Luca is a 7-year-old boy with Duchenne Muscular Dystrophy. As his physical therapist, you are wondering about tests and measures that fit into the activity section of the ICF. Thinking of how to quantify his activity, you decide to use the North Star Ambulatory Assessment (NSAA) to measure transitions and mobility, the Timed Floor to Stand-Natural (TFTS-N) to time his rise from the floor, and the Six Minute Walk Test (6MWT) to measure distance walking.
“Nate, stand up”. Nathan is five, has cerebral palsy and takes a while to prepare to move his body. Thirty seconds or more can pass between the request to move and getting a response. He is quiet, then there may be a quiver of movement. Sure enough, after some patience, up comes the leg and he rises to standing with only a little assistance. In the context of the classroom, this extra waiting time is surely difficult. Nathan either arrives late to an activity or his aide is lifting and initiating for him throughout the day and a behavioral expectation is set up.
Children with motor planning difficulty need extra time to initiate and carry out their movement. Many of us live in a world where time is scarce and we don’t feel that we have time to wait. On the other hand, starting with the end in mind is crucial and takes a lot of training, repetition and patience. What have you decided to do when faced with this dilemma?