Caregiver and Children's Perceptions of an Interdisciplinary Intensive Therapy Program

Purpose/Hypothesis: Pediatric intensive therapy models are increasing in popularity across the United States, with a variety of models described in the literature including suit therapy, constraint induced manual therapy and bimanual training, neurodevelopmental treatment, and programs emphasizing gait, power, and strength. However, few studies describe interdisciplinary intensive models or the perspectives of caregivers and children with intensive models. Therefore, the purpose of this study was to explore caregiver and children’s experiences participating in a team-based, interdisciplinary, intensive therapy program.

Number of Subjects: 13 caregivers and 10 children (6-13 years old, 9 males, 10 with cerebral palsy and 3 other diagnoses).

Materials/Methods: Children participated in an intensive program including physical, occupational and/or speech therapy for 3-6 hours/day for 4-5 days/week for 4 weeks. The team including the child and caregiver determined treatment frequencies, durations, and types based on the child/caregiver’s functional goals and examination findings. Following the intensive 4-week period, caregivers and children participated in semi-structured interviews. Interviews were audio-recorded and transcribed verbatim. A research team consisting of 2 physical therapists (PT) and 2 PT students performed reflexive thematic analysis.

Results: An overarching theme describing the intensive program as Immersive was generated. Other subthemes identified were Everybody’s Empowered, Principles of Neuroplasticity, Progress Across the ICF, It Takes a Team, and Benefits Outweigh the Challenges. Caregivers described the immersive nature of the intensive program allowed them to focus on their child, prioritizing learning new strategies that could be implemented in the home and community. When describing perceived program benefits, caregivers intuitively described principles of neuroplasticity that made the intensive program unique and effective for their child. Overall, families acknowledged the challenges of the intensive program, but concluded it was worth it and described feeling empowered to maximize their child’s potential, now and in the future. Overall, children described the intensive program as “fun” and would choose to repeat it.

Conclusions: Caregivers and children valued participation in the intensive program. Many families explained they preferred it to traditional models for their child and family. All caregivers planned to participate in another intensive episode of care in 6 to 12 months, as they felt it was beneficial for their child and family.

Clinical Relevance: As part of family-centered care, it is vital to include child and caregiver’s voices in service delivery model research. Not only was this model acceptable to caregivers, it was often preferred to traditional models. Future studies should consider the role of an interdisciplinary team in intensive models for children with neurodevelopmental diagnoses.