PT, DPT, PCS, CFMT, BSPTS
Walking the style-bright streets of Saint-Honoré fashion district in Paris, a lighted sign catches your eye.
You want to believe those words but, your rational self whispers, “The perfect pair of jeans is born from the thoughtfully attentive hands of a sage-like tailor. A quietly confident professional perseverating on the subtleties of fabric, stitching and the smallest details of fit.”
Best wishes in your search for the perfect jeans and not to diminish the significance thereof, we turn to another important question.
Children are powerfully unique, impressionable and veraciously changing. Expert therapists value and respond directly to the qualities of each child. Like jeans, there is no “one size fits all” therapy. As the master tailor perseverates on “fabric, stitching and the smallest details of fit”, a strong therapist invests in understanding your child’s path of developmental, medical history, current presentation and the important insights you carry into the room as parents.
It is vital the clinician understand details of diagnosis (if present), past procedures, results of tests or imaging studies and response to previous intervention. These inform how to move forward, including potential risks of treatment, prognosis and what therapeutic tools may be of greatest benefit.
To effectively plan the intervention and accurately assess progress, the clinician must take baseline measures. These include the measurement of body structures, component abilities and whole functional skills. Baseline measurement establishes a reference from which to identify progress, or the lack thereof. Children grow in a spiraling and often non-sequential pattern. The challenge and ultimately the key to responsible care is differentiating functional gains attributable to natural growth from gains reflecting therapeutic intervention.
Best intentions aside, the talented clinician respects that bias is an innate side effect of having a human brain. Facilitating true functional gain in the life of a child requires objective measurement in the form of norm-referenced or standardized testing. Measurement tools are matched to specific populations of children and rated for the strength of information they produce. A reputable therapist demonstrates the functional benefit of intervention through change reflected on initial and subsequent measurements.
Literally, that’s what the term means. Clinical research simplifies to the idea that thousands of smart and compassionate people went to a great deal of trouble to identify the most beneficial tools for your child. Novice clinicians often wrestle with new evidence contradicting familiar therapeutic tools. Top therapists function like scientists, dynamically adopting techniques supported by the best available evidence. The demand to rapidly change practice in response to new evidence can bruise the therapist ego. Therefore, experts consciously aim to practice free from ego, instead focusing on the greatest benefit to your child.
Quality peer-reviewed evidence provides some good answers but many questions remain. Research combines with the clinician’s expertise and the unique values of each family to form the three fundamental pillars of clinical decision making. The most evidence-based and experienced therapist serves the needs of your child only to the extent that he or she values your input. Simply, your child’s therapy path begins with your goals and moves forward with your perception of progress.
The clinician’s communication reflects his or her cognitive approach to your child’s care. As you are the central members of your child’s therapy team, a strong therapist is open in offering and receiving information with you. He or she demonstrates knowledge of your child’s unique condition and willingness to discuss current evidence supporting the approach to your child’s care. Exchange of information extends from your child’s therapy team to his or her greater medial team and culminates in comprehensive care. Comprehensive or holistic care reflects shared ownership in the success of your child.
It is appropriate to expect excellence from your child’s therapy providers and worth the effort to seek out clinicians utilizing best practice guidelines. On the polished doorstep of that Parisian boutique, remember, you will end up wearing the jeans. It is worth the effort to find the perfect fit.