Active involvement of parents throughout the process of setting and implementing goals seemed to increase their feeling of competency and partnership with professionals. Concrete goals based on families' preferences and concerns, participatory observation, and discussions with professionals, came out as valuable means for practice of functional tasks within home environments.

By using the COPM and GAS in combination, a dynamic and interactive process of setting and implementing goals in the context of everyday activities emerged.

A substantial proportion of the "apparently normal" preterm infants exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older. Birth characteristics, minor abnormalities on the neonatal ultrasound scan of the brain, and motor milestones have only limited value in the early detection of these children. The aim of the present study was to investigate whether nonoptimal reaching and relatively immobile postural behavior at an early age are associated with dysfunctional neuromotor and behavioural development at school age. The preterm children and full-term children of the present follow-up study participated in a previous study on the characteristics of reaching kinematics and the kinetics of posture at 4 and 6 mo corrected age. At the age of 6 y, the children were re-assessed by means of the Touwen neurologic assessment, the Movement ABC, and the Child Behavior Check List. The results demonstrated that in preterm children without cerebral palsy, a lack of successful reaching at 4 mo and a nonoptimal quality of reaching at 6 mo are related to the development of a complex form of minor neurologic dysfunction (MND) and fine manipulative disability at 6 y. Thus, these early signs indicate the presence of clinically significant brain dysfunction. A relatively immobile postural behavior at 4 mo was associated with simple MND, coordination problems, and at 6 mo with a worse score on the Movement ABC and internalizing behavior. This suggests that a relatively immobile postural behavior points to a mild form of brain dysfunction. A substantial proportion of "apparently neurologically normal" preterm infants do exhibit minor and moderate dysfunctions in neuromotor outcome as they grow older (1). Yet, these dysfunctions, which may seriously interfere with daily living activities, are not generally detected before school age. We therefore need to increase our knowledge of risk factors and patterns of early neuromotor development that relate to impaired motor outcome at school age. So far, the prospective value of birth characteristics and minor abnormalities on the neonatal ultrasound scan of the brain have been inconsistent for later motor impairments in this preterm group (1,2).Prediction of motor impairments at school age on the basis of the assessment of motor milestones at an early age is hampered by the presence of many false negatives (3,4). Prediction based on the quality of early motor behavior may be better. Recent work by 6) indicated that an abnormal quality of GM, which had been present until about 4 mo corrected age, was related to MND at early and later school age. A nonoptimal quality of specific motor functions, such as reaching and grasping at 9 mo, has also been associated with reduced quality of hand motor performance at 2.6 y (7).Preterm infants often show an abnormal quality of postural behavior (8), which has been addressed in terms of transient

In recognizing the value of exploring children's experiences, professionals are left with the challenge of creating space for children to reflect on the worthiness of an ATD across place, time and functionality. Implications for Rehabilitation Used in everyday life, ATDs become social objects with potential both to exacerbate disability and to enhance selfhood, embodied capacities and participation. The child's everyday environment is a vulnerable setting for implementing rehabilitation interventions, such as ATDs. Creating space for children to reflect on the worthiness of an ATD, regarding place, time and functionality, may enhance their participation in everyday life.

This article advocates integrating ideas from phenomenological theory regarding the body with a psychoanalytical theory of language to enrich our understanding of the meaning of bodily presence in the practice of physiotherapy. The authors use this theoretical framework to explore bodily presence as a source for physiotherapists' professional development. They are using research on children as moving and meaning-producing subjects The concept of subject is used in different ways in phenomenology and psychoanalysis, and also in varying ways in each of the two traditions. However, here the concept is used more in line with ordinary language, in the sense that it emphasizes the child's active position in her/his being in the world. to illustrate the relevance of their perspectives. They argue that the perspectives might contribute to a physiotherapeutic practice that incorporates bodily presence in the professional language in addition to specific methods and techniques. Understanding bodily presence involves the physiotherapist recognizing the Other (i.e., the patient/child) in the present moment and trusting her/his own capacity to become aware of her/his own bodily presence. The authors assert that being aware of one's own bodily presence enables therapists to develop an appreciation of their own bodies and the bodies of their patients as they are and move in mutual relation to each other. Applying the article's theoretical framework, the authors consider the body as the starting point for speech, The concept of speech is used in a wide sense, including voice, tone, and rhythm in line with the article's psychoanalytical framework of Kristeva and the late Lacan. Thus, the call for being present for the child (as a patient) in the here and now includes participating in the speech of the child, even though the child does not use words. and suggest that introducing a richer professional language encourages practitioners to become more aware of the dialectic between body and language: how the body is the anchor for speech and how language influences the experience of the body.