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Journey of a DPT Student

Pediatric Assessments

Published November 19, 2012 5:49 PM by Lauren Rosso

We had the pleasure of attending a site visit at the Western Pennsylvania School for Blind Children last week. We had the opportunity to work in small groups with a therapist and a child to perform an evaluation, and we'll return this week to follow through with our intervention. Talk about a learning experience! This was the first time in the pediatric curriculum that we actually performed an examination and evaluation of a child, and there's probably not much that could have prepared me for it.

Pediatric evaluations are a completely different beast. I felt like I came to the table with an assortment of clinical skills, but not one of them was useful. I hadn't considered how to adapt them to a patient who was non-verbal, and I've never had to think about creative and exciting ways to perform a functional evaluation. I unfortunately hadn't considered any of this before I sat down with the patient. Even the smallest assessment items required an entirely new approach. As unprepared as I felt, it was such a great learning experience to actually get to work with a child and force myself to think on my feet and adapt my skills on the fly.

The entire experience made me realize how amazingly patient and energetic pediatric therapists must be. I don't know if I'm cut out for it, but I absolutely loved the experience and I'm looking forward to going to back to implement our treatment plan.

5 comments

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!

Jennifer Edwards March 25, 2013 3:42 PM

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".

Blair March 4, 2013 9:12 PM
Greenville NC

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.

Zach Long January 18, 2013 12:30 PM

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.

Lauren Rosso December 15, 2012 8:19 AM

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!!!!

Kelly , Pediatrics - PT, 0-5 y.o. and public school December 6, 2012 10:42 PM
AR

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