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Evaluate changes in two-wheel cycling skills and biking participation goals for children with neurodevelopmental disorders (ND) receiving a home visit and email following iCan Bike camp. Participants: 11 children with ND, 9–16 years, and one of their parents. A cycling skills checklist, two-wheel riding Goal Attainment Scaling (GAS), and biking participation GAS were completed before camp (T1), at support visit after camp (T2), and three months following camp (T3). Parents completed biking practice logs. Participants received a support visit to provide instruction, coaching, and address questions, and an email to check progress. Significant changes were made in two-wheel riding GAS T1 to T2 (p = 0.01), biking participation GAS T2 to T3 (p = 0.02), and cycling skills T1 to T2 (p = 0.01) and T2 to T3 (p = 0.02). Practice frequency was related to cycling skills (0.72, p = 0.01) and biking participation (0.86, p < 0.001); cycling skills were related to biking participation (0.81, p = 0.003). Children improved cycling skills and biking participation following camp, support visit, and email check-in. Children who practiced more had greater cycling skills and biking participation. Encouraging weekly bicycling and providing support may promote cycling skills and participation following camp. [ABSTRACT FROM AUTHOR]

The study purpose was to describe and evaluate the effectiveness of a 6-week, community-based, adaptive soccer program for 18 children with autism spectrum disorder (ASD). Pre- and post-soccer skill outcomes and a parent satisfaction survey documented the intervention effectiveness. Program physical intensity was moderate since the children averaged 5546 (SD = 2817) steps per session. Improvements in kicking accuracy (p = 0.048) and 15-yard agility time (p < 0.001) were observed and parents were satisfied with the program. This research supported the feasibility and effectiveness of an adaptive soccer program on improving soccer related skills and physical activity outcomes in children with ASD. Keywords: autism spectrum disorder; child; physical activity; soccer; community-based adaptive sports programs, Autism is a complex neurodevelopment disorder that involves impairments in communication and social interaction and repetitive or restricted behaviors (American Psychiatric Association, 2013). Children with autism spectrum disorder (ASD) also [...]

Pediatric physical and occupational therapists are in the unique position to provide therapeutic and health promotion interventions to children and youth with special health care needs (CYSHCN) including those with chronic conditions (such as overweight and obesity) in a variety of settings. In this commentary, the authors share their experiences in the design, implementation, and evaluation of health promotion programs in community settings. In community-based programs, a community is defined as any group of individuals who are connected in some way such as living in the same neighborhood, participating in the same church or club, or sharing the same social identity. Community-based health promotion programs may be implemented in schools, churches, community-based organizations (YMCA, Boys and Girls Club), the built environment (streets, parks, and greenways), health facilities (therapy departments, health clinics), and media resources (TV, billboards). (Contains 1 figure.)

Aim: The aims of the study were to: (1) build new item banks for a revised version of the Pediatric Evaluation of Disability Inventory (PEDI) with four content domains: daily activities, mobility, social/cognitive, and responsibility; and (2) use post-hoc simulations based on the combined normative and disability calibration samples to assess the accuracy and precision of the PEDI computer-adaptive tests (PEDI-CAT) compared with the administration of all items. Method: Parents of typically developing children (n = 2205) and parents of children and adolescents with disabilities (n = 703) between the ages of 0 and 21 years, stratified by age and sex, participated by responding to PEDI-CAT surveys through an existing Internet opt-in survey panel in the USA and by computer tablets in clinical sites. Results: Confirmatory factor analyses supported four unidimensional content domains. Scores using the real data post hoc demonstrated excellent accuracy (intraclass correlation coefficients greater than or equal to 0.95) with the full item banks. Simulations using item parameter estimates demonstrated relatively small bias in the 10-item and 15-item CAT versions; error was generally higher at the scale extremes. Interpretation: These results suggest the PEDI-CAT can be an accurate and precise assessment of children's daily performance at all functional levels.

The Pediatric Evaluation of Disability Inventory (PEDI) is a useful clinical and research assessment, but it has limitations in content, age range, and efficiency. The purpose of this article is to describe the development of the item bank for a new computer adaptive testing version of the PEDI (PEDI-CAT). An expanded item set and response options were reviewed by clinician experts and examined at parent and clinician focus groups. Eleven parents participated in 32 cognitive interviews to examine content, format, and comprehension of items and responses. A set of 76 self-care, 78 mobility, and 64 social function items with pictures and a four-point "Difficulty" scale were developed. The PEDI's Caregiver Assistance scale was replaced by a "Responsibility Scale" with 53 items. Content validity was established incorporating input from clinicians and parents. The new item bank covers a broad range of functional activities for children of all ages and abilities. (Contains 4 tables and 1 figure.)

The effectiveness and safety of a group aquatic aerobic exercise program on cardiorespiratory endurance for children with disabilities was examined using an A-B study design. Sixteen children (11 males, five females) age range 6 to 11 years (mean age 9y 7mo [SD 1y 4mo]) participated in this twice-per-week program lasting 14 weeks. The children's diagnoses included autism spectrum disorder, myelomeningocele, cerebral palsy, or other developmental disability. More than half of the children ambulated independently without aids. Children swam laps and participated in relay races and games with a focus of maintaining a defined target heart rate zone. The strengthening component consisted of exercises using bar bells, aquatic noodles, and water resistance. The following outcomes were measured: half-mile walk/run, isometric muscle strength, timed floor to stand 3-meter test, and motor skills. Complaints of pain or injury were systematically collected. Significant improvements in the half-mile walk/run were observed, but not for secondary outcomes of strength or motor skills. The mean program attendance was 80%, and no injury was reported. Children with disabilities may improve their cardiorespiratory endurance after a group aquatic aerobic exercise program with a high adult:child ratio and specific goals to maintain training heart rates. (Contains 2 tables.)

To compare the effects of upper extremity constraints on functional and dynamic postural control in children with hemiplegic cerebral palsy. Twelve children with hemiplegic cerebral palsy and 12 typically developing children ages 5 to 12 years (GMFCS I–II) were evaluated with the Timed Up and Go (TUG) and Biodex Balance System during three upper extremity (UE) conditions: 1) Free UEs (no constraints), 2) Simple UE constraint (unaffected/dominant UE constrained with a sling), and 3) Difficult UE constraint (Simple constraint plus the other UE holding cup of water). The UE condition had significant effects on Overall Stability Index (OSI) (F(2,44) = 24.899, p <.001), Medial-Lateral Stability Index (MLSI) (F(2,44) = 4.380, p =.018), Anterior-Posterior Stability Index (F(2,44) = 6.187, p =.004), and TUG scores (F(2,44) = 113.372, p <.001). Group was significant for OSI (F(1,22) = 7.906, p =.010), MLSI (F(1,22) = 13.113, p =.002), and TUG (F(1,22) = 36.282, p <.001). The upper extremity appears to have a role in maintaining functional balance and postural stability in children with hemiplegic cerebral palsy and should be considered during intervention programs. [ABSTRACT FROM AUTHOR]

Objective The purpose of this case report is to describe the challenges that COVID-19 presented for therapists in a pediatric hospital and the response to these challenges. Methods The case report setting is a physical therapy and occupational therapy department (department) of an academic pediatric medical center that provides a range of health care services for children and youth. Challenges that COVID-19 presented to the department included (1) managing safety concerns for patients, their families, and staff; (2) continuing to provide high-quality therapy services within state-mandated restrictions; (3) triaging patients; and (4) keeping clinicians employed and working productively. Results The department therapists responded to these challenges by (1) increasing communication huddles; (2) developing procedures for staffing and triaging of patients; (3) developing procedures for telehealth therapy services; and (4) designing a remote work program for all department employees. The number of patients and staff on site were reduced by initiating telehealth services, triaging patients, and developing a remote work plan. Communication huddles, department meetings, and supervision meetings were converted to virtual meetings. Staffing rates, patient-care productivity, and department project work were maintained. Conclusion In response to COVID-19, the department developed new protocols and provided information about the protocols, which might be helpful for other pediatric hospitals or outpatient settings when planning for future pandemics or other issues that challenge the ability to provide usual care. Increasing the frequency of verbal and written communication on operational topics is recommended. Primary sources of information from national organizations (eg, the American Physical Therapy Association and the American Occupational Therapy Association) can assist with determining the scope of practice and code of conduct during a pandemic. Impact COVID-19 posed challenges to operations and delivery of patient care. Although this case report is specific to COVID-19, principles applied and lessons learned from this experience can be applied to other emergency situations. [ABSTRACT FROM AUTHOR]

To systematically examine the efficacy of lower extremity cycling interventions for youth with intellectual disability (ID). Seven databases were searched from March 2000 to October 2019 for English-language articles on cycling interventions for youth with ID. The American Academy of Cerebral Palsy and Developmental Medicine guidelines were used for assigning levels of evidence and grading study quality. Eight articles met inclusion criteria. Children and young adults, 7-26 years (n = 229), with diagnoses of Down syndrome, autism spectrum disorder, or unspecified ID participated in the studies. Moderate evidence (one level II single subject design study) suggests that a specific cycling intervention can improve two-wheeled cycling skills in youth with ID. Weak evidence (level II group studies) supports stationary cycling for short-term improvements in cognitive skills and two-wheeled riding intervention for increasing physical activity one-year after intervention. Moderate to weak evidence exists to support two-wheeled cycling instructional programs or stationary cycling interventions for children and young adults with intellectual disabilities. Therapists can use this information when discussing cycling interventions for individuals with ID. Further research is needed to inform therapists in clinical decision-making related to dosing cycling interventions. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the content validity of the PEDI-CAT Speedy Mobility domain through analysis of item and content area exposure, score range and scoring precision. Methods: Retrospective analysis of 3,364 items from assessments (n = 301) completed from 2013 to 2017. Content validity was appraised through analysis of item and content area exposure (item, content area, response frequency), score range (floor and ceiling effect) and scoring precision (person fit, score reliability, item information function). Results: Sixty-five of the 75 general mobility items from the PEDI-CAT Mobility domain item bank were exposed. "Stands up from the middle of the floor" (68%) was the most frequently exposed non-mandatory item. Almost half (49%) of all items were from the Basic Mobility and Transfers content area. Scaled scores ranged from 26.77 to 69.40 with a floor (scores ≤27; n = 51, 17%) but no ceiling effect. Person fit statistics were acceptable for 238 (79%), suggesting limited outliers. Score reliability was sufficient with 68% of scores above threshold (>0.9). Item information function plot indicated less discriminating items at the lower end of the score range. Conclusion: Content is adequately and reliably measuring the intended construct, but additional items at the lower end of the scale could improve score precision. [ABSTRACT FROM AUTHOR]

To identify available judgment-based measures of ambulation with assistive devices for the purpose of examining item content and responses to aid in the expansion of the Pediatric Evaluation of Disability Inventory Computer Adaptive Test (PEDI-CAT) Mobility Domain. PubMed and CINAHL databases were used to identify measures meeting the following criteria: 1) applicable for children/youth; 2) self-report, proxy-report, or interview administration; and 3) assistive device (walker, cane, crutches, gait trainer) use specified or considered with responses. Population, administration, respondent(s), items, and responses were compiled. Item content was categorized and response scales grouped by type. Fifteen measures met inclusion criteria. Measures included child and proxy-report. Item categories included Surfaces, Steps/Stairs, Dual Tasks, Negotiation of Environment, Distance, and Time. Only two measures distinguished between device type within items. One measure specified gait trainers. "Difficulty" and "Assistance" were the most frequently used response scales. Available measures have content examining device use; however, none of the measures are comprehensive, devices are not consistently specified, and responses are imprecise. Items with well-defined responses for measuring a child's ambulation with an assistive device are needed for clinical practice, research, and program evaluation. [ABSTRACT FROM AUTHOR]