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.

Poster

Handout

 

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