Family Centred Practice

Having had nothing to do with children before my paediatric placement it was a little strange at first getting my head around all these little people and seeing in the flesh how they move and communicate. It did not take long before I felt comfortable assessing and treating children. I actually found children to be uncomplicated. Even the children with severe disabilities were relatively uncomplicated compared to the real complexity - the family situation.

An example is of 2 children, both 16 months old who were referred to physio by the same child health nurse because they were not weight bearing through their legs. The assessment and treatment of these children were pretty much the same. The real issue became the assessment and treatment of the parents! One of the mothers felt so guilty for not bringing her child in earlier that she burst into tears at the end of the session and much gentle but firm counselling and education about her child’s developmental delay and what could be done to improve things was required in order to hopefully gain compliance with the home program.

The mother of the other child had a history of depression and had difficulty attending appointments. During physio she appeared distant and uninterested and did not voice any concerns even when asked. A home visit by an early intervention teacher was arranged for this patient in order to assist with implementation of the home program and monitor the child’s progress.

The experience made me appreciate the importance of “family centred practice”. After all, our hands on treatment with the child may only be half an hour a fortnight. This will only provide the tools for treatment. It is what goes on everyday at home that counts.