Meeting the Physical Therapy Needs of Children.

Meeting the Physical Therapy Needs of Children Effgen SK, ed. Philadelphia, PA 19103, FA Davis Co, 2005, hardcover, 568 pp, illus, ISBN: 0-8036-0250-2, $59.95.

This text contains information from a perspective other than disease or medical diagnosis that would be useful to physical therapists who work with children in any setting. The book is intended to provide the beginning physical therapist with knowledge on the latest aspects of pediatric care in all settings, and it can help update the experienced therapist in the pediatric setting. This textbook succeeds in that purpose by integrating a dynamic systems perspective with the concepts of patient/client management as put forth by the American Physical Therapy Association (APTA) and the organizational structure of the World Health Organization's International Classification of Functioning, Disability and Health (ICF). These concepts are applied to case examples throughout the text.

The textbook is divided into 5 sections: "Foundations of Service Delivery," "Systems," Service Delivery Settings," "Intervention Supports," and "Case Studies." The organization is consistent from section to section. Each chapter concludes with discussion questions and references, and some chapters include recommended readings for more information on specific topics. This text is easy to read with several examples of the concepts discussed throughout. Although all contributors write in a consistent style, the scope of their information and documentation is not equal.

Section 1 contains the foundation chapters. The first chapter gives an excellent overview of how to combine the disablement models and the ICE The chapter also provides a comprehensive template for a pediatric physical therapist evaluation mad plan of care, examples from pediatric care for each aspect of the Guide to Physical Therapist Practice (Guide), and an overview of the models of team interaction, models of service delivery, and issues that influence pediatric practice (ie, the federal legislation and the changing health care delivery system). Although the next chapter is a broad overview of theories, influences, and descriptions of development, a key feature of this chapter is the presentation of tests and measures that not only consider development but also are tests of function, impairment, and quality of life. Presentation of this information encourages the reader to consider the comprehensive nature of an initial examination. The last chapter in this section is "Family-Centered Intervention," which interweaves concepts, case examples, and practical suggestions to help implement this very important aspect of pediatric physical therapy.

Section 2 covers examination, evaluation, and intervention for patients who are classified in the 4 Guide categories (musculoskeletal, neuromuscular, cardiopulmonary, and integumentary). Taken as a whole, these chapters are up-to-date, well documented, and very informative. Each chapter offers substantial features. For instance, highlights of the musculoskeletal chapters include information on developmental biomechanics, the comprehensive musculoskeletal examination (with specific procedures and their evaluation), and discussion of intervention strategies for common pediatric conditions. The chapters on the neuromuscular system emphasize the task-oriented approach for examination and spotlight guidelines for conducting activity-focused practice. The chapter on the cardiopulmonary system provides clinical guidelines for appropriate examination and interventions and discusses issues of physical fitness and emerging health promotion and wellness programs for all children. The final chapter in this section covers the integumentary system and highlights the mechanism of healing, integumentary impairments, aspects of examination and evaluation, and the application of these concepts through a case example.

Section 3 features information on service delivery settings. The information in these 6 chapters, although they define each setting, are the most redundant in presentation and the least supported by evidence. For example, the chapter rifled "Early Intervention" has many of the same concepts that were previously presented in the chapter, "Family-Centered Intervention." The chapter on rehabilitation settings lacks case examples of how the concepts, such as the matrix management model, are applied. Although this repetition of information could be most helpful for physical therapist students, broader examples of application would benefit all readers.

Section 4 is titled "Intervention Supports," and the information in this section helps the reader to understand the concepts of assistive technology, the role of physical therapy in decision making, and the direct or indirect implementation of devices for positioning, mobility, and augmentative communication. The implementation can be direct by providing training to use or indirect by reinforcing the training that others have given. Section 5 provides comprehensive case studies that generally follow children through several phases of childhood. This feature instructs the reader on the different episodes of care and how treatment will differ throughout the child's lifetime. The other excellent aspects in this textbook are the 170 life-like illustrations based on the child and the concepts, and the multiple tables and figures that organize information and enhance learning.

Karen Kott, PT, PhD

Hampton University

Hampton, Va

Dr Kott is Associate Professor in the Department of Physical Therapy where she teaches pediatric physical therapy. She has 'reviewed numerous books on this topic for Physical Therapy.