LER: Pediatrics – August 2015
From the editor: A matter of perspective
Often, especially when talking about family or intimate relationships, people qualify the meaning of normal—adding “whatever that means.” In pediatric gait training, though, normative values do exist, and parents and practitioners commonly strive to help children achieve these benchmarks.
A number of studies show that parents of children with cerebral palsy (CP) prioritize walking as a primary goal for their child, often focusing on these normal gait patterns as well as their child being able to walk independently. Research on the children’s perceptions and values, however, shows their views on the definition of normal walking—as well as their desire to achieve it—aren’t as clear-cut.
In a study of robotic gait training detailed in this issue (see “Robotic gait training doesn’t wow young patients with CP: Kids, parents differ on ‘normal’ gait,” page 7), young participants sometimes saw their current, though technically impaired, gait as normal. In addition, unlike their parents, the children didn’t explicitly express a desire to walk using nondisabled gait patterns.
Similarly, in research reported previously in LER on children’s and parents’ beliefs about the value of walking, the investigator-author noted that, by internalizing ideas about what parents and society see as “normal” gait—as well as the value of reaching that standard—children may struggle with self-image and self-esteem if they can’t achieve these goals or need to use assistive devices (see “The value of walking in children with CP: A matter of perception,” LER, January 2013, page 14).
By reflecting critically on how perspectives on gait may diverge among young patients and those most involved in their care, and by focusing on outcomes and attitudes that support the child’s needs, desires, and self-confidence, practitioners can help patients and their parents achieve feasible goals that are meaningful to the child.
By Emily Delzell, Senior Editor
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