Study of the feasibility of using goal attainment scaling in children with severe motor, sensory and cognitive impairments to measure outcomes of physiotherapy treatments

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Study of the feasibility of using goal attainment scaling in children with severe motor, sensory and cognitive impairments to measure outcomes of physiotherapy treatments

 

Author: Au, Lai-fun Ada
Title: Study of the feasibility of using goal attainment scaling in children with severe motor, sensory and cognitive impairments to measure outcomes of physiotherapy treatments
Degree: M.Sc.
Year: 2001
Subject: Children with disabilities -- Rehabilitation
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xi, 61 leaves : ill. (some col.) ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1569095
URI: http://theses.lib.polyu.edu.hk/handle/200/469
Abstract: Introduction: There are few studies reporting on outcomes measures sensitive enough to assess and evaluate progress of children with severe cognitive, sensory and motor impairments. Recently, Brown and colleagues showed the effectiveness of Goal Attainment Scaling (GAS) to monitor gross motor changes in non-ambulatory individuals (mean age: 20 years old) wit severe mental retardation (Brown et al. Physical Therapy, 78: 934-947, 1998). The objectives of the present study were 1) to explore the feasibility of using GAS to assess outcomes of physiotherapy treatments in pre-school children with severe cognitive, sensory and motor impairments, and 2) to determine the inter- and intra-rater reliability of GAS for this population. Methods: Nineteen pre-school children (12 girls, 7 boys) of the Developmental Disability Unit of Caritas Medical Centre, aged two to six years old (mean +- sd: 4.0 +- 1.4), were recruited for this study. The physiotherapists (including the principal investigator), caretakers, and parents/legal guardian whenever feasible, identified three gross motor goals based on the individual child's realistic abilities. With one of the three goals randomly selected as a control goal, goal orientated twice-weekly physiotherapy treatments were given for the other two goals. Changes in targeted gross motor abilities were measured using GAS after eight and sixteen weeks of treatment. All evaluation sessions were videotaped to allow scoring by two independent raters, as well as re-scoring by the intervening physiotherapist, to establish the inter- and intra-rater reliability respectively. For the purpose of statistical analysis, all GAS scores were convened into T-scores using the formula derived by Kiresuk and Sherman (1968). Two-factor (goal types x duration) analysis of variance (ANOVA) was used to depict the presence of any significance difference in change in gross motor abilities between the control and treatment goals. Intraclass correlation coefficients (ICCs) were computed to establish the inter- and intra-rater reliability of the scorings. Results: Significant differences (p<0.05) in targeted gross motor abilities were depicted between the control (37.90 +- 5.40) and treatment goals (54.80+- 7.40). High inter- and intra-rater reliabilities were highlighted by ICCs of 0.995 and 1.0 respectively. Conclusion: The present results demonstrate the feasibility of using Goal Attainment Scaling to assess outcomes of physiotherapy treatments in children with severe cognitive, sensory and motor impairments. It is shown to be a sensitive tool to reliably assess small changes in gross motor abilities of this population. However, when using GAS, the challenge remains in the ability of the healthcare and caregivers team to develop realistic, functional and measurable goals for each client.

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