HOPFA

Question 1

What is the HOPFA

Answer 1

• Clinical framework designed to guide students and novice clinicians through clinical reasoning process in pediatric PT practice.
• A systematic stepwise guide to patient/client management process
• Helps PT students in developing pediatric clinical reasoning
• Promotes a child and family centered approach to pediatric PT practice.

Question 2

What is the HOPFA NOT??

Answer 2

• Not intended to provide specific guidelines for pediatric PT practice
• Not built upon a specific therapeutic examination or intervention philosophy.

Question 3

How many steps does the HOPFA have?

Answer 3

12 steps

Question 4

1st step of the HOPFA

Answer 4

Initial Hypothesis
- build a mental image of the child and what they should be doing at the age.
- think about the referring medical dx and think of what the primary and secondary impairments associated with the child’s medical dx.

Question 5

2nd step of the HOPFA

Answer 5

Initial Data Collection
- review of records both educational and medial
- interview with the family
- observe child throughout interview — helps generate an initial impression of the kiddo’s functional capabilities and status

Question 6

3rd step of the HOPFA

Answer 6

Problem Statement
- statement that specifically describes why the child and family are seeking PT
- ensuring the child and family’s goals and expected outcomes are well understood and delineated prior to the examination is FOUNDATIONAL FOR FAMILY CENTERED CARE

Question 7

4th step of the HOPFA

Answer 7

Hypothesize Goals
- propose STG and LTG that are functional and will help direct the exam
- ensure that these coals are consistent with child and family’s desired outcomes
- these goals might not be the definitive goals established for POC!! Just helps us guide the examination part

Question 8

5th step of the HOPFA

Answer 8

Examination Planning
- tests and measures are identified based on..
— PT’s mental image of child
— Problem statement
— hypothesized goals
— info gathered in initial data collection/subjective history
— PTs knowledge of tests and measures
- must include a systems review.

Question 9

6th step of the HOPFA

Answer 9

Examination
- administer tests and measures
- measures of activity and participation not routinely employed in clinical settings
- measures must be valid, reliable, feasible, and able to detect clinically relevant changes

Question 10

7th step of the HOPFA

Answer 10

Evaluation
- synthesis of exam findings
- facilitates the inclusion of contextual factors during synthesis of exam findings.

Question 11

8th step of the HOPFA

Answer 11

Diagnosis and Prognosis
- identify the primary 1-2 PT problem areas that are most limiting the child’s functional activity level
- then prioritize those problem areas
- this will assist in focusing PT POC and helps drive intervention strategies
- Refine mental image of child based on exam and eval

Question 12

9th step of the HOPFA

Answer 12

General Intervention Planning
- PT interventions are based on the POC
- must be procedural interventions
- Patient and family centered instruction must be included — HEP!!

Question 13

10th step of the HOPFA

Answer 13

Intervention Session Planning
- base interventions for individual sessions on a specific goal
- should consider the motivational factors, play, feedback mechanisms, and how to increase/decrease the difficulty

Question 14

11th step of the HOPFA

Answer 14

Reflection
- continued monitoring!!!
— think: was the intervention session successful? Are we progressing toward STG or LTG?

Question 15

12th step of the HOPFA

Answer 15

Formal Re-Examination
- re-administration of examination tests and measures to modify and redirect interventions.