Pediatric Assessments

I completely agree about pediatric evaluations being challenging! I just completed a 10 week clinical in a pediatric setting and it was true for every evaluation I did there. These situations forced me to become very creative to get all of the information that I needed. Suddenly the goniometer was an alligators mouth and we had to see how wide we could get it to open, or describing mmt for hip extensors by telling a child to kick the ceiling. Usually my first way to approach these things doesn't work out so I have to find another way to explain it or describe what I want or am doing. Usually just a 1 year difference in ages can totally change how you get through an evaluation. For one child you may be able to describe what you need and give verbal instructions but with another you are relying on your observation skills through their movement patterns to get the same information. In every case you just have to constantly be creative and on your toes. And the reassuring thing is I think it gets better with time!

This sounds like an extremely challenging position to be in!  I am a first year student in East Carolina's DPT program and we are preparing to go on our first clinical in a couple of weeks.  It's interesting to hear what you have to say about needing to think on your toes and problem-solve to figure out how to achieve a goal.  I, like you, am not sure I'm cut out for pediatrics, but I plan on keeping my options open as well.  It's amazing how different PT's personalities/how they achieve goals can be depending on which field they choose to be in.  I completely agree with you that pediatric PT's have a ton of energy and do a very good job of getting children to achieve goals while thinking they are just "playing".

you are completely right about pediatric examinations being a completely different ball game!  With adults, they typically understand why they are at PT and what they may get out of it.  Especially when working with younger patients, they may not even realize their is a problem with them that needs attention.  Standardized testing is very difficult.  It is a constant struggle to get your evaluation finished while not boring the pediatric patient to the point of them completely checking out.  An grading muscle strength...near impossible.  That takes a lot of clinical judgement and looking at movement patterns and making informed guesses.  I do think things get easier when it comes to interventions because you can become a little more creative as far as integrating games into their treatment.

Kelly- that sounds great!  I give you credit, I really don't know if I could have the energy and patience to work with children every day.  It takes a very special type of person.

Pediatrics is totally different than any other field and requires on the job training as well as much energy and patience. Children love interaction even though they do not speak. I am not sure I can last into my older years and give the children the energy they need and love to progress, but I do a good job so far at 47 years old!!!!