Episode 210 (Professor Gareth Baynam)
Rare Care Centre at Perth Children's Hospital and the Head of the Western Australian Register of Developmental Anomalies
Reflections on this episode (Dr Pool)
Professor Gareth Baynam is a globally recognised clinical geneticist, researcher, and advocate for rare diseases. He is the Director of the Rare Care Centre at Perth Children's Hospital and the Head of the Western Australian Register of Developmental Anomalies. With a career dedicated to improving the diagnosis, management, and care of individuals with rare and genetic conditions, he has been at the forefront of integrating cutting-edge technologies such as genomics, artificial intelligence, and precision medicine into healthcare.
Professor Baynam is also a leader in Indigenous health initiatives, championing equitable access to rare disease diagnostics and treatment. Through his work with organizations such as the Global Commission to End the Diagnostic Odyssey for Children with a Rare Disease and the European Rare Diseases Research Alliance (ERDERA), he continues to drive global collaborations and innovations that aim to transform rare disease care.
Episode 209 (A/C Prof. Anita Gross and A. Prof Nikki Mine)
SPINAL MANIPULATION AND MOBILISATION IN PAEDIATRICS - AN INTERNATIONAL EVIDENCE-BASED POSITION STATEMENT FOR PHYSIOTHERAPISTS
Reflections on this episode (Dr Pool)
Coming soon!
Abstract
Introduction: An international taskforce of clinician-scientists was formed by specialty groups of World Physiotherapy - International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) & International Organisation of Physiotherapists in Paediatrics (IOPTP) - to develop evidence-based practice position statements directing physiotherapists clinical reasoning for the safe and effective use of spinal manipulation and mobilisation for paediatric populations (<18 years) with varied musculoskeletal or non-musculoskeletal conditions.
Method: A three-stage guideline process using validated methodology was completed: 1. Literature review stage (one scoping review, two reviews exploring psychometric properties); 2. Delphi stage (one 3-Round expert Delphi survey); and 3. Refinement stage (evidence-to-decision summative analysis, position statement development, evidence gap map analyses, and multilayer review processes).
Results: Evidence-based practice position statements were developed to guide the appropriate use of spinal manipulation and mobilisation for paediatric populations. All were predicated on clinicians using biopsychosocial clinical reasoning to determine when the intervention is appropriate.1. It is not recommended to perform:• Spinal manipulation and mobilisation on infants.• Cervical and lumbar spine manipulation on children.•Spinal manipulation and mobilisation on infants, children, and adolescents for non-musculoskeletal paediatric conditions including asthma, attention deficit hyperactivity disorder, autism spectrum disorder, breastfeeding difficulties, cerebral palsy, infantile colic, nocturnal enuresis, and otitis media.2. It may be appropriate to treat musculoskeletal conditions including spinal mobility impairments associated with neck-back pain and neck pain with headache utilising:• Spinal mobilisation and manipulation on adolescents;• Spinal mobilisation on children; or• Thoracic manipulation on children for neck-back pain only.3. No high certainty evidence to recommend these interventions was available.Reports of mild to severe harms exist; however, risk rates could not be determined.
Conclusion: Specific directives to guide physiotherapists' clinical reasoning on the appropriate use of spinal manipulation or mobilisation were identified. Future research should focus on trials for priority conditions (neck-back pain) in children and adolescents, psychometric properties of key outcome measures, knowledge translation, and harms.
Keywords: Spine; adolescent; child; infant; manipulation; mobilisation.
Episode 208 (Professor Alicia Spittle)
EARLY DETECTION AND EARLY INTERVENTION - WHERE ARE WE NOW (AND WHAT DOES THE FUTURE HOLD)?
Reflections on this episode (Dr Pool)
Early Detection and Early Intervention - where are we now (and what does the future hold)?
The last time we had Alicia on the pod, we spoke about the Cochrane Review she led titled “Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants” which was published in 2024. In this week’s episode, we thought we’d ask Alicia about the state of early intervention right now and what the provision of therapy looks like within our current context of early detection and early intervention for children with cerebral palsy.
There have been some rather significant developments in the early detection and early intervention space over the past 20 years. From the rapid technological advances to the value of co-design and involvement of people with lived experience, we now have some impressive evidence to guide our clinical pathways. However, what is very clear now is the vital importance of implementation. The industry has generated substantial knowledge that now needs to be implemented into practice with one particularly important aspect that we must include - family involvement and well-being.
Alicia speaks ever so passionately about our role as therapists and I cannot help but to feel even more compelled to ensure that the family is at the centre of everything we do. It is exciting to know that we have the evidence now, so it’s time to put it into practice and it can start in your very next session.
https://findanexpert.unimelb.edu.au/profile/27041-alicia-spittle
Episode 207 (Dr Michelle Jackson)
IMPLEMENTING CLINICAL PRACTICE GUIDELINES FOR IMPROVING FUNCTION IN CEREBRAL PALSY: DEVELOPMENT OF A FIDELITY TOOL
Reflections on this episode (Dr Pool)
In this study, the research team developed a 21-item fidelity tool to help clinicians implement evidence-based guidelines for improving function in children with cerebral palsy. Designed for goal setting, intervention, and reflection, the tool was found to be practical and useful but faced challenges like time constraints and family expectations. The study highlights the need for education, self-reflection, and organisational support to bridge the gap between research and practice.
Personally, I love the idea of a fidelity tool. It provides the framework to start a great conversation with a family or therapist. It provides some structure to talk about what is important and what makes up an effective treatment plan. Every child and their family circumstance is different so the value of setting appropriate goals and setting up some key parameters to achieve their goals is just so vital. There is also a lot of value in using this tool as part of supervision and training for therapists. For more experienced therapists or sole practitioners, perhaps this may serve as a reflection tool.
Ultimately, the more we align with the fidelity tool which captures what we know about effective interventions, the better the outcomes that will be achieved. When this happens, it is the child and family that benefit from it the most and that is what we are all wanting! I know I will be using this within our practice to keep us on track and provide a framework for identifying areas we can perhaps improve on or be the focus of our professional development activity.
https://cerebralpalsy.org.au/wp-content/uploads/2024/07/Fidelity-Tool-Guidance-Document.pdf
https://cerebralpalsy.org.au/cerebral-palsy/treatments/
Episode 206 (Professor Nick Gottardo)
BRAIN TUMOUR RESEARCH PROGRAMME
Reflections on this episode (Dr Pool)
Professor Nick Gottardo co-leads the Brain Tumour Research Programme at The Kids Research Institute Australia. He is also Head of the Paediatric and Adolescent Oncology/Haematology Department and the Stan Perron Chair in Paediatric Oncology and Haematology at Perth Children’s Hospital.
Nick is also the Chair of the Australian and New Zealand Children’s Haematology/Oncology Group, the peak professional body for paediatric oncologists and health professionals who care for children with cancer and the national cooperative clinical trials group for childhood cancer.
He leads several international clinical trials, including the front-line clinical trial for WNT subgroup medulloblastoma patients for the US based Children’s Oncology Group. He also sits on the Executive and Steering committees for the COllaborative Network for NEurooncology Clinical Trials (CONNECT) Collaborative, an international paediatric Neurooncology clinical trials group.
Episode 205 (Dr Ashleigh Thornton and Dr Dayna Pool)
KNOWLEDGE TRANSLATION
Reflections on this episode (Dr Pool)
A special episode with our illustrious hosts before we catch up with Professor Nick Gottardo, Professor Alicia Spittle, Professor Andrew Whitehouse, Dr Gareth Baynam, Assoc. Professor Nikki Milne and Assoc. Clinical Professor Anita Gross amongst many others!
Episode 204 (Professor Roslyn Boyd)
RANDOMIZED COMPARISON TRIAL OF REHABILITATION VERY EARLY FOR INFANTS WITH CONGENITAL HEMIPLEGIA
Reflections on this episode (Dr Pool)
The REACH trial is the largest randomised comparison study to date, investigating Baby-CIMT (constraint-induced movement therapy) and Baby-BIM (bimanual therapy) in infants as young as 3 to 9 months of corrected age. The study found that both therapies significantly improved early hand function, but neither was superior—challenging assumptions about unimanual versus bimanual approaches in early neuroplasticity.
Interestingly, there were signals in the data that infants who commenced therapy before 6 months of age showed greater functional improvements, reinforcing the importance of early intervention. With direct clinical implications for therapists, this study provides crucial insights into therapy selection, dosage, and parental engagement in infant rehabilitation.
Episode 203 (Assoc Prof. Brian Hoare and Dr Sue Greaves)
UPPER LIMB THERAPY FOR INFANTS AND YOUNG CHILDREN WITH UNILATERAL CEREBRAL PALSY: A CLINICAL FRAMEWORK
Reflections on this episode (Dr Pool)
The core of our discussion revolved around two major therapeutic approaches: Constraint Induced Movement Therapy (CIMT) and Bimanual Therapy.
One of the most important takeaways for me, and I believe for our listeners, was the shift away from normalising movement towards focusing on effective and efficient strategies for achieving functional goals.
Dr. Greaves and Dr. Hoare also provided valuable insights on the appropriate use of physical guidance, emphasising a "hands-off" approach as much as possible to promote active learning and avoid creating dependency. They stressed the significance of careful selection of toys and activities to provoke desired actions and the importance of grading the environment
Finally, we touched upon navigating the landscape of different therapies, with a strong emphasis on setting clear, explicit, and specific goals and actively involving and supporting families in the therapy process. This episode truly underscored the critical need for therapists to move beyond simply applying techniques and instead deeply understand the principles behind effective early intervention for children with unilateral cerebral palsy .
Episode 202 (Dr Stacey Cleary)
EXPERIENCES OF PARTICIPATION IN DAILY LIFE OF ADOLESCENTS AND YOUNG ADULTS WITH CEREBRAL PALSY: A SCOPING REVIEW
Reflections on this episode (Dr Pool)
The adolescent and young adult stage of life is a critical transition, moving away from structured environments and towards greater autonomy and independence, which presents unique complexities for this population. This work helps to illuminate these experiences and underscores the vital importance of understanding participation not just as attendance, but also as the subjective experience of involvement.
The central theme that emerged from the review, "claiming adulthood and doing life," really resonated with me. It highlights the strong desire of young people with CP for autonomy, inclusion, and meaningful engagement across all life domains, including healthcare, relationships, and social activities. However, the review also revealed the significant barriers they encounter, such as inaccessible environments, systemic inadequacies, and societal misconceptions. The crucial role of a close circle of support, encompassing family and peers, in facilitating participation was also emphasised. Importantly, the transformative impact of peer connections and mentorship among young adults with CP was particularly striking, offering encouragement and expanding perceptions of their own capabilities.
Moving forward, this research underscores the urgent need for tailored interventions and structural supports to enhance participation. As clinicians and researchers, it's imperative that we shift our focus to participation as a starting point rather than just an outcome. Stacy provided valuable advice for families and young adults, emphasising the importance of autonomy and seeking out supportive providers.
I'm hopeful that this paper will encourage more CP-specific training for professionals, improvements in accessibility, and the fostering of inclusive attitudes within communities. Future research should prioritise understanding the participation experiences of individuals with more complex disabilities and in diverse global contexts to inform more effective and equitable supports.
Episode 201 (Dr Rainer Blank and Dr Sebastian Schroeder)
A SPECIAL PRE-EACD 2025 EPISODE!
To round off 2024 and as an extra special lead-in to a stellar 2025 ahead, we have a holiday special - all about the EACD & IAACD 2025 Conference to be held in Heidelberg Germany! 🇩🇪
It's going to be a very unique conference this year as a combined EACD/IAACD event - so join with Dr Sebastian Schroeder and Dr Rainer Blank as they speak with our very own Dr Dayna Pool!
From a behind the scenes look, to what you can expect from the conference this year, the pre-conference sessions at the breathtaking UNESCO Monastery Maulbronn (FREE shuttles included in the conference registration!), be sure to join us for a brilliant conversation with some of Germany's very finest!
Also - are you curious about what a German Christmas looked like? Or what handy german phrases you should be working on before arriving, we've got you covered! 😉
Season 5!
This week, we catch up with Dr Paula Chagas!
All about the GMFR - the Gross Motor Family Report! The episode releases this weekend.