Conferences
Pathways.org Medical Roundtable and expert staff present at workshops and conferences across the United States in the pediatric therapy and maternal and child health fields. Explore this section for a look at our published abstracts, research posters, and exhibits.
Parents’ Knowledge and Perception about Child Development: Evidence from a Practice-Based Survey
Summary:
This poster is on a parents’ survey was a study conducted in two parts. The first was a Chicago-area sampling of 544 parents, done in collaboration with the Children’s Memorial Hospital’s Child Health Data Lab. The second was a national sampling of 423 parents, done in collaboration with the Hyde Park Group. One of the more important findings of the survey was that 80% of parents do not recognize the physical milestones of a three-month-old infant and, therefore, would not be able to detect a delay.
Where and When:
- American Physical Therapy Association February 2006 in San Diego, CA
- American Academy of Cerebral Palsy and Developmental Medicine September 2006 Boston, MA
- Neuro-Developmental Treatment Association October 2006, Stamford, CT
- National Association of Pediatric Nurse Practitioners March 2007 Orlando, FL
- Mother Baby/Neonatal Nurses combination conference – September 2007 Las Vegas,NV
- Zero to Three Conference December 2007 Orlando, FL
Authors:
Gay Girolami, MS, PT1; Amy Becker Manion, RN, MSN, CPNP1; Felicia Kurkowski1, Rosemary White-Traut, PhD, RN1, Mariana Glusman, MD1; Jennifer Cartland, PhD2; Suzanne Green McLone, MPH2;
Abstract:
Parent reporting of their child’s motor skills and collaboration with a health care professional is a key factor in identifying movement delays at an early age and initiating early intervention. This study examines parents’ knowledge of early motor development and their understanding of the importance of early intervention. There is increasing evidence that early therapy services have a positive effect on developmental outcomes for young children with movement delays. Several studies report developmental and functional benefits for children receiving interventions. (Ketelaar M, Effects of a functional therapy program on motor abilities of children with cerebral palsy, Phys Ther 2001:81:1534-45, Brooks-Gunn J, McCarton C. Casey P, et al, Early intervention in low birth weight premature infants, JAMA 1994;272:1257-62
Description:
Subjects needed to be at least 18 years of age and the parent of a child 36 months or younger. 544 parents were recruited from eight pediatrician’s offices in the Chicago area and a national sampling of 423 parents from demographics to reflect gender, income, ethnicity, age and the geography of this population. Parents were asked to complete a survey while in the waiting rooms of pediatrician’s offices in the Chicago subjects. The national subjects completed an internet survey. Parents were surveyed about their understanding of early child development, their preferences for obtaining resource information regarding the general health of their child and for answers related to concerns about their children’s motor skills.
Results:
Twenty three percent of the parents surveyed reported concerns about one of their children having a motor delay.
Seventy-five percent of parents regard pediatricians and physician specialists as the most reliable sources of general child health information and identify them as the sources they would most often use if they had a concern about their children’s motor skills.
Less than half of all parents report that they would talk to their child’s pediatrician before 12 months of age if they had concerns about their child’s motor skills. For the three months infant motor skills milestones, 80% of all parents would talk to their child’s pediatrician later than what is recommended. Therefore, most parents would not reach out at this critical time.
For parents who did discuss concerns about their child’s motor skills with a pediatrician, the majority were advised by their pediatrician to talk to a physician specialist or non-physician specialist right away; about 40% were advised to wait and see or to get more information before seeking additional medical care
Conclusion:
The majority of parents surveyed were unaware that earlier screening of movement delays is critical. Research supports family engagement in early therapy for children with motor delays has an impact on a greater range of developmental outcomes (Lekskulchai and Cole, 2001). The results of this study suggest that there are a number of ways to increase the early detection of movement delays in children. Increasing parents’ familiarity with early childhood development will increase the reporting of and thus detection of a possible motor delay. More importantly, this knowledge would empower early collaborative discussion of concerns with the family pediatrician, which in turn would facilitate early intervention.
Teaming Parents and Health Professionals to Optimize Early Detection
Summary:
An integral part of the mission of Pathways is to target and inform parents of infants about the importance of early detection and early intervention. By familiarizing parents with the Pathways brochure “Assure the Best for Your Baby’s Physical Development” formerly known as “Is My Baby Okay?”, the organization is able to introduce essential knowledge about the early warning signs of a motor delay.
Where and When:
- Poster #1:
- American Academy of Cerebral Palsy and Developmental Medicine – September 2002 New Orleans, LA
- The Physical and Developmental Environment of the High Risk Infant – Jan 2003 Clearwater, FL
- International Conference on Cerebral Palsy – May 2003 Quebec City, Quebec Canada
- Poster #2:
- Zero to Three National Training Institute – December 2003 New Orleans, LA
- American Physical Therapy Association Annual Meeting – June 2004 Chicago, IL
Authors:
Gay Girolami, P.T., M.S.; SUZANN K. CAMPBELL, P.T., PH.D.; DR. MICHAEL N. NELSON, PH.D.; DR. JOHN F. SARWARK, M.D.; DR. H. GARRY GARDNER, MD; FELICIA KURKOWSKI; (PATHWAYS AWARENESS FOUNDATION, CHICAGO, IL 60601, USA)
Abstract:
Enhancing the quality of life for children with physical movement differences by offering a tool to educate parents about the benefits of early detection and intervention is an essential role of the practitioner. The Pathways Awareness Foundation can assist health care providers in attaining this goal.
Description:
Pathways utilizes a self-produced brochure, Is My Baby Okay, in conjunction with low-cost distribution opportunities to inform parents and the medical community about the early signs of physical movement disorders. The Illinois Chapter of the American Academy of Pediatrics endorses the brochure, written by the Pathways Awareness Foundation Medical Roundtable team of experts. The centerpiece of the brochure is an illustrated comparison of postural and movement milestones of typically developing infants, juxtaposed with illustrations of postures associated with atypical development. Additional written text advises parents about the benefits of early detection, and an 800 number is provided for questions and recommendations for additional resources.
Over 1.7 million copies of the brochure, available in English, Spanish and Portuguese, have already been distributed nationally and internationally. Early Intervention offices in each state have received complimentary copies, and many currently use it to fulfill the Child Find obligation of IDEA. Five Chicago area hospitals include the brochure in their newborn gift box, and collaboration with the Offices of the Governor of Illinois and the Mayor of Chicago permits versions of the brochure to be mailed to every parent of an infant born in the state of Illinois.
Conclusion:
Education of pediatric health care professionals regarding early detection and intervention can save precious time, permitting children with movement disorders to achieve a higher level of function and improved quality of life.
National Survey of Pediatric Experts Indicates Increase in Infant Motor Delays: More Tummy Time is Key
Summary:
A national survey of 409 pediatric physical, occupational and speech therapists, with an average of over 20 years’ experience, confirmed what early childhood medical professionals have been observing. Two-thirds of the responding therapists reported seeing a rise in early motor delays in infants during the past six years, and those who saw this increase said that lack of tummy time experience during awake hours is the number-one contributor to the escalation in cases.
Where and When:
- MB/NNN – Phoenix, AZ Sept. 2009
- Zero to Three – Dallas, TX December 2009
- APTA – Orlando, FL Jan 2010
- NAPNAP – Chicago, IL March 2010
- NDTA – St. Louis, MO – May 2010
- Illinois AAP – Lisle, IL – June 3-4, 2011
- AAP Future of Pediatrics – Chicago, IL – July 29-31, 2011
Authors:
Gay Girolami, MS, PT1; Rosemary White-Traut, PhD, RN1, Felicia Kurkowski
Background & Purpose:
A national survey of 400+ pediatric physical, occupational and speech therapists, with an average of over 20 years’ experience, confirmed what early childhood medical professionals have been observing. Two thirds of the responding therapists reported seeing a rise in early motor delays in infants during the past six years, and those who saw this increase said that lack of tummy time experience during awake hours is the number-one contributor to the escalation in cases. Tummy time can be described as the supervised time babies spend on their stomachs while they are awake. An early motor delay occurs when a child isn’t able to meet critical physical milestones in the first months and years of life, which can later affect a child’s ability to learn basic skills such as chewing, grasping, crawling, standing and walking. This poster is intended to bring attention to the results of this survey, reinforce the need for tummy time, and draw other medical professionals into this important conversation.
Outcomes:
This survey quantifies experienced observations by qualified professionals, which may serve as a hypothesis for a future scientifically controlled study on the rate of increase and causes of early motor delays.
Two-thirds of therapists (66 percent) reported that they had observed an increase in early motor delays in babies under twelve months of age. Of therapists noting an increase in early motor delays, the vast majority named lack of tummy time as the number-one reason for the increase (84 percent), followed by the rise in premature births (59 percent) and back sleeping (54 percent).
Nearly two-thirds (61 percent) of all respondents thought that early motor delays could be caused or exacerbated by back sleeping, and 77 percent had observed early motor delay cases that could be attributed to babies spending extensive time on their backs while awake (in car seats, bouncers, etc.)
Therapists observed that most parents have little or no understanding of how to provide safe tummy time experiences for their infant (70 percent).
Discussion:
The vast majority of babies now sleep on their back to prevent Sudden infant Death Syndrome (SIDS). Back-sleeping, coupled with more awake time in “containers” like car seats, bouncers and strollers, add up to so much back time that babies aren’t able to develop their neck and back muscles, contributing to the increase in early motor delays.
A few simple tummy time tips include the following: Lay baby tummy down across your lap to sooth instead of holding upright on your shoulder. Carry baby around the house tummy-side down instead of upright. Start early, providing infants with just a few minutes of tummy time per day. By three months of age build up to an hour of tummy time distributed throughout the day. Standards for tummy time are also included.
Objectives:
- The participant will understand the significance of these national survey results.
- The participant will be able to explain the link between early motor delays and lack of Tummy Time.
- The participant will include the importance of Tummy Time in patient education.
- The participant will be able to inform others of what tummy time is and why it is important.
- The participant will be able to implement different tummy time positions into playtime with baby.
- The participant will learn what to do if he or she suspects an Early Motor Delay.
Modification and use of the Physical Therapy Interventions in Pediatrics (PTIP) system at an outpatient clinic: A pilot study
Physical Therapy Interventions Poster
Survey Results of The Effectiveness of a Curriculum for Pediatric Nurse Practitioner Students and Pediatric and Family Medicine Residents Entitled: The Importance of Early Detection and Intervention of Motor Delays
Summary:
Healthcare providers play a key role in detecting early motor delays and determining appropriate intervention and referral procedures for infants at risk. This poster describes an education curriculum designed to enrich current nurse practitioner and pediatric and family medicine residency training. The program provides a deeper understanding and knowledge base regarding early motor delay detection, intervention and referral procedures and possible outcomes associated with lack of tummy time. Results of a post-presentation survey completed by a total of 408 students/residents were reported. Survey results indicate over 80 percent of the students/residents were presented with new information. The majority of students/residents indicated they would be interested in more information on the topics of early detection, early intervention, and the importance of tummy time
Where and When:
- NDTA – Rye Brook, NY May 20-22, 2011
- Illinois AAP – Lisle, IL June 3-4, 2011
- AAP Future of Pediatrics – Chicago, IL July 29-31, 2011
- APTA Section on Pediatrics – Anaheim, CA Aug 30-Sept 1, 2011
- MB/NNN – Washington, DC – September 8-10, 2011
- Zero to Three National Training Institute – Washington, DC Dec. 9-11, 2011
- NAPNAP – San Antonio, TX – March 24-26, 2012
Authors:
Amy Becker Manion, PhD, RN, CPNP 1, H. Garry Gardner, MD, FAAP1, Deborah Gaebler-Spira, MD, FAAP1, Gay Girolami, PT, MS, PhD, C/NDT1, , Michael E. Msall, MD, FAAP1, John F. Sarwark, MD, FAAP, FAAOS1, Felicia Kurkowski2, Amanda Krupa, M.Sc2
Abstract:
Members of the American Academy of Pediatrics Council on Children with Disabilities estimate as many as 400,000 children born each year are at risk for some form of an early motor delay. Healthcare providers play a key role in detecting early motor delays and determining appropriate intervention and referral procedures for infants at risk, however they often lack the requisite knowledge and skills. Residency and pediatric nursing programs must ensure adequate training in these areas to address this gap. This poster will describe an education curriculum designed to enrich current nurse practitioner and pediatric and family medicine residency training by providing a deeper understanding and knowledge base regarding early motor delay detection, intervention and referral procedures and possible outcomes associated with lack of tummy time. This curriculum has been presented to programs throughout Illinois from June through October of 2010. A total of 542 attended the presentations over the course of five months. Results of a post-presentation survey completed by a total of 408 students/residents will be reported.
Results:
Survey results indicate 87 percent of nurse practitioner students, 77 percent of pediatric residents, and 88 percent of family medicine residents were presented with new information. Following the presentation, 99 percent of nurse practitioner students, 83 percent of pediatric residents, and 71 percent of family medicine residents indicated their timing for referring an infant for a screening/evaluation would change and they would now refer earlier. With respect to tummy time, students and residents in both groups performed poorly on questions that would reflect a strong understanding of the importance of the prone position and its impact on development. The majority of nurse practitioner students (93 percent) and pediatric (85 percent) and family medicine (78 percent) residents indicated they would be interested in more information on the topics of early detection, early intervention, and the importance of tummy time.
The results of this survey are an important first step toward documenting knowledge on topics related to early detection and early intervention of motor delays. Survey results suggest an opportunity to enhance nurse practitioner and pediatric and family medicine residency training with respect to early motor delay detection, intervention, referral procedures and possible outcomes correlated with lack of tummy time. An aggressive offering of lectures, demonstrations, and seminars by therapy departments, program directors, and/or non-for-profit organizations on these topics in medical school and residency programs is recommended. When medical professionals (and parents) know what to look for, they can effectively recognize the signs of an early motor delay. However, missing the cues or deciding to wait and see may lead to delays in motor development and acquisition of functional skills. If therapy is the recommended course of action, it is important for the healthcare professional to work with the family and team of therapists to determine treatment time, duration and functional therapy goals. Close collaboration of the physician/nurse practitioner and the therapist is essential in maximizing the child’s functional outcome.
Curriculum Survey on Importance of Early Detection & Intervention
Sensory Processing and Integration Deficits: Steps Towards Earlier Diagnosis and Treatment
Summary:
It is estimated that between five and 15 percent of children in the United States today have difficulty integrating sensory information (Ahn et al. 2004). Children with sensory processing deficits struggle in the areas of play and social skills, movement and coordination, daily activities, and self-expression. Frequently these children are either not identified or misidentified. Thirty experienced pediatric occupational, physical and speech therapists collaborated to develop nine checklists for the age groups: one to three months, through six plus years. The checklists are organized into four areas: play and social skills, motor coordination, daily activities, and self-expression. Under each area typical activities and behaviors for a particular age group are listed. When healthcare professionals and parents know what to look for, it is easier to recognize the signs of sensory processing and integration differences. However, missing the cues can often compromise progress towards functional goals.
Where and When:
- Illinois AAP – Lisle, IL June 3-4, 2011
- AAP Future of Pediatrics – Chicago, IL July 29-31, 2011
- APTA Section on Pediatrics – Anaheim, CA Aug 30-Sept 1, 2011
- Zero to Three National Training Institute – Washington, DC Dec 8-10, 2011
Authors:
H. Garry Gardner, MD, FAAP, John F. Sarwark, MD, FAAP, Angelica Barraza, OTR/L, Felicia Kurkowski, Amanda Krupa MSc
Abstract:
Deficits in processing and integrating sensory information becomes a concern when participation in daily activities are hindered due to the difficulty in discriminating and/or modulating sensory input. A recent study states that sensory processing deficits affect an estimated one in 20 children. (Ben Sasson, A., Briggs-Gowan, M.J., Carter, A.S., 2009). Children with sensory processing deficits struggle in the areas of play and social skills, movement and coordination, daily activities, and self-expression. Often these children are not identified or misidentified. (Pathways.ogr, 2010)
Between May 2009 and November 2010, 507members of the American Occupational Therapy Association (AOTA), the American Speech-Language-Hearing Association (ASHA), the Pediatric Section of the American Physical Therapy Association (APTA) and the Neuro-Developmental Treatment Association (NDTA) participated in a web-based survey. Survey responders averaged more than 17 years experience working regularly with pediatric clients. In the results of the survey: More than two-thirds (68 percent) of pediatric therapists evaluated or treated children between ages three and eight years old who had been previously misidentified with learning disabilities or behavioral issues. An overwhelming majority reported seeing children with sensory processing deficits that were misidentified as having other rehabilitation or medical diagnosis.
In an effort to refer infants and children to therapy earlier, 30 experienced pediatric therapists collaborated on a list of developmental sensory integration behaviors to assist healthcare professionals and parents. Evidence suggests therapy using a sensory integration (SI) approach may result in positive outcomes in the areas of sensory motor skills, motor planning, socialization, attention, behavioral regulation, and reading (May-Benson & Koomar 2010).
The behaviors of a child with sensory processing and integration differences are extremely varied, making them hard to detect by health professionals and parents who are not familiar with the condition. This list of developmental sensory integration behaviors is an important step towards earlier identification and early therapy for a child. Deficits in sensory processing and integration can translate into delays with coordination, balance, focus, organization, and fine motor skills, which impact performance in home, school and social settings.
When healthcare professionals and parents know what to look for, it is easier to recognize the signs of sensory processing and integration differences. However, missing the cues can often compromise progress towards functional goals. Earlier identification and a comprehensive therapy program addressing all deficits will help infants and children reach their fullest potential.
References:
Ahn RR, Miller LJ, Milberger S, et al. (2004) Prevalence of parents’ perceptions of sensory processing disorders among kindergarten children. American Journal of Occupational Therapy 58:287-293.
Ben Sasson, A., Briggs-Gowan, M.J., Carter, A.S. (2009). Sensory over-responsivity in elementary school: prevalence and social-emotional correlates. Journal of Abnormal Child Psychology, 37, 705–716
Pathways.org. (2010) Therapist Survey II. Retrieved February 2011 from https://pathways.org/awareness/healthcare-professionals/surveys/
May-Benson TA, Koomar JA. (2010) Systemic review of research evidence examining the effectiveness of interventions using a sensory integrative approach for children. American Journal of Occupational Therapy 64: 403-414.
Sensory Processing and Integration Deficits Poster
Workshops
CityMatCH: The National Organization of Urban Maternal Child Health Leaders – San Antonio, TX
December 2012
Importance of Tummy Time and Social Media
Presenters: Felicia Kurkowski and Christine Dodge
American Academy of Pediatrics National Conference and Exhibits – New Orleans, LA
October 2012:
Back to Sleep and Tummy to Play: Why Tummy Time is Important
Presenter: Michelle M. Macias, MD, Professor of Pediatrics, Medical University of South Carolina
Chicago Metro Association for the Education of Young Children (CMAEYC) Annual Head to Toe Infant/Toddler Conference, Chicago, IL
April 2012
Topic: Early Detection, Early Intervention and Prevention and Tummy Time
Presenters: Felicia Kurkowski and Kathy O’Brien
Association of Maternal & Child Health Programs Annual Conference Washington, DC
February 2012
Importance of Tummy Time and Social Media
Presenters: Felicia Kurkowski and Christine Dodge
Chicago Metro Association for the Education of Young Children – Chicago, IL
January 2011
Importance of Tummy Time
Presenter: Felicia Kurkowski guest presented with Illinois SIDS
Parents as Teachers – St. Louis, MO
November 2009
Importance of Tummy Time
Presenters: Felicia Kurkowski and Kathy O’Brien
Consortium for Children with Medically Complex Needs – Chicago, IL
July 2009
Early Detection, Early Intervention and Prevention/Tummy Time
Presenters: Megan Lenz and Stacey Dickert
Parents as Teachers – St. Louis, MO
March 2008
Early Detection and Early Intervention
Presenters: Felicia Kurkowski and Kathy O’Brien
The Infant Toddler Mental Health Coalition – Phoenix, AZ
September 2007
Early Detection and Early Intervention
Presenter: Michael Nelson, PhD
CJ Foundation national Conference – St. Louis, MO
September 2007
Early Detection and Early Intervention
Presenter: Felicia Kurkowski
PACES (Parent And Child Education Services) in Lombard, IL
September 2005
Early Detection and Early Intervention
Presenters: Felicia Kurkowski and Kathy O’Brien
PACES (Parent And Child Education Services) in Edison Park – Chicago, IL
November 2004
Early Detection and Early Intervention
Presenters: Felicia Kurkowski and April Brooks
Born Learning Parent Workshops hosted by Chicago Mayor’s Early Childhood Initiative (En Español)
– Chicago, IL
February 2004
Early Detection and Early Intervention
Presenter: Luisa Rodriguez, OTR/L
American Baby – Baby Faire – Rosemont, IL
November 2000
Early Detection and Early Intervention
Presenters: Felicia Kurkowski and Dana Beckman