Physical Therapy

Evaluation of the Child

Amy Shuckra, MPT

Physical Therapist

Shriners Hospitals for Children

Salt Lake City, Utah

Objectives

• Identify model of assessment

• Physical therapy evaluation

• Goal setting

• Intervention plan

• Consideration of age

Approach to Assessment

Bottom-Up Approach

Intervention Plan

and Strategies

Determine Goal

Identify Strengths

and Weaknesses

Asse

ssm

en

t

Components of the Evaluation

• History

• Clinical

Observations

• Objective Measures

• Standardized

Assessments

• Assessment

• Plan

History • Obtain the history

• Parent/child/caregiver interview

• Review medical records

• Medical history

• Suspected diagnosis, medications,

surgeries

• Family history; the pregnancy, labor and

delivery of the child; and perinatal and

neonatal events

• Developmental history

• Social history

• Environmental characteristics, culture,

education

Clinical Observation

• At rest in various

positions

• Parent/caregiver

and child

• Interaction with the

environment

• Social responses

and communication

Objective Measures

• Range of Motion

• Strength (Motor Grading

Scale)

• Tone (Modified

Ashworth Scale)

• Motor Control

• Posture/Balance

• Sensory

• Functional Skills &

Standardized Tests

• Adaptive Equipment

Assessment

• List the child’s strengths

• List problems and hypothesize reason

• Goals

• Long-term vs. Short-term

• Measurable and functional

• Include a time frame

• Set by family, child and therapist

• Goals change with change in problem

• Re-evaluate if goal is not achieved

Treatment Plan

• Designed to meet

specific goals

• Changes with child’s

age

• Geared to function

the child needs as

grows and develops

• Integrate play for

motivation

Prognosis & Outcome

• What’s the child’s

prognosis?

• What’s the

outcomes you want

to achieve with

treatment?

• Reassess your

goals, treatments

and outcomes at

each session

References

• Campbell, SK. (1999). Decision Making in Pediatric

Neurologic Physical Therapy. NY, NY: Churchill

Livingston.

• Campbell, SK, Linden, DW, Palisano RJ. (2000).

Physical Therapy for Children (2nd Edition).

Philadelphia, PA: W.B. Saunders.

• Long, TM and Cintas HL (1995). Handbook of

Pediatric Physical Therapy. Baltimore, MD: Williams

& Wilkins.

• Tecklin JS. (1999). Pediatric Physical Therapy.

Philadelphia, PA: Lippincott Williams & Wilkins.