Gross and fine motor skills of children with Hurler syndrome (MPS-IH) post umbilical cord blood transplantation: a case series report.

PURPOSE: Recent advancements in medical treatment of Hurler syndrome have resulted in longer life expectancies and a greater need for therapeutic services. The purpose of this case series is to provide recommendations for assessing children with Hurler syndrome after umbilical cord blood transplant (UCBT). CLINICAL DESCRIPTIONS: Two children with Hurler syndrome were seen for longitudinal assessments following an UCBT for Hurler syndrome. METHODS: The raw scores and percentage of fine and gross motor items each child completed on the Motor Scale of the Bayley Scales of Infant Development II (BSID-II) were reviewed. RESULTS: Both children gained new motor skills with each successive motor assessment. Both children were able to complete a higher percentage of fine motor skills than gross motor skills in the most advanced item set assessed. DISCUSSION: The children presented in these two case reports both had better fine motor skills than gross motor skills, which inflated their standard scores on the BSID-II. Clinicians assessing children with Hurler syndrome should use standardized assessments that allow for differentiation of fine and gross motor skills to prevent this situation.

Pediatric physical therapists' consultation with a community dance instructor: a case report.

PURPOSE: This case report contributes to defining the role of pediatric physical therapists in promoting recreation for pediatric clients by describing the consultation methods employed by three pediatric physical therapists in a consultative partnership with a community dance instructor of children with disabilities. METHODS: Consultants provided written and verbal recommendations intended to address the dance instructor's identified needs, enhance instructor technique, and improve quality of child participation. Instructor interviews, written surveys, observation of classes, and a consultation logbook were used to assess consultation services. RESULTS: Fifty-four percent of the total 24 consultation recommendations provided to the instructor were implemented at least once. Implementation of recommendations resulted in enhanced class structure and improved child participation, and the dance instructor reported high satisfaction with consultation services. CONCLUSIONS: Pediatric physical therapists have a range of valuable expertise to offer community recreation and leisure activity (RLA) providers, including expertise in physical, social, behavioral, system-level, and other parameters related to RLA participation.