What is the best treatment method?
Bleck, 1984, noted that a rare study conducted to determine the efficacy of Neuro-developmental Treatment (N.D.T.) physical therapy for students with cerebral palsy showed no significant differences between the treated and untreated children after a one year follow-up. The 47 children used in the study were all under the age of six and were randomly divided into three treatment groups. One group received N.D.T. therapy for 12 months, the second group received no therapy for 12 months and the third group received no therapy for six months followed by six months of therapy.
At the time this study was conducted, the N.D.T. model of physical therapy was being used basically in "pull out" programs whereby the therapist would work with the student using discrete trials in artificial environments such as medical treatment units. It was assumed that these motor patterns would then be remembered in other environments and would automatically be used for functional activities. Karl and Bertha Bobath, (in Scrutton, 1984), changed the emphasis of the N.D.T. model after realizing that the improved motor skills were not being carried over into activities of daily living. They now suggest that therapists should task analyze the functions that need to be performed and provide therapy while the child is performing the activity in a natural environment such as the home or the school.
Campbell, 1987, agrees with the concept of including motor skill training throughout the entire day. She explains that it is common for students to receive "motor programs" for part of the day and other programs for the rest of the day. She has noted that basic motor skills are required for every learning situation including communication, self-help, vocational, leisure, and recreational, as well as academics.
So, the bottom line is: The best treatment method is the one that makes a positive, functional difference in the life of the student, the parents, and the community today as well as when the student graduates from the public school system.
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