presented by Venita Lovelace-Chandler
Why do therapists practicing in pediatrics need to take a patient history? Why do they need to screen systems and recognize the signs and symptoms that indicate the need for a medical or health care practitioner referral? This introductory course is designed to enhance the skills of therapists working with children in conducting selected portions of an examination which include taking a history, quickly screening systems, addressing health promotion, and recognizing the signs and symptoms that indicate the need for a referral to another health practitioner. Screening might be needed at any time when a patient suddenly presents with a new sign or symptom.
Dr. Lovelace-Chandler has been an educator in pediatric topics for over 30 years to professional and post-professional physical therapy students. She has over 40 years of experience in pediatrics, has recertified as a specialist two times, and still carries a small caseload. She taught numerous Advanced Clinical Practice courses in pediatrics for the APTA, has published articles and book chapters on pediatrics and has numerous presentations and workshops on pediatrics. She was named as the recipient of the 2011 Linda Crane Memorial Lecture awarded by the Pediatrics, Cardiopulmonary and Education Sections, won the Service Award for 30 years of Service awarded by the Section on Pediatrics in 2003, was the Featured speaker at Opening Ceremonies of the American Board of Physical Therapy Specialties at CSM in 1991, and won the CAPTE Distinguished Service Award in April of 2014, the TPTA President’s Award for Outstanding Service in 2016, the Commission on Accreditation in Physical Therapy Education Distinguished Service Award in 2014, the Service Award for 23 Years of Service to the Arkansas Chapter of the APTA in 2003, and the Outstanding Service Award of the Federation of State Boards of Physical Therapy in 2008. She holds a BS in PT from Southwestern Medical School (1971), an MA in college teaching from the University of North Carolina (1976), and a PhD in Academic Administration/Health Education from Texas A&M University (1989). She was Vice-Chair and Professor, Department of Physical Therapy, University of North Texas Health Science Center (UNTHSC) prior to retirement in 2014. She served as Chairperson for the University of Central Arkansas and Chapman University programs in physical therapy and as Associate Director in the School of Physical Therapy at Texas Woman’s University before joining UNTHSC. She has served in numerous APTA elected leadership positions, was the pediatric content expert for the APTA’s Move Forward public site for 4 years, ending in 2016, served as secretary of the TPTA from 2013-2015, and has served as a delegate to the APTA House of Delegates for Texas for the last 6 years.
Therapists practicing in pediatrics are expected to be able to determine if a patient should receive therapy or be referred to another practitioner in addition to or instead of receiving services from the therapist. That determination requires an understanding of scope of practice and professional standards.
Children present with clinical manifestations unique to the pediatric population, and techniques for assessment and examination differ as well. This chapter provides therapists with best practice concepts in taking a history, including family-centered care.
Screening of systems follows the taking of a history, and the goal of screening is to recognize the need for referral to a physician or other practitioner as quickly as possible for best patient outcomes. Therapists need to identify signs, symptoms and flags while rapidly screening the following systems: neurological, musculoskeletal, cardiopulmonary, gastrointestinal, integumentary, and urogenital. Examples of red flags are offered and explained.
While taking the history, the therapist also identifies health restoration and prevention needs and coexisting health problems that may have implications for intervention. Therapists are able to provide consultation time to discuss current, pertinent health issues, to anticipate any preventative information the family should know in the near future, and to suggest physical activities to promote health.