Article

Evidence for effectiveness of pediatric physical therapy in infants
at high risk for developmental motor disorders is limited. Therefore, "Coping
With and Caring for Infants With Special Needs" (COPCA),
a family-centered, early
intervention program, was developed. The COPCA program is based on 2 components :
(1) family involvement and educational parenting and (2) the neuromotor
principles of the neuronal group selection theory.
The COPCA coach uses
principles of coaching to encourage the family's own capacities for solving
problems of daily care and incorporating variation, along with trial and error in
daily activities. OBJECTIVE: The purpose of this study was to evaluate whether
the content of sessions of the home-based, early intervention COPCA program
differs from that of traditional infant physical therapy (TIP) sessions, which in
the Netherlands are largely based on neurodevelopmental treatment. SETTING: The
study was conducted at the University Medical Center Groningen in the
Netherlands. DESIGN: A quantitative video analysis of therapy sessions was
conducted with infants participating in a 2-arm randomized trial. PATIENTS AND INTERVENTION: Forty-six infants at high risk for developmental motor disorders
were randomly assigned to receive COPCA (n=21) or TIP (n=25) between 3 and 6
months corrected age. Intervention sessions were videotaped at 4 and 6 months
corrected age and analyzed with a standardized observation protocol for the
classification of physical therapy actions. Outcome parameters were relative
amounts of time spent on specific physical therapy actions. RESULTS: The content
of COPCA and TIP differed substantially. For instance, in TIP sessions, more time
was spent on facilitation techniques, including handling, than in COPCA sessions
(29% versus 3%, respectively). During COPCA, more time was spent on family
coaching and education than during TIP (16% versus 4%, respectively).
LIMITATIONS: The major limitation of the study was its restriction to the
Netherlands, implying that findings cannot be generalized automatically to other countries. CONCLUSION: The COPCA program differs broadly from TIP as applied in
the Netherlands. Studies on the effectiveness of this family-centered program are needed.
Enfant

Langue : ANGLAIS