineral content in a population of infants (1-18 months) with a form of spina bifida called myelomeningocele (MMC). They chose patients with MMC because this condition presents with...

For children with developmental disabilities who are non-ambulatory or have minimal capabilities to move, passive standing in an adaptive stander is an important intervention with resulting benefits in many of the body’s systems including the musculoskeletal system. However, research is now leading us to believe that opportunities for dynamic standing can be even more beneficial especially for the...

Physical therapists frequently implement supported standing protocols in pediatric settings for children whose disabilities would otherwise confine them to wheelchairs for most of the day. But there is a lack of evidence pertaining to the timing and frequency of adaptive standing for best outcomes. Ginny Paleg, PT, MPT, DScPT and her team chose to address the problem and recently came out with a...

Bone Mineral Density It’s widely recognized that non-ambulatory children with physical disabilities such as cerebral palsy are at risk for decreased bone mineral density (BMD). (1-3) Children with CP can also present with altered skeletal maturation and thinner, smaller bones. (4-6) As a consequence, these children are at an increased risk for fractures. (7-10) Research indicates that fracture risk...

Current evidence is challenging our traditional approaches to contracture management in children with cerebral palsy. Following is a brief review of the literature. Passive stretching, performed manually or with serial casting and positioning techniques, has long been the traditional approach to contracture management in children with cerebral palsy (CP). Behind this approach is the belief that stretching...

Today’s post concludes our discussion on Motor Learning and Practice. The introductory post defined motor learning terminology, discussed the MOVE Curriculum (as an example of applied motor learning) and emphasized the importance of practice.  The second post looked at transfer-appropriate training and practice scheduling and leads into today’s evidence-based discussion on the difficulty...

This post continues our discussion begun last week, Motor Skills Learning & Practice part I, where we defined motor learning terminology, discussed the MOVE Curriculum (as an example of applied motor learning) and emphasized the importance of practice.   Transfer-Appropriate Training One question that we must address is, “What should we practice?” This question clearly relates to...

Today’s post is the first in a series of articles on motor learning and practice. You’ll notice that I make frequent reference to the MOVE Curriculum. For those unfamiliar with this, MOVE is an activity-based program designed to teach children with severe disabilities the functional motor skills needed to sit, stand, and walk as independently as possible. There’s a great video...

This evidence update is focused on autism. It is a topic that’s been in the news lately, and the Spring 2012 Pediatric Physical Therapy Journal features two great articles and one commentary on this subject which I summarize below. Additionally, it is timely for the Rifton autism chair which is now available. I have also included a remarkable (and provocative) ABC news video at the end which you...