Children with many types of motor dysfunction have problems maintaining postural stability. Because maintenance of postural stability is an integral part of all movements, therapists evaluate and treat to improve postural stability in these children. This article reviews current pediatric assessment tools for postural stability and issues affecting testing this construct in children. The tests and measurements are classified according to their testing purpose and the National Center for Medical Rehabilitation Research disablement framework, focusing on the impairment and functional limitation dimensions. Postural stability is defined from a systems perspective with tests related to the sensory, motor, and biomechanical systems described. Reliability and validity information on the measurements is discussed. Relatively few measurements of postural stability in children are available that have acceptable reliability and validity documentation. Suggestions for research on test development in this area are discussed.

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The purpose of this study was to determine whether 155 ethnically diverse clients with traumatic brain injury (TBI) and stroke (cerebrovascular accident; CVA) who received occupational therapy services perceived that they reached self-identified goals related to tasks of daily life as measured by the Canadian Occupational Performance Measure (COPM). This study found that a statistically and clinically significant change in self-perceived performance and satisfaction with tasks of daily life occurred at the end of a client-centered occupational therapy program (p < .001). There were no significant differences in performance and satisfaction between the TBI and CVA groups. However, the group with right CVA reported a higher level of satisfaction with performance in daily activities than the group with left CVA (p = .03). The COPM process can effectively assist clients with neurological impairments in identifying meaningful occupational performance goals. The occupational therapist also can use the COPM to design occupation-based and client-centered intervention programs and measure occupational therapy outcomes.

The purpose of this study was to examine the interrater and test-retest reliability of a one-leg balance test and a tiltboard balance test. Twenty-four normally developing children aged 4 through 9 years participated in the study. Time and quality of balance on one leg and degrees of tilt on a tiltboard prior to postural adjustment were measured. Both tests were completed with eyes open and with eyes closed. Interrater reliability was examined using two raters. Test-retest reliability, with a one-week interval between test and retest, was examined for a subgroup consisting of 12 children. Spearman rank-order correlation coefficients were used as indexes of both interrater and test-retest reliability for time and degrees of tilt. To supplement the correlation coefficients, the magnitudes of difference between raters' scores and between test and retest scores were calculated. Spearman coefficients were moderate to high for one-leg balance when scores for both feet were combined for both eyes-open and eyes-closed conditions. The magnitude of difference between scores was low, indicating good agreement between raters and across time. Interrater and test-retest reliabilities of quality of one-leg standing balance were examined by calculating percentages of agreement and Cohen's Kappa statistics. Results of these analyses revealed the need for further study. The Spearman coefficients for the interrater tiltboard test were high; however, the test-retest coefficients were low. The magnitudes of difference between scores were small for the two raters, but large for test and retest. These results are important to consider when using these tests for initial evaluation or for monitoring patient progress.

The data support our hypothesis that, independent of sleep schedule changes, increasing adolescent daytime sleepiness is related to brain maturational changes indexed by declining EEG power. Our working hypothesis is that the declines in delta and theta power are correlates of an adolescent synaptic pruning that reduces waking arousal levels.