The Role of Parent Coaching by Pediatric Physical Therapists: An Exploration of Current Practice

Abstract

Children with disabilities are not the sole clients of the pediatric physical therapy practitioner. However, research, best practice, and federal mandated legislation oblige therapists to transition from a traditional medical child-centered model o f intervention to a family-centered model. This model places an emphasis on instructing parents, guiding their development as the dominant change agent for their children. Viewing parents as the predominant learner during intervention sessions is hampered by the paucity of family-related and adult-learning content in the professional preparation programs in higher education. It is further inhibited by professional attitudinal beliefs that continue to place a higher value on child characteristics for clinical decision making. This qualitatative study explored the scope of four private practice pediatric physical therapists' role as a parent coach. Each therapist was videotaped with two young children diagnosed with movement dysfunction and their mothers. Using a 7 Learning Style of Learners 132 FIGURE 1 LIST OF FIGURES PAGE Therapeutic Reciprocal Interplay of Therapist, Parent, and Child 25 CHAPTER I

How nurses and other health professionals use learning principles in parent education practice: A scoping review of the literature

“…Conversely, Archibald and Scott [78] used the term 'information needs', to clearly describe parents' 'knowledge mobilisation', confidence, vigilance, capability in medication administration techniques and long-term prevention strategies required for effective care following face-to-face asthma education, yet made no mention of the concept of Learning Principles, which they had implicitly described. A number of the authors of publications who did not use Learning Principles aligning with the Dimensions of Learning did not describe parents' decision-making and problem-solving skills development needed for autonomy in their children's care [79,81,84,88,89,92,96,99,100,104,115,121]. Only 4/89 (4.5%) publications made clear distinctions between factual (declarative) knowledge and practical (procedural) knowledge [75,76,79,104].…”

“…Descriptions of HPs' teaching activities overshadowed the perceptions and use of Learning Principles within the learning process. Learning styles, learning modes and information presented in language that was easy for parents to understand were explicitly perceived as the most influential aspects of the learning process in 10/89 (11.2%) of publications [50,58,62,68,77,84,99,107,113,121] although this was implied in most publications. Thompson and Thompson [75] and Thompson [76], emphasised that these activities were only part of the complex learning process of extending parents' thinking abilities.…”

“…This highlighted HPs' differing perceptions of Learning Principles. The most commonly cited theorist was Knowles and his Adult Learning principles, which was cited in 15/89 (16.9%) publications [42,59,65,67,71,82,84,86,87,90,93,95,96,99,116]. Reference dates utilised for Knowles' Learning Principles ranged from 1970 to 2011-interestingly, Knowles started with four Learning Principles, with two more added by 1987 [13].…”

“…Burkhart et al [39] concurred, as a lack of theoretical underpinning prevented generalisation of their results about the influence of parent education in asthma treatment adherence behaviours. Our scoping review identified that those publications reporting successful behaviour changes, a key aspect in the definition of learning, most commonly drew upon Bandura's Social Cognitive theory (sometimes termed Social Learning Theory) [17] and at least one other theoretical construct [42,52,65,67,71,74,75,76,77,84,87].…”

“…Differences in the degree of parent involvement in the decisionmaking processes of parent education strategies were contentious in 8/ 89 (9%) of publications. Nurses used their own beliefs of perceived learning needs as the basis of the learning process, not those of parents [63,68,84,98,114,116,120,121]. One study did highlight partnerships with parents when information was provided, reflecting a need for shared decision-making and parents having expectations to learn [[98], p. 228].…”