Hopeful Steps.

O'Toole B, Mason-halls G, McConkey R, writers. Guyana Community Based Rehabilitation Programme, producer. Liliendaal East Coast Demerara, Guyana, Guyana Agency for Health Science Education, 1992, VHS, 100 min, $50.

This videocourse focuses on training "home visitors" who are working in a community-based program in Guyana with children who have disabilities. The "home visitors" share a wide variety of backgrounds, the majority being outside of the medical profession. The course is designed to increase the volunteer's understanding of children with disabilities, to improve assessment skills, to assist in die selection of appropriate teaching ideas to help the children progress developmentally, and to facilitate communication with colleagues in the Community Based Rehabilitation Training Programme. The videocourse addresses the intended audience well, appropriate language, on-site filming in Guyana, and family member participation and providing instructional manuals on assessment and appropriate activities to reinforce the information presented in the videotape.

There is narrative throughout the videotape that directly relates to the instructional manuals. The "home visitors" instruct the families on assessment and then demonstrate appropriate activities. The same children and family groups are shown throughout the videotape. The material is presented from the perspective of a health care professional for the purpose of training "home visitors."

There are five units in the videocourse, entitled "Introduction," "Learning to Move," "Learning to Think," "Learning to Talk," and "Learning to be Independent." The instructional manuals are broken down into five sections for each unit. These sections are entitled "Assessment Sheets," "Teaching Aides," "Video Presentation," "Video Record Sheets," and "Review of Key Points." The examples of sequential development are very broad, with significant deletions of transitional skills between skill levels. Basic motor skills and cognitive skills are addressed in a very simplified format and reinforced with functional activities. Considering the audience to be addressed, the information is presented in a realistic manner.

The sequential skills that are presented in this videocourse coordinate with normal motor development. The assessment sheets, however, appear to begin assessing development at different stages in each unit and cover a 4- to 5-year span of development using only five skills to assess this time span. The program does not appear to address the child who is functioning lower than the lowest assessed skill and where that child would begin in this program. Lakewise, it is not stated in the video, or in the instructional manuals, that children with disabilities should not all be expected to master all of the developmental skills within this program.

The videotape's production is of good quality, with stimulating, culturally appropriate audio, and is filmed in a variety of realistic settings. The participants are families and volunteers that are currently participants in the Guyana Community Based Rehabilitation Programme. Each new unit is introduced with a cartoon caricature, title, and festive music changes.

Within the physical therapy profession, increasing emphasis is being placed on functional assessment, functional goals, and independence. In the area of pediatrics, the transdisciplinary approach to treatment has been successful and has received extensive recognition. This videocourse emphasizes functional assessment/activities and the development of independence. it describes a fairly comprehensive home program that is implemented by a transdisciplinary staff in a very rural setting. The activities that are presented are functionally based and are presented within the context of the family, who would be the primary reinforcers of these skills.

This videocourse would be appropriate to use as training material for multiskilled professionals and volunteers working in rural settings for patient/family education. It could also be used as an education resource for an entry-level physical ther-apy curriculum, reinforcing the concept of the transdisciplinary approach to treatment and describing the concept behind a community-based intervention program. The information presented in this videocourse, however, is very basic in nature, and has a significant absence of developmental information between the skills that are addressed. The concept that all children with disabilities are unique and develop differently is not adequately conveyed in the course materials, and "home visitors" and families may falsely assume that all children who participate in this program will eventually walk, talk, and think "normally."