Pediatric Specialty Day

Thursday, September 26, 2024
8:00 AM - 4:00 PM
Union Station Hotel, St. Louis, MO

We are excited to announce the inaugural ASHT Pediatric Specialty Day! We invite you to join us on a journey beyond the fundamentals, delving into the intricacies of pediatric hand and upper extremity therapy. This specialized course promises an exploration of unique diagnoses, innovative treatments and the myriad triumphs and challenges inherent in the realm of pediatric hand therapy.

Whether you're a seasoned practitioner seeking to deepen your expertise or a newcomer eager to expand your knowledge, ASHT Pediatric Specialty Day is your gateway to a comprehensive understanding of the evolving landscape of pediatric hand therapy.

Embodying the overarching theme of the 2024 meeting, "Integrating Perspectives: Learning, Collaborating and Innovating," this day is designed to foster an environment where professionals can come together to share insights, collaborate on best practices and collectively advance the field.

Pediatric Specialty Day will be held as a full day of programming prior to the start of the ASHT Annual Meeting that evening. Registration will be available for purchase on its own or as an add-on to the full conference package. 

Peggy Faussett, MOTR/L, CHT
2024 Pediatric Specialty Day Co-Chair

Lindsey Williams, OT, CHT
2024 Pediatric Specialty Day Co-Chair

Registration

Registration is available for Pediatric Specialty Day or select a specially priced bundle and add the Annual Meeting to your registration. Select one of these options to register for Pediatric Specialty Day!

If you have already registered for the Annual Meeting and would like to also register for Pediatric Specialty Day, contact meetings@asht.org for assistance. 

Register

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CE Hours

This continuing education activity offers a maximum of 6.5 continuing education hours or .65 CEUs.

Program:

8:00 - 8:15 AM | Welcome

Join the 2024 Pediatric Specialty Day Co-Chairs, Peggy Faussett, MOTR/L, CHT and  Lindsey Williams, OT, CHT and the 2024 ASHT President, Aviva L Wolff, EdD, OTR, CHT as they kick off the inaugural Pediatric Specialty Day!

8:15 - 9:15 AM | Learning Session 

8:15 AM - 8:30 AM | Flipping Into the World of Gymnast's Wrist

The rise in popularity of the sport of gymnastics calls for further examination of the injuries often associated with the sport. Gymnast’s wrist, or distal radial epiphysitis, is one of the most common overuse injuries that affect young gymnasts and can ultimately lead to discontinuation of the sport. For the young athlete, gymnast’s wrist can be a lengthy and daunting treatment process and for the treating therapist it can be a confusing diagnosis to navigate, especially when considering return to sport. This presentation will dive into the complex world of gymnastics and provide an overview of gymnast’s wrist, as well as treatment interventions to consider when working with your next patient with gymnast’s wrist.

Learning Objectives: 

1. Review gymnast’s wrist and outline the basic components of this intriguing diagnosis
2. Discuss various considerations during evaluation such as assessing wrist proprioception through the Active Wrist Joint Position Sense test 
3. Discuss treatment interventions integral to the patient’s success, and how to create a specialized treatment plan including exercises that can simulate return to sport

Speaker: Savana Ashton, MOT, OTR

 

8:30 AM - 8:45 AM | Spilling the Tea on Proprioception in Teenage Wrist Pain

In pediatric hand therapy, the diagnosis of “wrist pain” is prevalent and therapists must be able to thoroughly evaluate for all potential causes of pain.  One such cause of pain is wrist instability.  There have been advances in understanding the static and dynamic stabilizers of the wrist and the importance of implementing proprioceptive exercises to address wrist instabilities. In this presentation, a case study will be utilized to discuss evaluation of wrist pain that identified a wrist instability.  Proprioception exercises will be discussed as well as how the patient was progressed through the therapy plan of care.
 

Learning Objectives: 

1.    Identify subjective and objective measures that would indicate a wrist instability.
2.    Describe exercises to properly engage the dynamic wrist stabilizers.

Speaker: Cara Smith, PT, DPT, CHT

 

8:45 AM - 9:00 AM | Objective Measures in Burn Therapy

This session will review objective measures that are validated and utilized in burn therapy to evaluate and measures outcomes. Outcome measures that are validated in the burn population in addition to outcome measures that are commonly utilized by burn and hand therapists will be presented. The speaker will discuss specifications for use of each measure as well as provide resources for accessing outcome measures.

Learning Objectives: 

1. Describe objective measures that are vital to a comprehensive burn evaluation ​
2. Review outcome measures that have been validated specifically in burn care ​
3. Discuss additional outcome measures utilized in by burn therapists to capture hand and quality of life outcomes

Speaker: Nichole Schiffer, MOTR/L, CHT, BT-C, BCP

9:15 - 10:15 AM | Collaborating Session 

9:15 AM - 9:30 AM | Set Up for Success: Opportunities to Support Patients with Upper Limb Differences Outside of the Clinic

This instructional session will explore how the pediatric hand therapist can collaborate with others in the community to impact the life experiences of their patients with upper limb differences. In the educational setting, children with upper limb differences may benefit from accommodations in the classroom to help them keep pace with their peers. The pediatric hand therapist can collaborate with the educational team by providing a letter listing potential accommodations for the child’s 504 plan. Outside of the classroom, the pediatric hand therapist can contribute to the multidisciplinary team by volunteering at a camp for children with limb differences and their families. Personal experience will be shared based on this therapist’s role as a volunteer for Camp No Limits. Lastly, the importance of connecting families of children with limb differences will be highlighted by describing a local support group in Austin, TX. Inclusion of the lived experience will be illustrated with a video of a local support group participant sharing their perspective on growing up with an upper limb difference.

Learning Objectives: 

1. Provide 2-3 potential school accommodations for a child with an upper limb difference.
2. Describe 2 benefits of the camp experience for children with upper limb differences.
3. Summarize the importance of support groups for children with upper limb differences.

Speaker: Karen Ayala, BS, MSOT, CHT

 

9:30 AM - 9:45 AM | Review of Hypermobility Spectrum Disorder CPG and Treatment

This informational session will review most recent diagnostic criteria for HSD and hEDS, including current nomenclature. I will also review the most recent evidence-based practice guideline (it should be finished/published by the time of the conference), including recommendations for multi-disciplinary care.

Learning Objectives: 

1. Describe the current diagnostic criteria for hEDS and HSD and understand the difference between the two diagnoses. 
2. Describe the current recommendations for management of hEDS and HSD, including when to make referrals for other discipline and how to coordinate care.

Speaker: Carrie Shotwell, OTR/L, MEd, DHS

 

9:45 AM - 10:00 AM | What Happens When our Kids with Congenital Hand Differences Become Adults?

This talk will discuss typical issues adults with pediatric hand differences face as they age, as well as the difficulty with getting seen by doctors and therapists who understand their abnormal anatomy.   It will expose the gap in treatment as children with congenital anomalies age out of pediatric hospitals equipped with support, understanding and expertise in their care and into the real world with doctors and therapists who mainly treat patients with typical anatomy.  This talk will identify the need for more education on pediatric congenital conditions with our adult trained hand surgeons and therapists.

Learning Objectives: 

1. Identify typical issues adults diagnosed with pediatric hand differences face as they enter adulthood
2. Expose the gap in treatment as children with congenital conditions age out of pediatric hospitals equipped with support, knowledge understanding and expertise and into the real world of adulthood with Dr.'s and Therapists who may not understand their abnormal anatomy
3. Identify the need for increased education with our adult hand surgeons and therapist on pediatric congenital conditions

Speaker: Amy Lake, OTR,CHT

10:15 - 10:30 AM | Break

Network with fellow attendees. 

10:30 - 11:30 AM | Innovating Session 

10:30 AM - 10:45 AM | Humeral External Rotation Orthosis Strap: A Less Prohibitive, Shoulder Positioning Orthosis for Brachial Plexus Birth Injury

The presentation will introduce the HERO Strap, an innovative solution to combat maladaptive glenohumeral development in infants with BPBI. A “how to” section will walk through obtaining supplies, fabricating, and applying the strap with key aspects being highlighted. We will compare preliminary, retrospective clinical and radiographic data for patients prescribed various orthosis solutions over the past 6 years (e.g. SupER Splint, Gunslinger, and HERO Strap). Finally, we will demonstrate the HERO Strap on a patient via video examples.

Learning Objectives: 

1. Distinguish meaningful differences among (3) proposed orthosis solutions to maladaptive, glenohumeral development in infants with BPBI.
2. Identify key aspects of HERO Strap fabrication and apply these techniques in their own practice as desired.
3. Understand the implications of early orthosis intervention in infants with BPBI who have incomplete recovery.
4. Identify indications for HERO Strap application.

Speaker: James H. Northcutt II, OTR, MOT, CHT

 

10:45 AM - 11:00 AM | What Does A Pediatric Flexor Tendon Protocol Look Like? (Presenting the use of early controlled motion with appropriate young patients)

Early controlled motion is a well established hand therapy intervention in the post operative treatment of adult flexor tendon injuries. This presentation outlines a therapy protocol that uses an evidence based, child friendly, phased approach to safely treating pediatric flexor tendon repairs, using the principles of early controlled motion.

Learning Objectives: 

1. Identify 3 characteristics of an appropriate patient for this approach.
2. List 2 components of each phase of the protocol.
3. Demonstrate 2 therapeutic interventions that could be used during this protocol.

Speaker: Yvonne Doreen Morris, Dip COT, OTR, CHT

 

11:00 AM - 11:15 AM | Impact of Sports- Related Upper Extremity Injuries on Occupations of Elementary-Aged Children

The increase in sports participation over recent years has contributed to an increase in physical activity levels among youth and adolescents. The increase in physical activity has increased the risk for sport-related injuries specifically of the upper extremity due to repetitive stress and improper technique. Because of the gap in the literature related to sports-related upper extremity injuries acquired by elementary-age children, we decided to conduct a quantitative study to collect data from parents of elementary-age children who have sustained a sports-related upper extremity injury. Data is being acquired and analyzed regarding how daily occupations are impacted by children’s upper extremity sports injury. Hand therapists and occupational therapists have a distinctive skillset and role in treatment of upper extremity sports injuries. They are not only skilled at addressing return to sports but are also trained in addressing children returning to their daily occupations including leisure, activities of daily living (ADLs), and school. Our research study focuses on the occupations which are affected by sports related upper extremity injuries in elementary-age children and aims to advocate for the importance of hand therapists and occupational therapists with pediatric athletes.

Learning Objectives: 

1. By the end of this presentation, participants will be able to describe how pediatric upper extremity sports injuries impact children’s daily occupations.
2. At the end of the presentation, participants will be able to explain the vital role hand therapists and occupational therapists play in returning pediatric athletes to performing their daily occupations.
3. By the end of the presentation, participants will be able to discuss the importance of therapist led research in the field of pediatric hand therapy and pediatric sports medicine.

Speaker: Reeti Douglas, OTD, OTR/L

11:30 - 12:00 PM | Research Session  

 Integrating Perspectives to Elevate Evidence for Pediatric Hand Therapy Practice

In this session, an overview of ways therapists may contribute to research in pediatric hand therapy will be discussed. Audience members will participate in identifying future research priorities for pediatric hand therapy.

Speaker: Jenny Dorich, OTR/L, PhD, MBA, CHT

12:00 - 1:00 PM | Lunch

Lunch is included with registration. 

1:00 - 1:50 PM | Keynote Speakers

Innovate, Collaborate and Empower: Developing a Transformative Model of Care for Children with Upper Limb Differences

The increasing challenges of access to care, staffing, and costs of health care demands that we innovate new models of care to provide care to optimize patient and systems level outcomes. In this presentation, we will present a new model of care has been implemented at the Hospital for Sick Children (SickKids) in Toronto, Canada that expands the role of an occupational therapist in the paediatric hand and upper limb program. An Occupational Therapy (OT) Practitioner role was created to improve access and quality of care for patients with non-surgical congenital hand and upper limb differences to reduce surgeon workload, streamline services, and provide holistic management of the child and family. The benefits of this new role and model of care in facilitating timely diagnosis and access to care, timely referrals for hand therapy and psychosocial support, and improved coordination and delivery of services to community care therapy providers will be presented.

Speakers: 
Kristen Davidge, MD, MSc, FRCS©
Emily S. Ho, PhD, OT. (Reg.)

2:00 - 2:55 PM | Breakout Sessions (attendees will be asked to select their session during registration)

Upper Extremity Serial Casting: Hands on Lab

Serial casting can be an effective way to reduce the severity of wrist contractures in children with spasticity, particularly when paired with botulinum neurotoxin A. We will review case studies and discuss when a serial cast may be used vs serial orthoses. We will demonstrate step by step how to make and remove a wrist serial cast during the session.

Learning Objectives: 

1. Discuss the potential outcomes and benefits for serial casting for surgical and non-surgical patients. 
2. Discuss when a serial cast may be an appropriate intervention to try with your pediatric patient vs an orthotic.
3. Learn instructions on how to fabricate a removable wrist serial cast using soft cast and fiberglass materials.

Speakers: Carrie Shotwell, OTR/L, MEd, DHS & Jenny Dorich, OTR/L, PhD, MBA, CHT

 

Flexor Tendon Trauma in the Pediatric Patient

This session will cover current trends in hand therapy for the treatment of flexor tendon injuries and apply them to the pediatric patient population.

Learning Objectives: 

1. Describe surgical techniques for the repair of flexor tendon injuries

2. Describe current advancements in the treatment of flexor tendon injuries and apply them to the pediatric population

3. Describe the benefits of an early active motion protocol within the pediatric patient population

4. Identify patient factors that influence participation in post-operative rehab following a flexor tendon injury

Speaker: Ashley Pittman, OTR, CHT

 

Evaluation and Treatment of the Child with a Brachial Plexus Injury

The presentation would review appropriate evaluation tools for the child with an obstetric  brachial plexus injury and discuss innovative orthotics for the prevention of  glenohumeral joint deformities.  It will also share age appropriate treatment activities.

Learning Objectives: 

1. At the end of this presentation, participants will be familiar with how to use the active movement scale to assess the child with a brachial plexus injury.
2. At the end of this presentation, participants will be able to describe the secondary muscle imbalances and joint contractures that may develop as a result of a brachial plexus injury. 
3. At the end of this presentation, participants will be able to identify critical intervention strategies when treating a child with a brachial plexus injury.
4. At the end of this presentation, participants will learn how to use the Modified Mallet Score to assess upper extremity movements of a child with a brachial plexus injury.
5. At the end of this presentation, participants will learn how to recognize co-contractures in a child who has a brachial plexus injury.

Speakers: Aaron Berger, MD & Yvette Elias, OT/L, CKTP, CHT

3:00 - 4:00 PM | Breakout Sessions (attendees will be asked to select their session during registration)

Evidence-based Practice Themes for Chronic Upper Extremity Paresis from Brain Injury

Clinical practice guidelines and systematic reviews of systematic reviews and RCTs are available to drive the selection of treatment and therapy dose for chronic upper extremity (UE) paresis from brain injury. In addition, guides are available to help caregivers understand this information. This body of work is based on studies of children with cerebral palsy (CP) of mixed and unknown etiology and reflects a wide range of disciplines and perspectives including occupational therapists, physical therapists, kinesiologists, and psychologists. This work reveals themes that clinicians can rely on for practical assistance.  The themes involve motor learning theory, “active therapies”, holistic care, and other top-down approaches. This breakout session will guide participants through a maze of terminology and literature (unilateral CP, stroke, hemiparesis, etc.) to draw treatment plans from a wide body of evidence. Splinting recommendations will be covered. The session will present new data showing that the dominant hand of children with “unilateral cerebral palsy” is often impaired.  I will discuss how this aligns with the theme of holistic care by using a case study. Finally, I will discuss the role of impairment-based interventions for clinical care and future research.

Learning Objectives: 

1. Describe “green light” therapy interventions and unifying themes of a large body of cerebral palsy research. 
2. Screen for impairments of the dominant hand. 
3. Identify clinical resources to assist in selecting both motor and cognitive interventions.
4. Discuss the role of impairment-based interventions, including splinting, in clinical care and research

Speaker: Todd Levy, MS, OTR/L, CBIST-AP

 

The Role of Occupational Therapy with Pediatric Burn Patients for Long-term Scar Management

The literature indicates acute and long-term treatment for pediatric burn injuries have significantly improved since the 1960s with changes in available interventions and compression therapy. Pediatric burn injuries provide long-term impacts on the patient and caregivers psychological, social, and emotional wellbeing. Hypertrophic scars within the pediatric population can cause significant complications impacting upper extremity limitations in active and passive range of motion, functional outcomes with activities of daily living, and decreased strength. The participants will gain professional knowledge on the specialized occupational therapy evaluation process, identification of scar appearance (indicated by the Vancouver Scar Scale assessment), and interventions for scar management, such as custom compression garments, scar massage, splinting, and silicone scar sheets/taping.

Learning Objectives: 

1. Discuss the evaluation process for pediatric burn patients that are referred to occupational therapy services for early intervention to prevent hypertrophic scarring. 
2. Assess the appearance of the burn using the Vancouver Scar Scale (VSS) in relation to its vascularity, pigmentation, pliability, and height. Identify the appropriate skilled scar management interventions for the upper extremity to improve quality of life.

Speaker: Nicole Avena, OTR/L

 

Utilizing Soft Cast and Plaster to Increase Passive Range of Motion in Pediatric Hand Therapy

Have you ever gotten that deer-in-headlights look from a patient and their family after going over a home stretching program? Or have a family struggling with the wear schedule or correctly donning an orthosis to gain passive range of motion? Joint stiffness and soft tissue contractures can be very difficulty and sometimes frustrating to treat, especially in pediatric patients. During this presentation, participants will learn the benefits of using plaster and soft cast as a valid and efficient treatment technique to add to their toolbox for treating passive ROM limitations. Benefits such as low maintenance care, the heat properties of the material on the joint, and the time spent at end range will be discussed. Patient populations that are appropriate for this technique will be reviewed through case studies, including radial longitudinal deficiency, camptodactyly, Volkman's contracture and arthrogryposis. The session will end with a live demonstrate of the application and removal of soft cast and plaster. Participants will receive a step-by-step guide on how to complete soft cast and plaster in their treatment settings.

Learning Objectives: 

 1. At the end of this presentation, participants will be able to identify the procedural steps for application and removal of soft cast and plaster effectively on a patient. 
2. At the end of this presentation, participants will be able to identify the precautions of the soft cast and verbalize what family would need to look for removal at home.

Speaker: Sarah Schmeda, OTD, OTR/L, CHT

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CE Hours

This continuing education activity offers a maximum of 6.5 continuing education hours or .65 CEUs.