Physical Therapy Assessment in Early Infancy.

Wilhelm IJ, ed. New York, NY 10011, Churchill Livingstone Inc, 1993, hardback, 316 pp, illus, $45.

The theoretical foundations and clinical tools fundamental to the complex process of completing a physical therapy assessment of an infant are presented in this volume from the Churchill Livingstone Clinics in Physical therapy series. The information is divided into 12 chapters prepared by 16 contributors. The depth and breadth of the material are sufficient to acquaint a physical therapist with the conceptual and practical basis of conducting a comprehensive assessment of an infant. The references provide the reader with the basis for further exploration of each of the topics.

The first chapter introduces the theoretical framework for physical therapy assessment in early infancy, focusing on infant interaction with the environment and emphasizing the assessment of functional outcomes. This framework is reflected throughout the remainder of the book. Chapter 2, for example, addresses the effects of the special-care nursery environment on the high-risk infant, and chapter 10 presents the theoretical basis and tools for the evaluation of motor function within a naturalistic framework. The evolving theoretical issues influencing the assessment of postural control (eg, hierarchical model versus systems model) are incorporated in another chapter.

A very large part of the text presents the specifics of the assessment process: neurobehavioral assessment of the high-risk neonate; assessment of musculoskeletal growth, cardiopulmonary function, and oral-motor function; and neuromotor and developmental assessment tools. Assessment of the family resources and needs is included as a fundamental component of the comprehensive evaluation. Each chapter incorporates theoretical and practical information. The overview of specific assessment tools in each area includes the purpose of the tool and its relative merits. This information serves as a guide to the reader's selection of specific tools for in-depth review. It is not the intent of the book to cover the details of each of the multitude of tools discussed.

The text concludes with two chapters that look toward the future. The clinical use of kinematic motion analysis in the assessment of infant movement patterns and documentation of changes are explored. Criteria critical to the construction of more comprehensive assessments of development in infancy are addressed in the final chapter.

The book is well written, with the authors using complementary styles of presenting their topics. A moderate number of illustrations and charts are included. Much of the text does not lend itself to visual presentation. The depth of the material may exclude this publication from consideration as a textbook in an entry-level curriculum; however, the information is fundamental to physical therapy practitioners responsible for the assessment of infants. I strongly recommend this book as a timely clinical reference.