Healthy Strides Foundation

so many choices of interventions for children with cerebral palsy and cerebral palsy like conditions (this includes neurodevelopmental conditions and children with a diagnosed or undiagnosed rare disease). And choose we must because there are only so many hours in the day. There is family, work, friends and school to consider. WHAT ARE EVIDENCE BASED INTERVENTIONS? Over the last decade in particular, researchers in child health have been working to develop guidelines to identify the most effective interventions available. Researchers have been working with families to identify areas of importance and where efforts should be placed to develop new interventions.[6]

The guiding papers to highlight evidence-based interventions in child health were published in 2013 with another revision in 2020. Both of these papers systematically and objectively evaluated the body of evidence as is currently stands in the area of cerebral palsy.[4, 7]

The results were presented by using a traffic light system with “green” light interventions suggesting that we should ‘do it’ because there is strong evidence to support its effectiveness, “yellow” light interventions which suggest that we can ‘probably do it’ and finally, “red light” interventions or stop and ‘do not do it’ because evidence has shown that they are ineffective.[4] (Figure 4.0)

WHAT ARE THE MOST EFFECTIVE EVIDENCE BASED INTERVENTIONS FOR IMPROVING MOTOR SKILLS? The most current and up to date approach focuses on meaningful activities and participation in daily life. Approaches that focus on what we call “body structure and function” of the ICF framework (Figure 2.0) are less effective in achieving and improving daily, meaningful skills that are needed to be part of the community and to participate in life. As such, researchers and scientists are able to confidently say that these approaches should be “discontinued based on current evidence.”[11]

These approaches include techniques known as neurodevelopmental therapy (or NDT), Vojta, Cuevas-Medek (or CME) and Dynamic Movement Intervention (or DMI). The basis of these approaches depart from what we know is effective in improving motor outcomes. As such, the decision for us as researchers, scientists and clinicians at Healthy Strides is to not provide these techniques because there are evidence-based interventions that have better odds or greater possibilities of achieving motor outcomes in children. NOT A PERSONAL OBJECTION

This decision is not based on a personal objection by any means. It is guided by the current state of the evidence and highlights the reasoning for Healthy Strides’ core value of providing only evidence-based approaches so that we have the greatest odds of achieving outcomes. This approach optimises the opportunities for children to spend more time out of a therapy setting, and more time in the world with their friends, family and attend school. IT IS ALL ABOUT AN INFORMED CHOICE

What is hugely important is that information about interventions is provided to enable families to make an informed choice. Only families know their own circumstances, their child and what works for them so there is never any judgement about the choices that families make. At the core, families just need to be able to make a choice based on the most relevant information available. An informed choice is ultimately a good choice!