Strategies for Acquisition of Motor Skills in Children with Medical Complexity

Children with medical complexity (CMC) display multiple system impairments and activity limitations which negatively impact motor development, learning, and acquisition. As a result, movement repertoires in CMC are often quite limited, appear minimal, and lack complexity; although, there is some indication of increased energy expenditure for motor skill completion. Evidence informs physical therapists that in order to develop, learn, and acquire new motor skills, movement experiences for children must be immense, immersive, repetitive, and progressively refined or shaped. Goal directed and context focused rehabilitation are evidence-based strategies that provide an underpinning for creating the necessary immersion and scaffolding of motor skill aquisition. The MR3 cycle defined as movement, reinforcement, repetition, and refinement, guides and advances the acquisition of motor skills. These approaches have been found effective in ambulatory children with disabilities and emerging pilot evidence indicates that CMC may benefit from similar approaches. By promoting, reinforcing, and optimizing motor skill development in CMC across home, school, and community settings, their participation and quality of life will be enhanced.

This learning session will review and apply evidence around goal attainment scaling, goal directed and context focused therapies and translation applications to CMC. The MR3 cycle will be introduced and serve as a framework to guide goal directed and context focused strategies. Case studies involving CMC will provide insight into measurement and implementation as well as support translation to home, school, and community clinical settings.