Empowering Parents, Patients, and Physical Therapists to Implement Therapy at “Just the Right Time”

For children with complex, life-long disabilities, identifying when to implement, change or discontinue physical therapy (PT) services is challenging. Children’s bodies and needs change with development. Age-appropriate motor skills may not be the expected outcome. Goal setting maybe completed by caregivers rather than the child and emotional tension can occur when a child reaches a plateau. A change in the PT plan may lead to the “loss” of a preferred treatment time or a feeling of “giving up” on the child. Therapists delicately balance hope, realism, and shared decision making while also understanding services much be skilled to ethically bill. Additionally, referring providers may continue to write scripts for return to PT. These emotional and logistical factors make it difficult to make changes in therapy plans.

This presentation will share an evidence-informed toolkit to assist with implementation of PT at “just the right time.” The toolkit includes point of care aides to identify meaningful participation level concerns (COPM and F-words) and evidence-based summarized prognostic factors for children with cerebral palsy, Down syndrome, and myelomeningocele to identify expected outcomes. Logistical and emotional supports for the implementation of various models of care, parent discussion points, and tips for collaboration with referring providers will be given. This multi-disciplinary presentation will be co-presented by an outpatient and a homecare physical therapist as well as a physical medicine and rehabilitation physician to discuss interdisciplinary strategies. Case examples and questions and answers will be used for interactive audience problem solving to enhance leaning and evaluate understanding.