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As pediatric PTs make the move from a Section on Pediatric Physical Therapy to the Academy of Pediatric Physical Therapy (APPT), almost 900 members enjoyed the final SoPAC and began looking toward the first APPTAC (Academy of Pediatric Physical Therapy Annual Conference) in 2017. The 7th SoPAC was held in Keystone, CO this month. This SeekFreak was in attendance and it was encouraging to hear new and validating information and to connect with pediatric PTs from across the nation and across practice settings.

SeekFreaks started to make a ‘home base’ for PTs, and now OTs and SLPs in school practice, to find and discuss evidence and how to apply it – and to continue the great conversations we have at conferences throughout the year! If you have just found SeekFreaks, we hope you will review the whole website and make comments on what you find! If you are a seasoned SeekFreak, use the comment section to let us know what you are thinking about what you found here! Also, let us know what articles you would like to see, topics you would like covered and share the Freakish goodness with others.

Now, back to SoPAC 2016…this conference is organized by each of the seven pediatric special interest groups (or SIGs):

  • Academic & Clinical Educators
  • Early Intervention
  • School-based Physical Therapy
  • Hospital-based Pediatric
  • Neonatology
  • Pediatric Sports-Fitness
  • Adolescents & Adults with Developmental Disabilities

ALL the programming and content of this conference is pediatric and balanced with a ‘strand’ of content for each SIG from peer-reviewed proposals. In addition to sessions, SoPAC offers pre-conference courses (1/2, 1 or 2 days), which, this year, included Aquatic Athletics for Children and Young Adults with Special Abilities, Cortical Visual Impairment: Identification, Assessment & Intervention, Hip Health for Children with Cerebral Palsy, Pediatric Neuromuscular Recovery Scale, Reconsidering Spasticity as a Management Target in Children with Diplegic CP – PLUS –  Tai Chi (for the early risers) each morning and a fitness challenge! And now to the programming, I discuss the session which I attended first, followed by the other concurrent sessions in italics, in case you are curious what else were offered. It was a struggle with so many tempting topics!!

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Friday 11/11   

10:45-12:15: 2 Bfit or Not 2B? An Exercise Program for Adolescents with CP Early Mobility in Pediatric Intensive Care Settings Dosed to Affect the Musculoskeletal System

Speakers: Mary Gannotti, PT, PhD; GeorgeGorton, MS, CCRP; Denise Gloekler, PT, DPT, PCS, cNDT; Melissa Bourgeois, DPT; Jessica Lobisser, DPT

Excellent review of characteristics of musculature with CP, such as:

  • Decreased muscle volume (18-50%)
  • Decreased cross-sectional area (14-48%)
  • Decreased strength (40-85%)
  • Fatigue resistant (>Type I fibers; weak/no max force; co-contraction; stiff).

Huge take home = TIME DEPENDENT MEASURE OF FORCE PRODUCTION IS KEY, IN ADDITION TO MAX STRENGTH. Rate of force development (RFD) is a better predictor of function (PODCI & ASKp) than strength!! Train for power & velocity not strength, or not strength alone—is intensity and duration inadequate?

They also described a fantastic, grant-funded, community fitness program (BFit) with professional students supervising exercises. Utilizing stations, reliant on collaboration, enthusiasm, grants, students and loud music. Tied to school calendar (cancellation, vacation). Impressive health and social outcomes. Next steps transitioning to community facilities.

Concurrent Sessions:

  • Flipping It Around for the Entry-Level PT Student: Advancements in Technology
  • Weeding out the Myths: Medical Marijuana Use in Children and Implications for PTs
  • PTs and Medical Professionals: Teaming up for Effective Medical Management for Adolescents and Adults with Developmental Disabilities
  • Relationship-based Intervention in Pediatric Physical Therapy
  • Transitioning the Medically Fragile Infant from the NICU into Early Intervention: A Team Approach to Family-centered Developmental Care

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2:45-4:15p: Physical Therapists’ Power to Help Disable Segregation Across the Lifespan for Children, Adolescents, and Adults with Developmental Disabilities

Speakers: Dan Habib, Samuel Habib

This was a great session featuring a student and parent with disabilities, describing the importance of inclusion. Quite the technological feat with video and real time, long distance connection. They provided insights on outcomes directly related to interactions with peers without disabilities. While it was clear that this family is well resourced, I really like the idea of having an annual meeting with family, friends, other key relationships and therapists/medical folks to discuss what Sam (the student) wanted to accomplish that year and future plans as well as what his friends wanted or family goals. This was wide ranging and led to therapeutic goals that are meaningful and progress that keeps focus on whether this is do-able or needs more help to accomplish.

I also heard the Inclusion Intervention session was very good; emphasizing collaboration and meaningful goals. The room was packed, this one was tough to miss.

Concurrent Sessions:

  • Interdisciplinary Inclusion Intervention for School Physical Therapy
  • Pediatric Residency Programs: What Are the Benefits and the Measures of Success?
  • Adaptive Sports for Individuals with Cerebral Palsy
  • Skin Integrity and Wound Care for the Patient in the Neonatal Intensive Care Unit
  • The Cross-Cultural Validity of Current Standardized Motor Development Assessments
  • The Good, Bad, and the Ugly: Treatment of Pediatric Complex
  • Regional Pain Syndrome and Centralized Pain – A Problem-Solving Approach

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Saturday 11/12

7:30-9a: Enhancing Participation of Children and Youth with Disabilities

Speakers: Dana Anaby, PhD; Rachel Teplicky, OT Reg, MSc; Mary Khetani; Wendy Coster, PhD, OTR/L; Mary Law, PhD, FCAOT, FCAHS

Longitudinal study (427 children over 3 yrs) found: participation intensity, especially for informal activity falls as children age; there are gender differences (boys – more physically active; girls – score higher at social, skills-based & self-improvement activities); there is no association between diagnosis & participation. Direct predictors of participation intensity include functional ability, family participation & preference for activities. Indirect predictors are perception of environmental barriers, family cohesion, supportive relationships.

In US & Canada, 36% of parents of children/youth with disabilities report no or limited availability of programs vs. 3% of parents of children/youth without disability (Bedell, 2013).

How can you measure participation? The Participation and Environment Measure for Children and Youth (PEM-CY) is a measure of participation & environment, including 3 settings (home, school & community), and using 4 scales (frequency, involvement, desire for change, environmental support/barrier). The Children Assessment of Participation and Enjoyment (CAPE) measures child’s perspective on participation & enjoyment via 55 items in 5 domains (recreation, active physical, social, skill-based, and self-improvement). It provides scoring on diversity, intensity, enjoyment, with whom & where.

Evidence supports involving child/youth/student in setting goals, developing strategies and parent coaching. The Pathways and Resources for Engagement and Participation (PREP) approach (make goals – map a plan – make it happen – measure process & outcomes – move forward) equips child/youth/student/family with the capacity to participate in community or family activities.

Concurrent Sessions:

  • Gait Analysis Techniques: From Free to the Gold Standard
  • Developmental Coordination Disorder: Clinical Pearls from the CPG Team

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10:30a-1p Team-Based Learning Roundtable: Ethics, Reimbursement, Policy, and Practice

Moderator:  Tricia Catalino, PT, DsC, PCS

I love the team-based learning. I always learn something about other practice settings. This is case-based collaboration/guided discussion with a great focus on ethics especially. Plus an opportunity to enlighten colleagues about school-based PT? Love it.

Concurrent Session:

  • Academy of Pediatric Physical Therapy Boot Camp for Students and New Professionals: Preparing for a Career in Pediatrics (CAT-EI)

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2:15-3:45p What Is Happening in Schools? Are We Doing the Same Interventions and Having the Same Outcomes Across the USA?

Speakers: Lynn Jeffries, PT, DPT, PhD, PCS; Lisa Chiarello, PT, PhD, PCS, FAPTA, Susan Effgen, PT, PhD, FAPTA

This session provided the next set of outcomes from the PT COUNTS study (a multi-site, national, practice-based study). Here are some findings:

  • Outcomes using the School Function Assessment (SFA) –
    • Change must be viewed in context of standard error measure for each subtest;
    • Most change in students < 8yo
    • Least change for students in GMFCS levels IV & V.
  • Outcomes using  Goal Attainment Scaling (GAS)
    • More sensitive than SFA
    • Very few self-care or academic goals
    • No significant difference in outcomes by GMFCS level, diagnosis or community-based services
  • The researchers found associations between outcomes and services, such as
    • Better participation outcomes with more mobility interventions
    • Posture/mobility goals were exceeded when more minutes of services on behalf of students were provided (collaboration, consultation, documentation)
  • Regional differences were examined  for PT demographics/ educational level, student demographics, other services provided, GMFCS level, and placement. I was most impressed by the difference in regions for GMFCS and placement –
    • GMFCS level I was in the Northeast (41%)/Central (41%)/Northwest (54%) of  this sample; in the Southeast 19%. GMFCS levels II & III NE (33%); SE (51%); Central (42%) NW (28%).
    • Placement was a shocker! Special education/self-contained NE (32%); SE (53%)!!!; Central (30%); NW (41%)

…I cannot wait for this article!!

Concurrent Sessions:

  • Achilles Kids: Running, Walking, Rolling in the Schools – Program Implementation and Outcomes for Students with Autism
  • Disparities in Early Intervention Utilization and Unmet Therapy Need: Implications for the Pediatric Physical Therapist
  • Aquatic Therapy as an Adjunct to Early Intervention (Part 1, Lecture)
  • Children with Visual Impairments: Interrelationships Between Visual Capacity and Early Motor Skill Development, and PT Strategies to Support This Development
  • Diagnosis and Treatment of Scoliosis in Children From Infants to Adolescents
  • Participation and Environment Measures (YC-PEM and PEM-CY): Opening the Door for Participation-focused Pediatric Practice and Research
  • Knowledge Translation Workshop

 

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4-5:30p: No PT Left Behind: Clinical Mentorship in School-based PT Practice

Speakers: Victoria Chu, PT, MA; Caren Goldberg, MSPT

This excellent session outlined the importance and key characteristics of mentorship using examples from a school-based practice of a highly-structured district. However, mentoring should be a part of every practice, whether it is supported/structured by your employer or not! NYC DoE has some excellent resources we can all use regardless of our setting…for free. Check out their website for these and many other helpful resources! Successful mentoring relationships are intentional, planned and monitored, full of trust and candor.

I also heard the Dual Perspective presentation was excellent, challenging and moving. Some of these time frames forced difficult choices filled with regret!

Concurrent Sessions:

  • Addressing the Needs of Students with Autism: A Dual Perspective as a School PT and as a Parent
  • Vision Development of Preterm Infants and Its Impact on Early Childhood and Beyond
  • Aquatic Therapy as an Adjunct to Early Intervention (Part 2, Pool Lab)
  • Caring for the Adult with Developmental Disabilities Through Participation in a Multi-Disciplinary Clinic Using a Clinical Practice Guideline
  • Knowledge Translation Workshop
  • Living an Abundant Life: Using Evidence-based Interventions to Counter the Effects of Stress in Individuals Living with Health Conditions
  • Physiologic Scoliosis-Specific Exercises (PSSE): Review of Current Literature, Definition, Indications, and Overview of Intervention Methods

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Sunday 11/13

7:30-9a: Medical-based vs School-based Pediatric Therapy: A Healthy Debate and a Productive Resolution

Speakers: Caro Vialu, PT< Magda Oledzka, PT, DPT, MBA, PCS, c/NDT

Another excellent session with an engaging back-and-forth debate structure. They provided a comprehensive and entertaining review of the similarities and differences between these practice settings. A survey was conducted and presented that highlighted some of the communication difficulties and barriers to overcome. It became clear how helpful and valuable it is to ensure the BORPAT (any problem can be solved with a Bunch Of the Right People Around the Table) principle is upheld. The session introduced the SBAR – Situation, Background, Assessment, Recommendation format of communication, which is a succinct and efficient way of relaying actionable messages for all of us time-deprived practitioners. Carlo and Magda also offered some models for us to consider in how we can improve our communication, procedures and, planning to be more inclusive. It will take therapists in each setting, administrative support, the child and family at the center, with assistance from technology, policy, procedures and guidelines. So good!

Concurrent Sessions:

  • Pearls from the IV STEP Conference

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9:15-10:45a: Fit4Work: Examination and Intervention Strategies that Maximize Participation for Youth with Disabilities

Speaker: Connie Johnson, PT, DScPT

Connie Johnson has a great approach for assessing and addressing youth with disabilities ability to perform work tasks and build capacity to get and hold a job. This is especially relevant for school-based practitioners working on transition goals! Fantastic tools and practical tasks to individualize interventions and document progress. Check out SeekFreaks’ recent Spotlight on her work with links to her website. {LINK}

Concurrent Sessions:

  • Looking Forward, Planning Backward: Promoting Lifelong Participation Goals in the School and the Community
  • Feeling Conflicted? Considerations When Practicing Under IDEA Part C, State Practice Acts and Regulations, and Local Agency Guidelines
  • Knowledge Translation Skills 1: Finding and Appraising Clinical Practice Guidelines
  • Life Transitions: Supporting Individuals with Autism Spectrum Disorder Through Preparation, Education, Interprofessional Collaboration, and Advocacy
  • The Movement Repertoire of the Preterm Infant: What Is the Significance of These Movements? Part 1
  • Yoga as a Therapeutic Tool: Promoting Growth and Wellness

 

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12:45-2:15p:  Implementation Science: Moving Programs and Practitioners Forward

Speakers: Laurie Ray, MPT, PhD; Lauren Holahan, MSOT, PhD Candidate

This was a session I presented with my OT colleague, Lauren Holahan. We offered an overview of implementation science with an example from our consultative work in NC and some practical suggestions to implement initiatives/concepts/approaches into an organization, agency or practice group. The last session of the conference, but a few stalwarts participated! Systematic change, or building capacity in a new area, requires a plan and efforts devoted to change.

Concurrent Sessions:

  • Facilitating a Successful Clinical Education Experience in Early Intervention
  • Youth Sports Objective Testing and Treatment of Lower-Extremity Dysfunction
  • Interprofessional Education: From Developing to Implementing Unified Personnel Competencies for Early Childhood Intervention Across Professional Disciplines
  • Knowledge Translation Skills 2: Implementation of Clinical Practice Guideline Recommendations
  • The Movement Repertoire of the Preterm Infant: What Is the Significance of These Movements? Part 2
  • Weeding out the Myths: Medical Marijuana Use in Children and Implications for Physical Therapists

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As always, SoPAC was lots of fun, inspiring vistas and information…we even got a lovely snowfall! I crave and SO enjoy time with my school-based SeekFreaks, face-to-face. We got to vote for a new President for our Academy. Joe has done an amazing job during his tenure. He deserves much gratitude for his quiet, visionary, efficient leadership! We cannot lose with our next President either, Mary Jane Rapport and Cindy Miles ran. Both excellent leaders so this is one election we can rest easy regardless of the outcome. Although I am still rehydrating, I am already looking forward to the first APPTAC in November of 2017.

Before then, we have the Innovations in School-based Physical Therapy Conference in July. We are in Washington, DC this year with Bob Palisano as our keynote speaker and overwhelmingly excellent speakers and topics. This year, proposals will be accepted for 15-minute platform presentations! Unfortunately, no travel costs can be covered for selected platforms but if you are local and plan to attend, why not get your great idea in front of a national audience? There will be a dorm option, and access to the venue via train from many locations. So it will be a fantastic value for SBPTs in the Northeast. Or we will see you at APPTAC in Cincinnati? Use the comment section to let us know if you plan to attend one of these conferences and if you would like to have a SeekFreaks gathering? Discussion and Delicacies in DC (Innovations)? Conversation and Cocktails in Cincinnati (APPTAC)? Or Noshing and Networking in New Orleans (CSM 2018)? Who is in??

If you attended SoPAC 2016, immediately go to the SeekFreaks comment section and tell us your favorite session, which sessions were worth the time investment, changed your practice or you disagreed with the content or perspective presented! If you did not attend, go to the comment section and let us know what topic or content you would like to see covered. What say you, SeekFreak?

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Readers of this article also read these:

 Spotlight on the Mid-Atlantic: Interview with Connie Johnson

HeFreak Says, SheFreak Says: 10 PT COUNTS Takeaways

32 Essential School-based OT, PT & SLP Documentation Tools

OT, PT & SLP Practice Guide Map

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