So, this year, the APTA Combined Sections Meeting had nearly 17,000 participants laissez le bon temps rouler (let the good times roll…) in New Orleans (6,000 were PT students). Both original SeekFreaks were in attendance, learned a LOT and made some time for fun with other like-minded PTs. One of our motivations to create the SeekFreak website was to continue great conversations we have at conferences. If you attended CSM 2018, please add what you learned, any comments or great places you visited in the comments section below? Also, let us know any ideas you have for content or topics you would like covered and please, share the Freakish goodness with others…

Thursday 2/22

6:30-7:30a: Academy of Pediatric PT Breakfast

Rifton sponsored another excellent breakfast and it always impresses me how rapidly the Academy of Pediatric Physical Therapy is growing. It was a great opportunity to meet your region’s director, your state representatives and other pediatric PTs from your area.

8-10a: I went to take in the Pediatric Platforms #1. It was interesting how the platforms were set up. All platforms were simultaneously presenting in the same area with each attendee receiving headphones. You could hear everything great, but it was a bit weird with offset applause from each Sections platforms…Regardless! There was an interesting platform by Tanya Tripathi that examined how sitting ability by infant predicted problem solving. Motor and cognitive skills develop concurrently; we need to leverage our work to impact both. Kristie Bjornson presented information on how short-burst interval training can improve ambulation for children with cerebral palsy. I am inspired to develop ambulation programs with our adapted physical educators and physical educators to get these benefits from special education in PE. I had to miss the last couple of presentations to get to my session in the convention center.

11a-1p: My colleague Dr. Dana McCarty and I presented= Implicit Bias: Everybody has it! I really enjoyed this session, but please allow me to disclose my extreme conflict of interest regarding this session!! Dana set up the session with great candor and vulnerability. She reviewed the evidence in this area and I supplied some suggested strategies to contend with the unconscious biases that we all have. We had planned to consider a case study to apply the offered evidence and strategies; but first, we asked if there were any questions. The ensuing rich discussion hijacked the remainder of the session. Everyone shared amazing perspectives and eye-opening experiences. I may write a post about this!

1-3p Academy of Pediatric PT Board Meeting: The Academy has established a new strategic plan, click here to review the draft (the plan will be released to members imminently!): http://www.pediatricapta.org/userfiles/files/APPTStratPlanGoalsObjStrat2018_2020.pdf  The Board is undertaking a governance review to ensure that our organization is effective and serving members most efficiently. The School SIG submitted a motion to fund Dr. Michael Giangreco (VT) to speak at either CSM or APPTAC (his choice). It passed!! So, stay tuned!

3-5p Many excellent choices but I went to= Monitoring Change over Time with CP. I came away with a couple of measures to employ: Early Clinical Assessment of Balance (ECAB), Functional Strength Assessment (FSA). I might also take a look at the Early Activities Scale of Endurance (EASE), a parent reported measure with moderate correlation to the 6-minute walk test. The collaborators developed a calculator to determine if a child is making progress within an appropriate range, less than expected progress or more. They also developed various levels of templates to report and discuss progress with parents. They reported on the type of information parents are and are not interested in; specifically, they want to know- what are my child’s abilities, how can I help my child, what should I expect? They do NOT want/need to understand how their child compares to other children or norms; nor do they want to learn all the medical terminology. I hope they will make the calculator and reporting templates public and free!!

Ruffin Ayers (school-based PT and long-time SeekFreak) also attended this session. Here is what she took away:

This was such an interesting session! It provided current information gleaned from the ongoing OnTrack Study through CanChild.  The presenters discussed information about the 4 measures being used, methods, and then shared preliminary data. I look forward to when the data is published for us to use! The most immediately helpful take away followed in the discussion about sharing this information with families. OnTrack has included research with parent to discover the type of information they want to receive and delivery method as we monitor the change in their child, share results, and plan together.   

Friday 2/23- Okay, Day 2! Really, just one day in? It seems like more…

8-10a After ‘sleeping in’ until 7:10am, I took in Making Children Smarter: Jointly Advancing Motor & Cognitive Development. The presenters clearly set out the research and integrated concepts like: joint attention, mastery motivation, clarity in and collaborating for goal attainment. They suggest we identify one or two problem-solving skills for a child and initiate 3 ways to set up practice for the problem-solving skill and motor skill. Then challenge and scaffold the skill/context/feedback accordingly.

Thanks again to Ruffin, we have insight into: ‘Toeing the Line’: Exam, Evaluation and Interventions for Idiopathic Toe Walking…Ruffin= I took information from this session home and implemented ideas on Monday! Review of research on the theories for idiopathic toe walking (ITW) set the stage along with discussion of evidence that toe walking is not a normal developmental gait pattern that children just outgrow. (How many times have we heard that from parents & doctors?!) A couple tools to help rule out other causes of toe walking and have an objective measure of foot posture that we can use in making our case to doctors and parents for early and consistent PT intervention were discussed. ITW intervention priorities were discussed and then various methods reviewed for each stage of intervention. Thank you, Ruffin!

11a-1p Objective, Functional Outcome Measures in School. Always great to have a session on school-based practice at CSM! It was also fun to see SeekFreak Carlo Vialu (and Maura Doyle)’s article cited. This session provided a nice overview of what IDEA requires especially in terms of evaluation. The TUG was suggested as a screening tool. The presenters also promoted our use of movement systems approach in school practice.

3-5p Beyond Positioning: Truncal Hypotonia  These presenters reviewed the neuroanatomy and motor pathways with updated evidence. I got a bit confused as to which diagnoses were with which citations and they went over the Segmental Assessment of Trunk Control (SATCo) and Early Clinical Assessment of Balance (ECAB). A new measure for me (must check it out) was the Level of Sitting Scale (LSS). Many of our students are working to improve core strength and/or increased independence in sitting. This may be a great outcome measure to employ. They reviewed potential interventions that may be difficult to access within a school practice (Whole Body Vibration, Hippotherapy, Body Weight Supported Treadmill, etc.).

6:30-8:30p Academy of Pediatric PT Business Meeting at the Academy meeting, we got to celebrate Laurie Bainer who was awarded the Susan Effgen Advocacy Award AND Susan Effgen who was awarded the Jeanne Fischer Distinguished Mentorship Award! It makes me so proud to see school PTs leading and recognized for their excellence! Yet, there is more! Dr. Irene McEwen endowed the Academy with $250,000 earmarked for research in school-based practice!! Whoohoo, Thank YOU, Dr. McEwen!! Let’s get some proposals ready for when the endowment is ready to award.

Saturday 2/24

6:30-7:30a School SIG Meeting We had a great meeting at the crack of dawn (I still cannot believe the stalwart show up at that ungodly hour!). We discussed hot topics like our human resource designation (classified or certified) and other issues. The School SIG also is recruiting for new workgroups (email pediatricschoolsig@gmail.com if you are interested?). There are new representatives being appointed and things are popping for the School SIG. We are the largest SIG with over 720 members in all 50 states and 3 other nations! Look for a factsheet on Safe Lifts and Transfers to be posting soon. Onward!

8-10a Coupling Timing & Dose of Therapy to Maximize Plasticity and Document. Iit was genius! Dr. Gannotti and Dr. Bailes each conveyed their expertise in very practical terms. Dr. Gannottii emphasized the critical periods for developing bone (girls 12 yrs old; boys 14 yrs old). We must work to increase intensity of novel, multidirectional forces (like jumping) for about 10 minutes at these ages. We need to address velocity/power, not just strength. How can we use research to promote more flexible, intense episodes of care in school? What would it take to convince IEP teams that brief, intense intervention can be effective and possible, research or IDEA principles?

11a-1p I missed out because I had a meeting and could not attend a session. Sorry, SeekFreaks!

3-5p The last session was one of the most eye-opening. Hospitalized Adults with DD was sponsored by the AADD SIG folks and provided excellent research on aging with developmental disability and the most common reasons folks with Intellectual Disabilities are hospitalized (Psychoses, Seizure Disorders, Respiratory Infections, Septicemia, Pneumonia), common complications following hospitalization and sad insight into the hospital experience from patients with disability. This made me think that we need to develop a summary of function geared towards hospitals and clinics (as our students change medical homes from pediatricians to adult care). Could these issues be addressed with transition plans in the area of independent living? How can we promote self-determination for our students to prepare them as consumers of health care?

My thanks to Ruffin Ayers for contributing her two cents! If you attended CSM 2018, share with everyone which sessions were worth the time investment, changed your practice or if you wished you had chosen a jazz brunch instead! Use the Comment section below!

CSM 2018 was in the Big Easy and it was very easy to find great music, fantastic food and a good time. I did not have a bad meal while I was there. Here are some of the spots you should check out if you are ever in New Orleans.

  • Red Gravy is the best place for breakfast. Cozy, delicious and excellent service from waiters who are very easy on the eyes. I loved the brown butter pancakes and had a hard time choosing from the many tempting options. I will be back!
  • Mother’s is great! It is New Orleans at it’s purest. I asked for the potato salad recipe (best I have ever eaten) to make my husband fall deeper in love with me, declined. The vegetables were phenomenal, sandwiches huge and delicious (check out the debris!) everything was great! There is always a line in front of Mother’s. When I left, they split on either side to make room for me to pass and we did an impromptu ‘Soul Train’. Fun around every corner in this city!
  • My friends took me to celebrate my 50th birthday at Maypop. It was remarkable, succulent fish, delicate seasoning, yum. The namesake Maypop pie was killer.
  • The music on Frenchman St. is great wherever you go! I love how asking for a dance is as common as air.
  • The most expensive meal I had was also amazingly delicious= Briquette had great service and superlative meals. The redfish was transformative as was my dessert, a martini made with vodka steeped in pralines.
  • City Park was beautiful. I was grateful the rain they called for did not manifest. The live oaks haunt me yet.
  • Cochon Butcher was great, I had a delicious pastrami on rye and brussel sprouts that persist in my memory.

Yes, I did eat my way through the city. I was relieved that the APTA challenged attendees to report steps through an app (I had 52k steps!). We stepped more than 100,000 so APTA donated $10,000 to Shoes4Kids.

Whoo, that was fun. I learned a lot, had amazing professional conversations, celebrated excellence, glowed with pride at our profession, ate too much, slept too little, laughed hard and rolled with many good times…until next time, New Orleans!!

Thanks for all the great feedback and compliments we received from the SeekFreaks who we got to meet in person! We loved your ideas best of all. If you have an idea for a post, check out our details for guest contributors, the more the merrier! Will we see you at Innovations 2018 in Seattle, Washington July 27-28? APPTAC in Chattanooga, TN November 9-11? Or the next CSM in Washington, DC January 23-26?

In the meantime, SeekFreaks Regular OT Contributor Peggy Morris and SeekFreak Carlo Vialu are headed to the AOTA Annual Conference in Salt Lake City, April 19-22, 2018. Join them as they present “Train the Brain! Motor Learning Strategies to Promote Neuoplasticity in Children and Youth with Disabilities” on Friday, April 20th, 1:30-3:00 pm.

Learn on, SeekFreaks. Learn on!

Need more practical interventions for your teenage clients? Join author, Laurie Ray, PT, PhD at Jump-Start Their Futures! OT and PT Tools to Promote Successful Transitions to Adulthood in New York, NY on April 9, 2018.