Associations of Gross Motor Delay, Behavior, and Quality of Life in Young Children With Autism Spectrum Disorder.

Background: Young children with autism spectrum disorder (ASD) often have gross motor delays that may accentuate problem daytime behavior and health-related quality of life (QoL). Objective: The objective of this study was to describe the degree of gross motor delays in young children with ASD and associations of gross motor delays with problem daytime behavior and QoL. The primary hypothesis was that Gross motor delays significantly modifies the associations between internalizing or externalizing problem daytime behavior and QoL. Design: This study used a cross-sectional, retrospective analysis. Methods: Data from 3253 children who were 2 to 6 years old and who had ASD were obtained from the Autism Speaks Autism Treatment Network and analyzed using unadjusted and adjusted linear regression. Measures included the Vineland Adaptive Behavior Scales, 2nd edition, gross motor v-scale score (VABS-GM) (for Gross motor delays), the Child Behavior Checklist (CBCL) (for Problem daytime behavior), and the Pediatric Quality of Life Inventory (PedsQL) (for QoL). Results: The mean VABS-GM was 12.12 (SD = 2.2), representing performance at or below the 16th percentile. After adjustment for covariates, the internalizing CBCL t score decreased with increasing VABS-GM (ß = - 0.64 SE = 0.12). Total and subscale PedsQL scores increased with increasing VABS-GM (for total score: ß = 1.79 SE = 0.17; for subscale score: ß = 0.9-2.66 SE = 0.17-0.25). CBCL internalizing and externalizing t scores decreased with increasing PedsQL total score (ß = - 0.39 SE = 0.01; ß = - 0.36 SE = 0.01). The associations between CBCL internalizing or externalizing t scores and PedsQL were significantly modified by VABSGM (ß = - 0.026 SE = 0.005]; ß = - 0.019 SE = 0.007). Limitations: The study lacked ethnic and socioeconomic diversity. Measures were collected via parent report without accompanying clinical assessment. Conclusions: Cross motor delay was independently associated with Problem daytime behavior and QoL in children with ASD. Gross motor delay modified the association between Problem daytime behavior and QoL. Children with ASD and co-occurring internalizing Problem daytime behavior had greater Gross motor delays than children without internalizing Problem daytime behavior; therefore, these children may be most appropriate for early physical therapist evaluation.

Essential competencies in entry-level pediatric physical therapy education.

BACKGROUND: The Section on Pediatrics (SoP) convened an Education Summit in July 2012 to examine, discuss, and respond to documented inconsistencies and challenges in teaching pediatric physical therapy (PT) content in entry-level professional education programs. Despite previous attempts by the SoP to provide guidance around teaching pediatric PT, variability continued to be extensive across programs. KEY POINTS: This article presents the core competencies developed out of the Summit to inform pediatric content in the entry-level PT curriculum. In addition, the core competencies were linked to teaching strategies, learning activities, assessment outcomes, and curricular structures. STATEMENT OF CONCLUSIONS: Consensus was reached on 5 core competencies that represent a knowledge base essential to all graduates of PT programs. In contrast to prior SoP documents, these competencies were specifically designed to focus on knowledge and skills unique to pediatric practice but essential for all graduates of accredited entry-level PT education programs. VIDEO ABSTRACT: For more insights from the authors, see Supplemental Digital Content 1, at http://links.lww.com/PPT/A50.