Purpose: The purpose of this Special Communication is to provide an overview of portfolio use in health professions education and to describe the potential of a digital electronic portfolio (ePortfolio) to support development and maintenance of pediatric physical therapy essential core competencies. Portfolios have been used in health professions education for formative and summative assessments, particularly for areas difficult to measure such as professionalism, core values, attitudes, and critical thinking. Summary of Key Points: With a trend toward competency-based education and updated pediatric core competencies, there is unique benefit in portfolio use across the continuum of practice, from entry-level (Doctor of Physical Therapy) to advanced specialty practice and beyond. Conclusion: Reflection, a key component of education portfolios, promotes learning through meaning-making and self-assessment toward continued development and growth. Recommendations for Clinical Practice: ePortfolios can be flexibly and individually applied across diverse physical therapy education goals to demonstrate learner competency and expertise in pediatric physical therapy.

Purpose: We report the effectiveness of task-specific walking training for a child with hereditary spastic paraplegia using various orthoses, assistive mobility aids, and tasks. Summary of Key Points: A 4-year-8-month-old boy, classified as Gross Motor Function Classification System level IV, had selective dorsal rhizotomy and single-event multilevel surgery. The child began walking training using knee-ankle-foot orthoses and a posterior walker, setting the tasks to be “just right” for improving the child’s abilities. Conclusion: At 6 years and 11 months of age, the child walked using bilateral ankle-foot orthoses and crutches at school, and scores improved on the Canadian Occupational Performance Measure, Gross Motor Function Measure-66, and Functional Mobility Scale. Recommendations for Clinical Practice: Physical therapists need to carefully select the factors involved in walking training based on an assessment and the difficulty level of each child in order to optimize improvements.

Purpose: Approximately 250 million children younger than 5 years in low- and middle-income countries are at risk of not reaching their developmental potential, often without access to rehabilitation. A training program was developed to provide physical therapists in Myanmar with the knowledge and skills to deliver family-centered early rehabilitation. Methods: Participants completed online coursework, discussions, synchronous mentoring sessions, and onsite training for 7 weeks. To assess the effectiveness of the training, participants completed surveys on their self-perception of knowledge and skills related to early rehabilitation at 4 intervals. Focus group interviews were also conducted to allow the participants to discuss their experiences. Results: There were significant improvements in knowledge and discussed implementation of the new skills in practice with a focus on family education and innovative use of home materials. Conclusion: The training program effectively enhanced participants’ confidence in their ability to implement family-centered interventions using available resources.

Purpose: To compare the participation ratings between children with special educational needs and their primary caregivers and investigate the activities children desire to change and their participation-based goals. Methods: Twenty children with special educational needs aged 8 to 12 years were interviewed using the Functioning Scale of the Disability Evaluation System—Child to measure participation frequency and independence and select desire-to-change activities. The International Classification of Functioning, Disabilities, and Health-based Collaborative Problem Solving was used to form participation-based goals. Results: Children reported participation differently from their primary caregivers. Nineteen children identified desire-to-change activities mostly related to the home and community settings and indicated a desire to change participation frequency. Children’s participation-based goals reflected their desires to do their preferred activities more often. Conclusions: Children with special educational needs had unique perspectives different from those of their caregivers, and they could identify desired activities and set participation goals with semi-structured methods.

Purpose: To compare the keep moving together (KMT) protocol between telerehabilitation (Tele KMT) or face-to-face (Face KMT). Methods: A randomized controlled clinical trial, including a goal-oriented training program for gross motor function activities for children/adolescents with cerebral palsy. One group will have supervised sessions with a physical therapist through telerehabilitation while the other will have face-to-face sessions. Both groups will receive sessions supervised only by a caregiver 3 times per week, at home. The KMT protocol is for 12 weeks. The primary outcome will be gross motor function using the Gross Motor Function Measure. Secondary outcomes are mobility, goals achieved, participation, caregivers’ satisfaction, and adverse events. Impact statement: If effective, the Tele-KMT may be an alternative when face-to-face interventions are not possible.

Purpose: To determine responsiveness of the Activity Measure for Post-Acute Care (AM-PAC) “6 Clicks” Basic Mobility Short Form (BMSF) and Basic Mobility Short Form – Low Function (BMSF-LF) for children in the acute care setting. Methods: Fifty-one children admitted to a large pediatric, acute care hospital participated in this retrospective study. The BMSF and BMSF-LF were administered by physical therapists during each admission at least 2 times. The standardized response mean (SRM) for the BMSF and BMSF-LF were calculated to determine responsiveness. Results: Moderate effect sizes were found for both the BMSF (SRM = .71) and the BMSF-LF (SRM = .76). Conclusions The AM-PAC BMSF and BMSF-LF have acceptable responsiveness to determine functional change in pediatric acute care setting.

Purpose: To establish the validity and reliability of the Turkish version of the Seated Postural Control Measure (SPCM-TR) in children with cerebral palsy (CP). Methods: The original version of the Seated Postural Control Measure was translated and culturally adapted according to international guidelines. The participants were 124 children with CP, with a mean age of 8.6 ± 2.6 years. The measures were administered by 2 independent physical therapists twice, 1 week apart. Convergent validity was evaluated with the sitting dimension of the Gross Motor Function Measure (GMFM), whereas construct validity was evaluated with the Gross Motor Function Classification System (GMFCS). Results and conclusions: Cronbach’s alpha values of the alignment and function subscales and total score were 0.83, 0.89, and 0.91, respectively. Correlations between SPCM-TR total scores and GMFCS (−0.92) and GMFM (0.91) scores were very good. The intraclass correlation coefficient was excellent (0.90) for intra-rater and inter-rater reliability. The results indicate that the SPCM-TR is a valid and reliable scale in children with CP.

Purpose: To explore the effectiveness of a wheelchair skills (PWC) training intervention provided using the IndieTrainer System. Methods: This 2-arm, parallel group, single-blinded, pre-test-post-test randomized controlled trial will have 2 groups. Outcomes will be assessed at 3 timepoints. Sixteen child-parent/caregiver dyads will participate in the study. Each child participant will have a diagnosis of severe cerebral palsy (CP), be 5 to 17 years old, and have cause and effect skills. Outcome measures will include the Assessment of Learning Powered mobility use, the Wheelchair Skills Checklist, and the Canadian Occupational Performance Measure. Impact: Children with severe CP are often dependent on others for mobility. PWC skills training may allow more children to meet the specifications for obtaining their own PWC, thereby maximizing their functional independence.

Purpose: Environmental enrichment (EE) represents a dynamic approach to enhance infants' cognitive and motor development through augmented environment with stimulating, novel opportunities. Despite the recognized benefits of EE on neuromotor outcomes, its integration into early physical therapy interventions for infants at risk of neuromotor delays and disabilities remains under-defined and inconsistently applied in standard practice. This gap underscores the necessity for comprehensive guidance to systematically incorporate EE into early intervention programs and daily routines. Summary of Key Points: This paper provides a preliminary framework for the integration of EE into the clinical and home environments for infants from birth to 1 year of age.Recommendations for Practice: With the 7 key components of EE, including sensory system stimulation (auditory, proprioceptive, tactile, vestibular, and visual stimulations), cognitive challenges, and social engagement, this framework aims to maximize cognitive and motor development for infants at both pre and post-term age by leveraging the principles of EE(Supplemental Digital Content,Video, available at: http://links.lww.com/PPT/A624).

Purpose/Hypothesis: Systematically review current evidence on the content of physical therapy (PT) examination and evaluation to inform the update to the 2020 Developmental Coordination Disorder (DCD) Clinical Practice Guideline (CPG). Methods: Eight databases were searched for studies that informed the content of PT examination and evaluation, including psychometric properties of tests and measures used in the PT management of DCD. Methodological quality and certainty of evidence were assessed. Results: Three systematic reviews and 30 cohort studies were included. Two findings impacting the 2020 DCD CPG are: (1) very low- to high-quality evidence supports cultural adaptations and cutoff scores for DCD-specific questionnaires, and (2) very low-quality evidence supports 4 outcome measures that are responsive to change with intervention. Conclusion: Newer evidence reaffirms 4 of 5 recommendations on examination of the 2020 DCD CPG and adds evidence that could increase the recommendation strength of 2 action statements from best practice to moderate.

Purpose: Systematically review current evidence on physical therapy (PT) intervention for developmental coordination disorder (DCD) to inform the update to the 2020 DCD Clinical Practice Guideline (CPG). Methods: Eight databases were searched for qualitative studies, randomized controlled trials (RCTs) and systematic reviews (SRs) that informed PT management of DCD. Risk of bias and certainty of evidence were assessed. Results: Sixteen studies were included. Three SRs, 3 RCTs, and 1 qualitative study supported task-oriented interventions, the first-choice intervention recommended by the 2020 DCD CPG. One SR and 7 RCTs supported supplemental activities, including a meta-analysis of 2 studies on active video gaming. One qualitative study informed how physical therapists adapt motor learning strategies for children with DCD. Conclusion: Newer evidence reaffirms 3 of the 5 recommendations on intervention of the 2020 DCD CPG and adds low to very low-quality evidence on new evidence-informed supplemental activities.

Purpose: To offer a consensus for pediatrics clinicians, educators, and researchers on the use of movement system (MS) and review evidence that supports physical therapists (PTs) as movement experts. Summary of Key Points: This paper describes the MS and discusses how a MS diagnosis (Dx) can lead to most effective interventions and plans of care (POC) in pediatrics. Three cases illustrate using organized formulation of MS Dxs and how a MS Dx assists in choosing affective interventions for the POC. Conclusions: Pediatric PTs are movement specialists designing individualized plans of care to meet functional goals in real world conditions. Using consistent terms to establish MS Dx will enable effective communication, and a foundation for interventions across the lifespan. Recommendations: Adopting MS Dx framework will support and assist students of physical therapy, entry level and experienced clinicians, educators, and researchers with a critical decision-making process for formulating optimal family centered care.