How could I apply this information?"As the authors shifted the focus of their intervention study from in-person to telehealth services in children with autism spectrum disorder (ASD), they found the focus of the study also shifted to one that was more family-centered. In the telehealth environment, caregiver engagement increased as did generalization of activities in the home. This finding is like that of other recent studies [1][2][3][4] and highlights the use of telehealth in a family-centered approach.This telehealth approach facilitated collaboration between the caregiver and the therapist, increasing caregivers' empowerment to perform movement interventions with their children, individualizing activities, and incorporating them into family routines. The child likely benefits from generalization of interventions beyond the structured session, practice in the natural environment, and ultimately the incorporation of physical activity into family life. "What should I be mindful about when applying this information?"Telehealth has the potential to increase access to services in a variety of circumstances and facilitate participation for children who have anxiety related to attending therapy sessions. [1][2][3][4] However, the authors highlighted challenges in telehealth delivery in general and specific to this population. Choices about whether to provide services in-person, via telehealth, or via a hybrid approach should be made on an individual basis.The authors included several family-friendly elements in their intervention including sending materials for sessions in the mail, using common household items, and providing explicit instructional documents and videos. Our parent partner also recommends using family-friendly language in materials, providing guidelines for how much time to perform each activity, and providing a choice of a few activities that accomplish similar goals for variety. Additionally, therapists could facilitate caregiver buy-in by providing education regarding benefits for child participation across environments and family life and to use telehealth as a periodic "check-in" once a home program is established. Telehealth is a viable option for movement interventions for children with ASD; however, more research is necessary to establish best practices.
Purpose: To explore perceptions of caregivers of children with neurodevelopmental conditions participating in an interdisciplinary intensive therapy program. Methods: Semi-structured interviews were completed with caregivers. The intensive program consisted of occupational, physical, and/or speech therapy 3 to 6.5 hours/day, 3 to 5 days/week, for 4 weeks. Team-based collaborative goal setting was used to determine each child's plan of care. Reflexive thematic analysis identified interview themes. Results: Thirteen caregivers participated. Children ranged in age from 6 to 13 years; diagnoses included cerebral palsy (n = 10), spina bifida (n = 1), ataxia (n = 1), and stroke (n = 1). An overarching theme of Immersive was identified; other themes included Everybody' s Empowered, Principles of Neuroplasticity, Progress Across the ICF (International Classification of Functioning, Disability, and Health) Framework, It Takes a Team, and Benefits Outweigh the Challenges. Conclusions: Caregivers valued interdisciplinary intensive therapy. For children with complex rehabilitation needs, an interdisciplinary, intensive therapy program may be a viable alternative to traditional therapy models for service delivery.
Background and Purpose: This report highlights the challenges of diagnosing pediatric vestibular neuritis following dental treatment and addressing fear avoidance behaviors. Case Description: An 11-year-old boy came to physical therapy with vestibular dysfunction following dental treatment that was unable to be diagnosed by emergency department staff. The participant received multispecialty treatment for 6 weeks. Measurements: Computerized Dynamic Posturography, Limits of Stability, Dizziness Handicap Inventory, Functional Gait Assessment, Dynamic Visual Acuity, and Modified Clinical Test of Sensory Interaction on Balance. Outcomes: Most notable improvements were seen in Limits of Stability and Computerized Dynamic Posturography. The participant made a full return to school and sport. Conclusions: The difficulty of pediatric vestibular neuritis diagnosis led to fear avoidance behaviors that were addressed by a collaborative specialty approach. What This Adds to Evidence: This is the first documented case of pediatric vestibular neuritis as a complication of a dental procedure with intervention focused on fear avoidance behaviors.
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