Experiences of Transition From Early-Intervention to Education-Based Therapy Services for Parents of Children With Physical Childhood-Onset Disabilities: A Scoping Review.
Sally Kidd, Sian A Williams, Fiona Graham
Parents of children with physical disabilities report that moving from early intervention to school-based therapy means less therapy, a smaller role in their child's care, and poor communication.
Caring staff and individualised support were the main positive experiences.
Key findings
1Seven of the eight included studies reported that children received less therapy after transitioning to school-based services, and five of eight described a shift from parent-centred to teacher-centred care delivery.
2In four of seven qualitative studies, parents described moving from a central role in their child's therapy decisions to a peripheral one, with authority and control shifting to the school.
3Most parents across six studies experienced communication from education-based therapy services as poor, with a shift from face-to-face contact in early intervention to written communication in school.
Still to come
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only eight studies were included, with a combined 223 participants, so the range of parental experience captured is narrow. Three of the eight studies scored below 3 stars on the MMAT quality appraisal, meaning methodological weaknesses in a substantial minority of the evidence base. All studies were conducted in Canada, the USA, or the Netherlands, so findings may not transfer to other health and education systems. Only two of the eight studies focused solely on children with physical childhood-onset disabilities; the rest included mixed disability groups, so the specific experience of, say, a child with cerebral palsy may be diluted. The MPOC, used in three studies to measure family-centred care, was developed for therapy rather than education services and has only moderate longitudinal validity, so its scores in this context warrant caution. The review excluded grey literature, which may have omitted relevant service-level data. Indigenous parents' perspectives were absent, and the authors note this may have led to uniform findings that overlook cultural views on inclusion and health.
Declared interests
Funded by the Paediatric Special Interest Group, Physiotherapy New Zealand. No other conflicts of interest were declared.
The easy way to misread this
Do not read the reduced therapy dose and role change as evidence that school-based therapy is inferior to early intervention. This is a scoping review of parental experiences, not a comparison of child outcomes. Only one of the eight studies directly compared pre- and post-transition scores, and parents also reported positive experiences with caring, individualised staff in the school setting.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →