The role of family-centered therapy when used with physical or occupational therapy in children with congenital or acquired disorders

Background: There has been inconclusive evidence to support the effectiveness of neurodevelopment treatment for long-term functional outcomes for children with cerebral palsy, which has led many current therapists to investigate other ways to approach therapy for this population. Objective: To review the literature to identify the effect of family-centered therapy (FCT) on family satisfaction and functional outcomes in children with congenital or acquired disorders when used with physical or occupational therapy. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for this review. Electronic and hand searches were conducted in PubMed, CINAHL, Academic Search Complete, Academic Search Premier, SPORTDiscus, and Psychology and Behavioral Sciences Collection. To be considered for review, the study required: (1) participants between the ages of 18 months through 12 years receiving physical or occupational therapy; (2) use of outcome assessment tools; and (3) children with congenital or acquired disorders. Quality assessment was performed using a variation of the GRADE scale and Cohen's Kappa (K) of agreement was utilized as a measure of author agreement for study selection and quality scoring. Results: The online search strategy resulted in 81 articles. These were narrowed down to a total of five articles that met the criteria for this review (K=0.79). Assessment using the GRADE scale was performed and two of the five studies consisted of strong evidence (K=0.88). All five studies showed improvement in outcome assessment scores, pre-to post-intervention, for participants using some form of family-centered therapy. This improvement was noted in both functional and satisfaction scores. Conclusion: Available evidence suggests pediatric patients' success in therapy was significantly improved by incorporating family training, parent feedback in regards to functional compensations utilized by the child, adapting the environment or task, and identifying goals. Further research is needed to strengthen current findings.