1. Maximizing Function-Goal Setting and the Rehab Perspective Deborah Gaebler-Spira, MD Rehabilitation Institute of Chicago Partnering for Progress: A Cerebral Palsy Conference for Parents & Caregivers August 11,2007, Chicago, Illinois

3. Goals of Rehabilitation Prevent secondary complications-deformity Improve and support function/development Promote assets-kids are not a sum of the deficits

4. Rehabilitation domains Self Care-dressing, bathing, toileting Communication Mobility-ambulation, transfers, stairs Continence-bowel and bladder

7. Developmental perspective Gross motor Fine motor Personal social language

14. Developmental Assements Vineland Peabody Batelle Bailey

15. Global Measurement of Disability/ Burden of care WeeFIM PEDI PECs

16. Prediction of Function-refined Gross Motor Functional Classification Spinal cord level/ Spina Bifida SMA MD

17. Goals change as the child grows Parent driven Therapist driven Doctor driven! Educationally driven

20. Mobility just gets you from here to there

22. National Center for Rehabilitation research model Pathophysiology Impairment Disability Functional limitation Societal limitation

23. Adopted as outcome paradigm

25. Old WHO Impairment Disability handicap

26. WHO 2001 model-International classification of function/components of health Impairment Activities Participation Impact of environment and personal factors

27. New/WHO/ICF

28. Body structure and function Physiologic functions of the body Anatomical parts of the body

29. Impairments Problems in body functions or structure, loss or deviations

31. Activities Execution of a task or action by an individual

32. Participation Involvement of a life situation

33. ICF Functioning and disability -body functions and structures Activities and participation Contextual factors Environmental personal

34. Environmental factors External factors Facilitating or hindering impact of the physical, social and attitudinal world

35. Personal factors Internal influences Or attributes of the individual

36. Maximizing function Therapy to Augment Function Compensate for Function Technology to assist function

37. What is the limitation ?

38. Quality of life-attention to the individual Modems-aaos Child Health Questionaire Care and comfort measure-perceived burden of care for the caregiver Canadian occupational measure