Chapter 3: Assessment Tools in Pediatric Physical Therapy

LEARNING OBJECTIVES

INTRODUCTION

Assessment tools include a wide variety of tests and measures and are commonly used in pediatric physical therapy to document a child’s current developmental status, determine eligibility for services, determine prognosis of future delay or impairment, or measure progress over time. Assessment tools allow for the objective gathering of information to guide physical therapist decision-making and service delivery. There are numerous assessment tools available for therapists to use clinically, each with unique properties and purposes. This chapter will detail strategies for selecting and completing appropriate measures in pediatric clinical practice.

SELECTION OF AN ASSESSMENT TOOL

Discriminative, Predictive, and Evaluative Purpose

Selecting an appropriate assessment tool is an important component of a pediatric physical therapy examination and requires consideration of multiple factors. Selection may begin with a review of the purpose of the test to assist the therapist in narrowing appropriate options for measures by providing important information as to how the test is intended to be used. For example, assessment tools can be categorized as discriminative, predictive, and/or evaluative.¹ A discriminative or norm-referenced measure is a type of assessment that provides information about a child’s ability compared to the abilities of other children.² Norm-referenced measures are often used to establish a child’s current developmental ability as compared to peers or to determine eligibility for services. The Bayley Scales of Infant and Toddler Development–Fourth Edition³ is an example of a norm-referenced test that examines a child’s adaptive behavior, cognition, language, motor skills, and social-emotional skills compared to same-age peers from 1 to 42 months of age and is widely used to determine eligibility for services for children in early intervention programs.⁴ Norm-referenced measures are helpful to determine if a child is demonstrating developmental delay.

Predictive measures help to predict or estimate outcomes for a child as they age and can assist with service planning. For example, the Test of Infant Motor Performance (TIMP)⁵ may be used as a predictive measure. The TIMP was designed as a measure of functional movement for infants from 32 weeks’ gestational age to 4 months postconceptual age and has demonstrated validity at 3 months of age to predict motor performance at 12 months of age,⁶ 2 years of age,⁷ and preschool age,⁸ and from between 34 weeks’ postmenstrual age and 16 weeks of age to predict motor development. ...