Physiotherapy from afar

The first stage is making contact with the patient prior to their arrival in order to offer the option of making a diagnoses during these times using video calls. If the family is in fact interested, their agreement must be documented , and a meeting can be made 

How can you ensure a quality meeting? 


Elements of diagnostic meeting for babies and toddlers:

On the agreed upon day and time, the Physiotherapist will call the family after going over the patients medical file. The medical file should be open, and the meeting should be documented. Documentation may also take place after the meeting. 

The conversation should take place in a closed room if possible, with no interruptions


Introduction

First of all, it's important to remind the patient that:

  • The meeting isn't being recorded

  • All relevant insurance forms should be forwarded prior to the meeting

  • If possible, the diagnosis should take place in a best environment (rug/mattress), and recommend a silent environment , and if necessary other relevant equipment. 


Opening

  • Always begin by asking general questions about the child's mood, and the child's and family's health at this time. 

  • Ask the parent what is bothering them and why they believe the child needs a diagnosis. 

  • During the meeting it's important to express positivity and reinforcements as often as possible. 

History 

The history taking is based on protocol for information collection which can be found on this website, which (amongst others) incudes the following questions:

Referal reason, child age, pregnancy and birth history, medical tests the child has done, family history, developmental history, educational frameworks, the child's communication abbilities, and eating and sleep habits. 


Examination

The examonation should take place via video . Ask the parent to put the camera in a location which will allow you to see the child and guide the parent on how to activate the child if necessary. 

The exam should include:

Observing the child for face size and structure. Try to get an impression of the relationship between the child and parent, and the child's play and communication abilities and curiosity.

Observe the child in different positions depending on the child;s age - back, stomach, sitting, standing and walking.

Ask the parent to present the child with age appropriate games which have been prepared ahead of time and to encourage activity according to what is being checked. 

Observe if the functioning is symmetric, and the level and nature of the child's activities. 

Ask the parents to encourage positions which will allow us to assess the child's strength and range of motion of different joints. 

Adjust the guidance to the understanding abilities of the parents, and you cam offer to demonstrate the specific task on a doll. Breaks should be taken when needed according to the child's abilities. 

At the end of the meeting the AIMS test should be done for children up to age one and a half. 

Before finishing, instruct the parents on how to encourage activity and positions according to the child's age and explain the future process


In conclusion

The clinic examinatino and results of the test should be summarized in the report as sent to the parents via email or fax. 


Nira Karvar, Head of Physiotherapy

Shlomit Nissim Gazit , Senior Physiotherapist and Clinical Instructor

Child development institute, Ministry of health southern district, Beer Sheva