presented by Venita Lovelace-Chandler
What systems should be reviewed when conducting a pediatric review of systems and screening for signs and symptoms? How does the history help to prioritize the physical examination, including inspection and palpation? This course describes evidence for conducting a review of systems in children and screening for signs and symptoms. The pediatric therapist should be able to organize findings to support the best intervention strategies, identify findings that should be shared with other professionals to ensure optimal care and outcomes, AND recognize findings that are outside the scope of the therapist’s knowledge, experience, or expertise and require a referral to an appropriate practitioner.
Dr. Lovelace-Chandler has been an educator in pediatric topics for over 30 years to professional and post-professional physical therapy students. She has over 40 years of experience in pediatrics, has recertified as a specialist two times, and still carries a small caseload. She taught numerous Advanced Clinical Practice courses in pediatrics for the APTA, has published articles and book chapters on pediatrics and has numerous presentations and workshops on pediatrics. She was named as the recipient of the 2011 Linda Crane Memorial Lecture awarded by the Pediatrics, Cardiopulmonary and Education Sections, won the Service Award for 30 years of Service awarded by the Section on Pediatrics in 2003, was the Featured speaker at Opening Ceremonies of the American Board of Physical Therapy Specialties at CSM in 1991, and won the CAPTE Distinguished Service Award in April of 2014, the TPTA President’s Award for Outstanding Service in 2016, the Commission on Accreditation in Physical Therapy Education Distinguished Service Award in 2014, the Service Award for 23 Years of Service to the Arkansas Chapter of the APTA in 2003, and the Outstanding Service Award of the Federation of State Boards of Physical Therapy in 2008. She holds a BS in PT from Southwestern Medical School (1971), an MA in college teaching from the University of North Carolina (1976), and a PhD in Academic Administration/Health Education from Texas A&M University (1989). She was Vice-Chair and Professor, Department of Physical Therapy, University of North Texas Health Science Center (UNTHSC) prior to retirement in 2014. She served as Chairperson for the University of Central Arkansas and Chapman University programs in physical therapy and as Associate Director in the School of Physical Therapy at Texas Woman’s University before joining UNTHSC. She has served in numerous APTA elected leadership positions, was the pediatric content expert for the APTA’s Move Forward public site for 4 years, ending in 2016, served as secretary of the TPTA from 2013-2015, and has served as a delegate to the APTA House of Delegates for Texas for the last 6 years.
Therapists rarely need to conduct an extensive physical examination, but they should be able to use the history to prioritize screening of systems. Even systems assumed not to be related to impairments should be quickly screened to eliminate the presence of comorbidities that might impede a successful response to interventions. This chapter describes a quick review of each of the systems to be included in the initial examination and assessment.
This chapter will define important terms for the screening process: signs, symptoms, and yellow and red flags. The chapter also discusses factors that indicate a finding should be a red flag that suggests a referral.
Pediatric therapists use the history, screening, and physical examination processes and other tests and measures to establish a plan of care. The traditional examination and assessment process will be briefly reviewed to illustrate how history taking, screening, and physical examination activities inform the process.