Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses.

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. "High" and "moderate" quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

Effectiveness of Tai Chi for health promotion for adults with health conditions: a scoping review of Meta-analyses.

PURPOSE: To complete a scoping review of meta-analyses summarizing evidence of the effectiveness of Tai Chi for adults with health conditions. MATERIALS AND METHODS: Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health and the Cochrane Library from database inception to early September 2018. Multistage deduplication and screening processes identified full-length, unique, peer-reviewed meta-analyses. Two people independently appraised 42 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. RESULTS: "High" and "moderate" quality evidence indicates that Tai Chi can significantly benefit adults with health conditions including cancers, chronic obstructive pulmonary disease, coronary heart disease, depression, heart failure, hypertension, low back pain, osteoarthritis, osteoporosis, Parkinson's Disease and stroke. Outcomes included significant improvements in activities of daily living, balance, exercise capacity, gait, mastery, mental health, mobility, motor function, participation in daily life, physical function, quality of life, range of motion, and strength; with reductions in blood pressure, body mass index, depression, disability, dyspnea, falls, fatigue, pain, stiffness, and waist circumference. CONCLUSIONS: Healthcare providers now have information to advise clients with health conditions on the effectiveness of Tai Chi for overall health promotion. IMPLICATIONS FOR REHABILITATIONTai Chi is a form of safe, enjoyable, light-to-moderate aerobic physical activity for adults that is inexpensive to implement in diverse community settings.Adults with health conditions require physical activity for prevention of secondary impairments and over-all health promotion.This scoping review of meta-analyses elucidates "high" and "moderate" quality evidence of the effectiveness of Tai Chi in improving important outcomes for people with numerous health conditions.This information can be useful for healthcare providers who wish to recommend effective community-based physical activity to clients they are serving.

Advancing the Evidence Base of Pediatric Physical Therapy: "Sincerely, From the Heart".

PURPOSE: To share reflections on themes that have become important to me as a developing pediatric physical therapy researcher contributing to knowledge generation in our field. KEY POINTS: The themes are: select strong mentors, assemble a research team with diverse perspectives and strengths, be family-centered, be rigorous in approaches to study design to match the research question, mentor the next generation, and engage in knowledge translation and exchange. CONCLUSIONS: I encourage everyone to reflect on who has been or could be your mentors or mentees, and on how you can be a part of an effective, family-centered research team, by encouraging a breadth of research designs to answer the many research questions that remain and by assisting in the implementation of knowledge to practice. CLINICAL RELEVANCE: Outcomes for children and families receiving pediatric physical therapy services are enhanced through the use of evidence-based knowledge.

Updating the Comprehensive Professional Behaviours Development Log.

PURPOSE: The Comprehensive Professional Behaviours Development Log (CPBDL) was designed as an explicit self-assessment tool to explore developing professional behaviours in entry-level master's of physical therapy students. The purpose of this project was to update the CPBDL to reflect current terminology and practice, using similar stakeholder involvement and consensus processes to those used in its initial development. METHODS: Nine individuals representing a range of stakeholder groups participated in two separate face-to-face meetings. The meetings followed the nominal group technique (NGT). The ideas derived from the NGT meetings were refined via the Delphi process until 80% consensus was reached. RESULTS: Eight of the original nine key professional behaviours were updated; one was deleted (Lifelong Learning). Many items within individual behaviours were merged or re-ordered. Items deemed to be obsolete were removed and new ideas were either added separately or incorporated into previously-written items. Some items were thought to belong better to different behaviours, so these were moved accordingly. Terminology was updated for items and for behaviour titles. DISCUSSION: The nine stakeholders involved in the updating process were satisfied with the new version of the CPBDL. The update better reflects current practices and can be adapted to settings outside physical therapy.

Determinants of playfulness of young children with cerebral palsy.

PURPOSE: To identify child, family, and service determinants of playfulness of young children with cerebral palsy. METHODS: Participants were 429 children, 18-60 months. Children were divided into two groups, Gross Motor Function Classification System levels I-II and III-V. Therapists collected data on body functions and gross motor function; parents provided information about children's health conditions and adaptive behavior, family life, and services. One year after the beginning of the study, therapists assessed children's playfulness. Data were analyzed using structural equation modeling. RESULTS: Higher gross motor function was associated with higher playfulness for both groups. Greater impact of health conditions on daily life was associated with lower playfulness for children in levels I-II. More effective adaptive behavior was associated with higher playfulness, and higher parent perception of therapists' family-centeredness was associated with lower playfulness for children in levels III-V. CONCLUSION: Supporting gross motor function, health, and adaptive behavior may foster playfulness.

Longitudinal trajectories and reference centiles for the impact of health conditions on daily activities of children with cerebral palsy.

AIM: First, to describe the impact of health conditions on daily activities over time in children with cerebral palsy (CP) and to create age-specific reference centiles. Second, to determine the amount of change typical over a 1-year period, across Gross Motor Function Classification System (GMFCS) levels. METHOD: A prospective, cohort design, with five assessments over 2 years, involved 708 children with a confirmed diagnosis of CP participating in the On Track Study (396 males, 312 females; mean age 6y [SD 2y 7mo]; range 18mo-12y at first assessment; 32.1% in GMFCS level I, 22.7% in GMFCS level II, 11.2% in GMFCS level III, 18.2% in GMFCS level IV, 15.7% in GMFCS level V). The impact of health conditions on daily activities was assessed using the Child Health Conditions Questionnaire. Data were analyzed using mixed-effects models and quantile regression. RESULTS: Linear longitudinal trajectories describe the relatively stable impact of health conditions over time for each functional level for children aged 2 years to 12 years, with the lowest scores (least impact) in GMFCS level I and the highest scores (highest impact) in GMFCS level V. Centiles were created for children in each GMFCS level. A system to interpret the magnitude of change over time in centiles was developed. INTERPRETATION: Longitudinal trajectories of co-occurring health conditions assist with understanding children's prognoses. Centiles assist in understanding a child's experience relative to children in similar GMFCS levels. Guidelines are provided to determine if children are progressing 'as expected', 'better than expected' or 'more poorly than expected' in regard to the impact of health conditions on daily activities. WHAT THIS PAPER ADDS: For children with cerebral palsy, the mean impact of health conditions on daily activities is relatively stable. Significant intraindividual and interindividual variability for the impact of health conditions exists, which complicates prognosis. Centiles enable interpretation of the impact of health conditions relative to Gross Motor Function Classification System level.

TRAYECTORIAS LONGITUDINALES Y CENTILES DE REFERENCIA PARA EL IMPACTO DE LAS CONDICIONES DE SALUD EN LAS ACTIVIDADES DIARIAS DE LOS NIÑOS CON PARÁLISIS CEREBRAL: OBJETIVO: Primero, describir el impacto de las condiciones de salud en las actividades diarias a lo largo del tiempo en niños con parálisis cerebral (PC) y crear centiles de referencia específicos de la edad. Segundo, para determinar la cantidad de cambio típica en un período de 1 año, a través de los niveles del Sistema de Clasificación de la Función Motora Bruta (GMFCS). MÉTODO: Un diseño de cohorte prospectivo, con cinco evaluaciones durante 2 años, involucró a 708 niños con un diagnóstico confirmado de PC que participó en el estudio On Track (396 varones, 312 mujeres; edad media 6 años de edad [SD 2 años 7 meses]; rango 18 meses-12 años a primera evaluación: 32,1% en GMFCS nivel I, 22,7% en GMFCS nivel II, 11,2% en GMFCS nivel III, 18,2% en GMFCS nivel IV, 15,7% en GMFCS nivel V). El impacto de las condiciones de salud en las actividades diarias se evaluó utilizando el Cuestionario de Condiciones de Salud Infantil. Los datos se analizaron utilizando modelos de efectos mixtos y regresión por cuantiles. RESULTADOS: Las trayectorias longitudinales lineales describen el impacto relativamente estable de las condiciones de salud a lo largo del tiempo para cada nivel funcional para niños de 2 años a 12 años, con las puntuaciones más bajas (menor impacto) en el nivel I de GMFCS y las puntuaciones más altas (mayor impacto) en el nivel de GMFCS V. Centiles fueron creados para los niños en cada nivel de GMFCS. Se desarrolló un sistema para interpretar la magnitud del cambio en el tiempo en centiles. INTERPRETACIÓN: Las trayectorias longitudinales de las condiciones de salud concurrentes ayudan a comprender los pronósticos de los niños. Los centiles ayudan a comprender la experiencia de un niño en relación con los niños en niveles similares de GMFCS. Se proporcionan pautas para determinar si los niños progresan "como se espera", "mejor de lo esperado" o "peor de lo esperado" en relación con el impacto de las condiciones de salud en las actividades diarias.

TRAJETÓRIAS LONGITUDINAIS E CENTIS DE REFERÊNCIA PARA O IMPACTO DAS CONDIÇÕES DE SAÚDE NAS ATIVIDADES DIÁRIAS DE CRIANÇAS COM PARALISIA CEREBRAL: OBJETIVO: Primeiro, descrever o impacto das condições de saúde nas atividades diárias ao longo do tempo em crianças com paralisia cerebral (PC) e criar centis de referência idade-específicos. Segundo, determinar a quantidade de mudança típica em um ano, nos diversos níveis do Sistema de Classificação da Função Motora Grossa (GMFCS). MÉTODO: Um desenho prospectivo de coorte, com cinco avaliações em 2 anos, envolveu 708 crianças com diagnóstico confirmado de PC que participavam do Estudo On Track (396 do sexo masculino, 312 do sexo feminino; méida de idade 6a [DP 2a 7m]; variação 18m-12a na primeira avaliação; 32,1% no nível GMFCS I, 22,7% no nível GMFCS II, 11,2% no nível GMFCS III, 18,2% no nível GMFCS IV, 15,7% no nível GMFCS V). O impacto das condições de saúde nas atividades diárias foi avaliado usando o Questionário das condições de saúde da criança. Os dados foram analisados usando modelos de efeitos mistos e regressão quantil. RESULTADOS: Trajetórias lineares longitudinais descrevem o impacto relativamente estável das condições de saúde ao longo do tempo para cada nível funcional para crianças com idades de 2 a 12 anos, com os menores escores (menor impacto) no nível GMFCS I e maiores escores (maior impacto) no nível GMFCS V. Centis foram criados para crianças em cada nível GMFCS. Um sistema para interpretar a magnitude da mudança ao longo do tempo em centis foi criado. INTERPRETAÇÃO: Trajetórias longitudinais de condições de saúde co-ocorrentes ajudam a entender o prognóstico da criança. Os centis ajudam a compreender a experiência da criança com relação a crianças em níveis GMFCS similares. Diretrizes são oferecidas para determinar se crianças estão progredindo "como esperado", "melhor do que o esperado"ou "pior do que o esperado" com relação ao impacto das condições de saúde nas atividades diárias.

Construction and validation of the fatigue impact and severity self-assessment for youth and young adults with cerebral palsy.

PURPOSE: The Fatigue Impact and Severity Self-Assessment (FISSA) was created to assess the impact, severity, and self-management of fatigue for individuals with cerebral palsy (CP) aged 14-31 years. METHODS: Items were generated from a review of measures and interviews with individuals with CP. Focus groups with health-care professionals were used for item reduction. A mailed survey was conducted (n=163/367) to assess the factor structure, known-groups validity, and test-retest reliability. RESULTS: The final measure contained 31 items in two factors and discriminated between individuals expected to have different levels of fatigue. Individuals with more functional abilities reported less fatigue (p < 0.002) and those with higher pain reported higher fatigue (p < 0.001). The FISSA was shown to have adequate test-retest reliability, intraclass correlation coefficient (ICC)(3,1)=0.74 (95% confidence interval [CI] 0.53-0.87). CONCLUSIONS: The FISSA valid and reliable for individuals with CP. It allows for identification of the activities that may be compromised by fatigue to enhance collaborative goal setting and intervention planning.

Parents' Experiences and Perceptions when Classifying their Children with Cerebral Palsy: Recommendations for Service Providers.

AIMS: This study investigated the experiences and perceptions of parents of children with cerebral palsy (CP) when classifying their children using the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), and the Communication Function Classification System (CFCS). The second aim was to collate parents' recommendations for service providers on how to interact and communicate with families. METHODS: A purposive sample of seven parents participating in the On Track study was recruited. Semi-structured interviews were conducted orally and were audiotaped, transcribed, and coded openly. A descriptive interpretive approach within a pragmatic perspective was used during analysis. RESULTS: Seven themes encompassing parents' experiences and perspectives reflect a process of increased understanding when classifying their children, with perceptions of utility evident throughout this process. Six recommendations for service providers emerged, including making the child a priority and being a dependable resource. CONCLUSIONS: Knowledge of parents' experiences when using the GMFCS, MACS, and CFCS can provide useful insight for service providers collaborating with parents to classify function in children with CP. Using the recommendations from these parents can facilitate family-provider collaboration for goal setting and intervention planning.

Description of Primary and Secondary Impairments in Young Children With Cerebral Palsy.

PURPOSE: We describe primary and secondary impairments in young children with cerebral palsy (CP); report differences in impairments on the basis of Gross Motor Function Classification System (GMFCS), age, and sex; and examine the extent that individual impairments account for the construct of primary and secondary impairments. METHODS: Participants included 429 children with CP (242 [56%] male; 1½ to 5 years) representing all GMFCS levels. Reliable assessors collected primary and secondary impairment data using clinical measures. Analyses included descriptive statistics, comparisons among GMFCS, age, and sex, and factor analysis. RESULTS: Young children with CP present with primary and secondary impairments. Significant differences in impairments occur among some GMFCS levels and age groups but not sex groups. Postural stability contributed most to primary impairments and strength to secondary impairments. CONCLUSION: Young children with CP across GMFCS levels may have already developed secondary impairments that should be addressed within therapy services.

Determinants of participation in family and recreational activities of young children with cerebral palsy.

PURPOSE: To test a model of child, family and service determinants of participation in family and recreational activities for young children with cerebral palsy (CP). METHODS: Participants were a convenience sample of 429 children (242 males) with CP, aged 18 to 60 months, representing all levels of the Gross Motor Function Classification System (GMFCS). Children were divided into two groups by GMFCS levels, levels I to II and levels III to V. Data on impairments and gross motor function were collected by therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later, parents reported on family life and services received. One year after the beginning of the study, parents reported their children's participation. Data from the two groups of children were analysed separately using structural equation modelling. RESULTS: The model explained 35% and 40% of the variance of frequency of participation in family and recreation and 28% and 38% of enjoyment in participation, for the two groups of children, respectively. Children's adaptive behaviour, family ecology, and number of community recreational programs were associated with the frequency of participation for both groups. Gross motor function was only associated with the frequency of participation for children in levels III-V. Adaptive behaviour was associated with enjoyment for both groups. The extent services met children's needs was associated with enjoyment for children in levels I to II and family ecology was a determinant of enjoyment for children in levels III to V. CONCLUSION: Supporting children's adaptive behaviour, family ecology, and access to community recreational programmes may foster participation in family and recreational activities for young children with CP. Implications for Rehabilitation Participation in family and recreational activities for young children with CP is complex and influenced by child, family and environmental factors. Practitioners are encouraged to support children's adaptive behaviour and access to community programs and family relationships, involvement in community activities and expectations of their children. Optimizing gross motor function for children who have limitations in self-mobility may enhance their participation in family and recreational activities. For children with a good prognosis for walking, providing services perceived by parents to meet their children's needs may enhance children's enjoyment of participation.

Ease of Caregiving for Children: a measure of parent perceptions of the physical demands of caregiving for young children with cerebral palsy.

The Ease of Caregiving for Children is a parent-completed measure of how difficult it is for them to safely help their children participate in activities of daily living. The objectives of this study were to determine the internal consistency, test­retest reliability, and construct validity (known groups methods) of the Ease of Caregiving for Children and create an interval-level scale. Participants included 429 parents of children with cerebral palsy (CP) and 110 parents of children without motor delay. Children ranged in age from 18 to 60 months. Parents completed the Ease of Caregiving for Children and therapists assessed children's gross motor function. The Rasch model of item response analysis was used to create an interval-level scale. Results indicated high internal consistency and acceptable test-retest reliability. Ease of caregiving varied by children's ages for parents of children without motor delay, however there was no significant difference by age for parents of children with CP. Parents of children with less gross motor ability reported more difficulty in caregiving than parents of children with higher gross motor ability. Rasch analysis for children with CP resulted in a hierarchical ordering of items by difficulty with good fit and logical ordering. Findings support the Ease of Caregiving for Children as a reliable and valid measure of parents' perceptions of their difficulty to safely assist their children to perform activities of daily living. The measure should enable health care providers to assess and provide interventions that address families' needs in caring for their children with CP.

Measuring postural stability in young children with cerebral palsy: a comparison of 2 instruments.

PURPOSE: To compare construct validity, interrater and test-retest reliabilities of the Pediatric Reach Test and the Early Clinical Assessment of Balance (ECAB), and their relationships with the Gross Motor Function Measure, 66-item version, Basal and Ceiling approach (GMFM-66-B&C) to appraise clinical utility of postural stability measures for children with cerebral palsy (CP). METHODS: A total of 28 children with CP, 2 to 7 years old, across all functional ability levels participated in 2 assessments over 2 weeks. Two assessors scored the measures during the first assessment. RESULTS: Both measures demonstrated construct validity, rs of 0.88 (P < .001). Both measures correlated with GMFM-66-B&C, rs > 0.95. Interrater and test-retest reliabilities were stronger for the ECAB than for the Pediatric Reach Test (intraclass correlation coefficients > 0.98 vs 0.87-0.94). The ECAB demonstrated lower measurement error and proportionately smaller minimal detectable change values. CONCLUSION: The ECAB is considered the better measure of postural stability among children with CP.

Determinants of self-care participation of young children with cerebral palsy.

OBJECTIVE: To test a model of child, family and service determinants of self-care participation of children with cerebral palsy (CP), grouped by Gross Motor Function Classification System levels (I-II and III-V). METHODS: Participants were a convenience sample of 429 children (242 males) with CP, aged 18-60 months. Data on impairments and gross motor function were collected by reliable therapists; parents provided information about children's health conditions and adaptive behaviour. Seven months later parents reported on family life and services received. One year after study onset, parents documented children's self-care participation. Data from two groups of children were analysed using structural equation modelling. RESULTS: The model explained a significant proportion of the variance of self-care participation, with higher motor function, fewer health conditions and higher levels of adaptive behaviour being associated with greater self-care participation. CONCLUSION: Supporting children's gross motor function, health and adaptive behaviour may optimize self-care participation.

Child Engagement in Daily Life: a measure of participation for young children with cerebral palsy.

PURPOSE: The objectives of this study were to determine the: (1) internal consistency and test-retest reliability of the Child Engagement in Daily Life measure; (2) construct validity of the measure (known groups methods), that is, the ability of the measure to discriminate participation in family and recreational activities and self-care among young children of varying age and motor ability and between children with and without cerebral palsy, and (3) stability and hierarchical ordering of the items for young children with CP to devise an interval-level scoring system. METHODS: 429 children with CP and their parents and 110 parents of children without CP participated in this methodological study. Parents completed the Child Engagement in Daily Life measure and therapists assessed the children's gross motor function. Rasch analysis was used to create an interval-level measure. RESULTS: Children's frequency in and enjoyment of participation in family and recreational activities and self-care varied by age and gross motor ability. Internal consistency of the domains of the measure was high, Cronbach alpha values ranging from 0.86 to 0.91; test-retest for participation in family and recreational activities was acceptable, ICC = 0.70, and in self-care was high, ICC = 0.96. The items in the measure had a good fit and a logical hierarchical ordering. CONCLUSION: Study results support the validity and reliability of the Child Engagement in Daily Life measure as an assessment of participation in family and recreational activities and self-care for young children with CP. IMPLICATIONS FOR REHABILITATION: Participation in family and recreational activities and self-care for young children with cerebral palsy can be reliably and validly assessed using the Child Engagement in Daily Life measure. Service providers are encouraged to support young children's participation in family and recreational activities and self-care.

Development and validity of the early clinical assessment of balance for young children with cerebral palsy.

OBJECTIVES: Validity of the Early Clinical Assessment of Balance (ECAB), to monitor postural stability in children with cerebral palsy (CP), was evaluated. METHODS: 410 children with CP, 1.5 to 5 years old, participated. Physical therapists scored children on the Movement Assessment of Infants Automatic Reactions section and Pediatric Balance Scale. Through consensus, researchers selected items from both measures to create the ECAB. Content and construct validity were examined through item correlations, comparison of ECAB scores among motor ability, age and gender groups and correlations with the Gross Motor Function Measure 66 basal and ceiling (GMFM-66-B&C). RESULTS: Internal consistency was high (Cronbach's alpha = 0.92). ECAB differed significantly among motor ability, children <31 months old scored lower than older children, but there was no difference between boys and girls. ECAB and GMFM-66-B&C scores correlated strongly (r = 0.97). CONCLUSION: Validity of the ECAB was supported. Reliability and responsiveness need study.

Determinants of gross motor function of young children with cerebral palsy: a prospective cohort study.

AIM: The aim of this study was to test a model of determinants of gross motor function of young children with cerebral palsy (CP). METHOD: Four hundred and twenty-nine children with CP (242 males, 187 females; mean age 3 y 2 mo, SD 11 mo) representing all levels of the Gross Motor Function Classification System (GMFCS) participated. Children in levels I to II and III to V were classified as Groups 1 and 2 respectively. Distribution of CP was quadriplegia, 44%; hemiplegia, 24%; diplegia, 23%; triplegia, 6%; and monoplegia, 2% (data not available for 1%). Impairment and motor function data were collected by reliable assessors; parents completed questionnaires on health conditions and adaptive behavior. Seven months later, parents were interviewed about family life and services received. One year after the study onset, motor function was re-evaluated. Analysis involved structural equation modeling. RESULTS: The well-fitting model explained 58% and 75% of the variance in motor function at study completion for Groups 1 and 2 respectively. Primary impairments (spasticity, quality of movement, postural stability, and distribution of involvement; ß=0.52-0.68) and secondary impairments (strength, range of motion limitations, and reduced endurance; ß=0.25-0.26) explained the most variance. Adaptive behavior was a significant determinant only for Group 2 (ß=0.21) and participation in community programs was significant only in Group 1 (ß=0.13). INTERPRETATION: Motor function is supported by optimizing body structures and function for all children and enhancing adaptive behavior for children with greater motor challenges.

Exploring the utility of measures of critical thinking dispositions and professional behavior development in an audiology education program.

BACKGROUND: Discussions about professional behaviors are growing increasingly prevalent across health professions, especially as a central component to education programs. A strong critical thinking disposition, paired with critical consciousness, may provide future health professionals with a foundation for solving challenging practice problems through the application of sound technical skill and scientific knowledge without sacrificing sensitive, empathic, client-centered practice. In this article, we describe an approach to monitoring student development of critical thinking dispositions and key professional behaviors as a way to inform faculty members' and clinical supervisors' support of students and ongoing curriculum development. PURPOSE: We designed this exploratory study to describe the trajectory of change for a cohort of audiology students' critical thinking dispositions (measured by the California Critical Thinking Disposition Inventory: [CCTDI]) and professional behaviors (using the Comprehensive Professional Behaviors Development Log-Audiology [CPBDL-A]) in an audiology program. Implications for the CCTDI and CPBDL-A in audiology entry-to-practice curricula and professional development will be discussed. RESEARCH DESIGN: This exploratory study involved a cohort of audiology students, studied over a two-year period, using a one-group repeated measures design. STUDY SAMPLE: Eighteen audiology students (two male and 16 female), began the study. At the third and final data collection point, 15 students completed the CCTDI, and nine students completed the CPBDL-A. DATA COLLECTION AND ANALYSIS: The CCTDI and CPBDL-A were each completed at three time points: at the beginning, at the middle, and near the end of the audiology education program. Data are presented descriptively in box plots to examine the trends of development for each critical thinking disposition dimension and each key professional behavior as well as for an overall critical thinking disposition score. RESULTS: For the CCTDI, there was a general downward trend from time point 1 to time point 2 and a general upward trend from time point 2 to time point 3. Students demonstrated upward trends from the initial to final time point for their self-assessed development of professional behaviors as indicated on the CPBDL-A. CONCLUSIONS: The CCTDI and CPBDL-A can be used by audiology education programs as mechanisms for inspiring, fostering, and monitoring the development of critical thinking dispositions and key professional behaviors in students. Feedback and mentoring about dispositions and behaviors in conjunction with completion of these measures is recommended for inspiring and fostering these key professional attributes.