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Pediatric Physical Therapy Interventions: Questions is in Below, also attached with other file on uplode. Related Reading: Independent search and attainment of one current journal article (See instructions in Question #1 below). Education-based Physical Therapy Services and Early-Intervention Services: Related Readings: Text Book (Campbell, S. K., Palisano, R. J., & Orlin, M. N. (Eds.). (2012). Physical therapy for children (4th ed.))- Chapters 30, 29. Websites (linked within respective Study Questions) APTA Fact Sheets (posted in Week 3 Learning Module- Resources): 1) “IDEA” 2) “Early Intervention Services under IDEA” 3) “Natural Environments” Text - Chapter 12 Question #1: Through the ATSU LRC data bases, locate one current journal article on a physical therapy intervention used for children with cerebral palsy. Provide a brief summary of the important concepts highlighted in the journal article. The article you select should have been published within the last five years. Use the following prompts for your summary: a) What is the basis for utilizing this type of intervention for children with cerebral palsy? b) Why is this intervention being investigated? Is there a lack of supportive evidence or are there controversies surrounding this type of intervention? c) Do the results of the study or summary of the study adequately support the efficacy of this intervention for children with cerebral palsy? Legislation Background Information: In the USA, all children and adolescents have the right to a free and appropriate public education. Federal legislation is in place which protects the rights of children and adolescents with special educational needs. PL 94-142: Education for All Handicapped Children Act introduced several new concepts/terms. These were further clarified in subsequent laws: PL99-457, PL102-119, PL105-17, and the most current reauthorization, PL 108-446, the Individuals with Disabilities Education Improvement Act of 2004 (currently referred to as IDEIA 2004). 1 Use the following resources for reading and understanding the current federally mandated education law: A) Text – Chapter 30 B) APTA Fact Sheet- IDEA Be sure that you understand the following terms or concepts that are components of the current legislation (IDEIA 2004). These concepts are a foundation for further understanding of educational services. a) Zero reject b) Least Restrictive Environment (LRE) c) Due Process d) Nondiscriminatory Evaluation e) Individualized Education Plan (IEP) f) Parent participation g) Related Services h) Transition Plan i) Assistive Technology j) Extended School Year Question # 2: PL 99-457: Education of Handicapped Act Amendments of 1986 first introduced legislation related to the service of infants, toddlers, and preschoolers. In the 1997 reauthorization of PL 105-17 (Individuals with Disabilities Education Act- IDEA), and more recently, reauthorization of the IDEA in 2004 (IDEIA 2004), service of the younger children falls under Part C. For Question #2: Briefly explain the services provided under Part C of the IDEA or IDEIA legislation. Question # 3: Discussion: There are two areas of controversy regarding the current legislation that often impact physical therapists. The first is the issue of least restrictive environment (LRE). The textbook states, “Placement in the LRE is not necessarily as widely accepted as one might hope. General educators are often concerned about having children with special needs placed in their classrooms without appropriate support services. Administrators are often concerned about the cost to the educational system. Parents sometimes believe that segregated environments have better services for their children”. Read the following website posting on the pros and cons of inclusion: SEDL Website: http://www.sedl.org/change/issues/issues43.html (SEDL is the Southwest Education Development Laboratory, a non-profit organization which focuses on educational research and development. Website URL: www.sedl.org) Question #3: What are your thoughts on inclusion? Is inclusion the best educational situation for all children (children with special needs and children without special needs)? 2 Question # 4 Discussion: Another difficult and gray area for school-based physical therapy services is the concept or definition of “educationally relevant physical therapy”. IDEIA or IDEA 2004 clearly indicates that education is to prepare students for independent living and economic self-sufficiency but the exact role and limitations of physical therapy within this definition is still interpreted very differently from school district to school district. Some common areas are listed below: Accessing the educational environment: -locomotion to and from classrooms, cafeteria, rest rooms, etc. -fire drills Participating with peers: - classroom - playground - fieldtrips - transportation (when wheelchair or other adaptive seating is necessary) The ability to learn (gross motor limitations that interfere with learning): - head control - sitting posture - upper extremity control Self-care issues as they relate to the learning environment Endurance: - to move from one place to another - enough endurance to last through the day Equipment needs for school Positioning for communication Please read the textbook section (Text - Chapter 30, pp.983-986 ) on developing goals and objectives then answer Question #4 below. Although you are familiar with writing physical therapy goals, the organization of these within the educational setting is a little different than in an adult medical center or therapy clinic. There is a nice example of the structure for goal-writing in Box 30-4 in Text Chapter 30, page 985. The information that I give to entry-level students is as follows: Annual Goals with Short-Term Instructional Objectives or Goals Annual Goal: States the expected outcome for the child . Short-Term Instructional Objectives or Goals: Intermediate steps between present level of performance and annual goals. Five Components of Goals: 3 Identification of the target behavior (ideally a function-related task) The conditions under which the behavior is to occurThe criteria of acceptable performance (accuracy, frequency, duration, rate, speed) Procedures that will be used to evaluate performance The schedule for evaluating performance (in objective or on IEP/Progress note) Examples: A. Robert will be able to walk up 3 steps holding onto one railing while other children are present in less than 90 seconds in 4/5 trials as measured by observation. B. With verbal instruction, Paul will walk a distance of 100 feet within 3 minutes for 5 consecutive days as measured by monthly observation. Question #4: Read the brief case study for Derek at the end of Text -Chapter 12, pp. 376-377 (this case starts in the third paragraph on p. 376). Write one Annual Goal and two Short- Term Objectives that may have been included in this child’s IEP at some point in his school years. Please also view the Evolve website’s video clip for a child with Muscular Dystrophy. Question #5: First, review the following resources on Natural Environments: Website: http://www.ifspweb.org/environments.html (Website URL: www.ifspweb.org) APTA Fact Sheet: “Natural Environments”- (Posted in Week 3 Learning Module- Resources) Describe how the definition of “natural environments” is more than just switching from clinic-based to home-based services. (Note: The webpage is a component of the IFSP website for the State of Nebraska.) Question # 6: Through these different education laws, parents were given more and more rights. Unfortunately, many parents are not aware of these rights. Identify the important information you would want to tell the parents of a child with physical and cognitive special needs regarding their rights in advocating for their child. For this question, use the information you have already read in Textbook Chapters 30 and 29. Additional information is available through the following website: http://www.birth23.org/Families/ParentalRights.asp (Website URL: www.birth23.org)



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