FACT SHEET

Using APTA’s Guide to Physical Therapist Practice 3.0 in Pediatric Settings

WHAT IS THE GUIDE TO PHYSICAL THERAPIST PRACTICE 3.0?

The Guide to Physical Therapist Practice 3.0 (Guide 3.0) is the description of physical therapist practice for use
by physical therapist and physical therapist assistant educators, students, and practitioners. It was revised
from the previous version by the American Physical Therapy Association (APTA) and expert physical
therapists through a consensus process and made available in 2014. Guide 3.0 has five parts and includes a
History of Guide Development and Glossary.

1. Introduction contains the purpose; description of physical therapist practice; roles in primary, secondary,
and tertiary care, prevention and fitness; physical therapist direction and supervision of personnel;
constructs that inform physical therapist practice (ICF, Evidence Based Practice, Professional Values
and Quality Assessment); and education, specialization and licensure.
2. Principles of Physical Therapist Patient and Client Management describe the patient client management
model.
3. Measurement and Outcomes describe measurement concepts including psychometric terms (reliability,
validity, detecting clinically meaningful change), clinical utility, self-report vs performance-based
measures; and factors affecting outcomes.
4. Physical Therapist Examination and Evaluation: Focus on Tests and Measures lists and describes test
and measurement categories. Each category is linked to a definition of the category, examples of clinical
indications, which tests and measures quantify that category, examples of data gathering tools and data
to use in documentation. Case examples link to PTNow and Specific Tests and Measures in PTNow.
5. Interventions include definitions, selection of interventions, and intervention categories.

The Guide 3.0 is available for free to APTA members (http://guidetoptpractice.apta.org/) as a download and
can be read using a free ePub reader. Guide 3.0 can also be purchased.

WHY IS THE GUIDE 3.0 IMPORTANT TO PEDIATRIC PRACTICE?

Guide 3.0 describes physical therapist practice and provides a framework for clinical decision making in physical
therapy. It is intended to be easily updated online within PTNow and EDGE web pages. PTNow includes case
examples for selected diagnoses using the Guide’s patient and client management model.
To provide high-quality pediatric physical therapy services and education, therapists need to consider the
Guide 3.0; and other documents that guide practice such as APTA standards of practice and Guide for
Professional Conduct; federal and state legislation; practice setting; and research-based evidence for practice
decisions.

2017
HOW DO WE APPLY THE PRINCIPLES OF PHYSICAL THERAPIST PATIENT/CLIENT
MANAGEMENT MODEL TO PEDIATRIC PRACTICE?
Pediatric physical therapists support children and families to actively engage throughout all elements of the
process of care. In pediatrics, physical therapists often “co-manage”, that is, share responsibility with others in
the care plan. In collaboration with the child, family, and other health and educational team members,
FACT SHEET
therapists make decisions regarding the examination, evaluation, diagnosis, prognosis, and intervention, as
well as service delivery, outcomes, and criteria for discharge/termination of services. In addition to referrals to
Ankle-Foot Orthoses and Footwear for Children with Cerebral Palsy -
other health care and educational professionals, pediatric physical therapists assist families in accessing
appropriate community resources Selecting
and consultOptimal Designs
with community programs for children.

The table below defines the six elements of the patient/client management model and the consideration for
pediatric physical therapy practice:

HOW DOES THE PATIENT/CLIENT MANAGEMENT MODEL APPLY TO PEDIATRICS?

Element Pediatric Considerations

Examination: Includes a family-centered interview to gather information on the family’s concerns,

History priorities, strengths, and resources.
Includes a review of the developmental domains that influence a child’s function:
Examination: cognition; language and communication; social/emotional development; adaptive
System’s review
function; physical development, including vision and hearing; and play.
Pediatric physical therapists use the Guide’s information on tests and measures to
select the most appropriate tools to gather information on the child’s participation in the
Examination: home, school, and community; ability to do activities; and the implications of health
Tests and conditions, personal/environmental factors, and body structures/functions on
Measures performance. Pediatric physical therapists, as part of a team in a variety of settings
(e.g. EI, Schools, rehabilitation programs), may collaboratively select and administer
comprehensive developmental and/or functional tests.

Evaluation In early intervention and school settings, the process of “evaluation” and “assessment”
are defined differently than how these words are used in Guide 3.0. However, the
process of collecting and interpreting information to develop an appropriate plan of care
is espoused in both the Guide and in federal legislation for early intervention and
educational services.

When interpreting tests and measures, pediatric physical therapists consider the
influences of the domains of the ICF, including personal and environmental factors, and
developmental trajectory.
Diagnosis It is important for the emphasis of the diagnosis to highlight the activity limitations and
participation restrictions. When sharing diagnostic information with the individual and
family, therapists are supportive, and use strength-based and family friendly
language.
Prognosis Pediatric physical therapists consider the facilitators and barriers across all domains of
the ICF when predicting optimal level of improvement and the time needed to reach that
level.

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 Intervention Pediatric physical therapists provide interventions in hospital, clinical, and natural
settings; and support participation in home, school, and community with consideration of
the individual’s and family’s interests, preferences, and strengths. Patient/client-related
instruction is a reciprocal sharing of information among the therapist, individual, and
family. Therapists respect that families are the experts on their child and have
FACT SHEET meaningful and valid information to share. Therapists recognize the importance of self-
determination for the individual and self-efficacy for the family. Therapists share
Ankle-Footinformation
Orthoses toand Footwear for Children with Cerebral Palsy -
enable the family to make informed decisions. Therapists provide
information toSelecting Optimal
assist families Designsthe medical, educational, and community
in negotiating
systems and planning for the future. Home or school activity programs are developed
collaboratively within the context of daily routines and activities.
Outcomes Outcomes may include goal mastery and self-report measures to ensure that outcomes
of physical therapy service reflect a meaningful impact to the individual and family.

HOW DO WE USE THE INFORMATION GENERATED DURIGN PATIENT/CLIENT MANAGEMENT

IN PEDIATRIC PHYSCIAL THERAPY PRACTICE?
In certain pediatric practice areas, teams collaboratively develop overall plans or programs to guide services,
such as the Individualized Education Program (IEP) in school-based practice or the Individualized Family
Services Plan (IFSP) in early intervention practice. As part of the team, pediatric physical therapists provide
input and recommendations. The physical therapist’s plan of care is based on supporting the child’s needs
outlined in the IEP or IFSP. Goals are integrated and implemented across professional domains. The team
collectively identifies when it is appropriate to discontinue services. Coordination, communication, and
documentation ensure that children receive person-and family- centered services during their episode of care.
Pediatric physical therapists honor documentation requirements in their practice setting, such as IEPs or
IFSPs, but also need to maintain supplemental documentation to meet the standards for licensure and the
profession. Therapists use family-friendly language in documentation and discussions with individuals and
families to ensure health literacy.

© 2017 by the APTA Academy of Pediatric Physical Therapy,1020 N Fairfax St, Suite 400, Alexandria,
VA 22314-1488, www.pediatricapta.org

Developed by the Practice Committee of APPT, with expert contributors Lisa Chiarello, PT, PhD,
FAPTA, and Connie Johnson, PT, DScPT. Supported by the Fact Sheet Committee of APTA Pediatrics.

The APTA Academy of Pediatric Physical Therapy provides access to these member-produced fact
sheets and resources for informational purposes only. They are not intended to represent the position
of APTA Pediatrics or of the American Physical Therapy Association.

2017 APTA Pediatrics Fact Sheets | 3