F-Words Paper – The ‘F-words’ in childhood disability: I swear this is how we should think


Therapy – it should be all about the F Words?!

This is a great article encouraging therapists and parents to think about the future of children with disabilities – in a positive way – right from the start. Addressing function, family, fitness, fun and friends to constantly remind us of what is important in the development of all children.

It made me reflect about my role as a Physio and how successful I am in my aims – which are; to reduce the impact each child’s impairment has on their ability to join in with their friends and family, have fun, be successful at something and be fit and able to face their future. And, to support families and carers so they have the skills and knowledge to bring the best out of the children they are caring for.

Are all my programmes and session plans focused around what the child wants to do? Am I always successful in my goal to make sure my therapy input enriches the lives of children and their families?

I have seen many therapy programmes (some of mine included) with aims like “to maintain length of hamstring muscle”; “to improve posture and balance in sitting” and I am now more than every asking, so what?

Parent’s feedback to me frequently that they feel guilty for not doing therapy with their child more often – not spending more time, out of their quality family time, to do their therapy programme – this can’t be the message we are meaning to send out.

It makes me question where we are going wrong, we should be making the lives of families less stressful, enabling their child and therefore making parents worry less about the future.

Let’s think about the F- words from the article, I think as therapists we can strive to deliver an approach that has these words at the heart of it and as families we can check that we make decisions and advocate for our children with the now and their future in mind.

Function – Children’s lives should be rich with experience. They need opportunities to practice skills, be suitably challenged, make mistakes and learn from them. We need to ensure their environment is suitably adapted, that they have adequate support so that they can be more independent, more involved. We need to promote activity and with that comes function.

Family – Empowering families so they can make informed decisions. I was once asked to help a Mum sort through all the advice and therapy programmes she had been given for her 5 year old child (with Cerebral Palsy) as she couldn’t see how she could follow it all. Well, she had 5 different Physio programmes; 3 feeding programmes, speech advice about using signs, key words and switches, 4 Occupational Therapy programmes; play therapists ideas; school homework and then various different pieces of equipment she had been given over the years with advice about how long to use it for. She didn’t know if the most recently dated therapy programme replaced the others or if she should be doing it all – and to be honest it wasn’t clear to me either (for a few the newer programmes seemed to add things into a home programme but didn’t necessarily replace an older programme). There was nothing in all the information she told me, or that I saw written, that pulled it all together – nothing that linked the therapy aims to her goals for her child!

Fitness – Children need to be able to access recreational opportunities to become and stay physically active, some kids may love doing a strengthening programme with an adult – for a while – but most will want to get stronger so they can… wheel faster in there chair; kick their legs more in the swimming pool; run faster in their walker/ running bike; knock more skittles down…

Fun – What is fun for one child may not be for other so first things first; find out what your child wants to do. Most activities can be adapted to allow all children to pursue their interests. They may not do it the way others do it, or the way we may want them to do it, but if they are participating and having fun then they are achieving!

Friends – Social development is an essential aspect of personhood. In this article Rosenbaum and Gorte ask us to consider, “what can be done to encourage, empower and enhance children’s opportunities to develop and nurture meaningful peer connections”.

Future – “the future is what child ‘development’ is all about” – isn’t it just! We need to choose a therapy approach that is centred on the strengths of each individual child and their family. Think positively about the future and what each child can do; about how we can support them to have Fun, make Friends, and be Fit and Functioning to the best of their ability.

7 thoughts on “F-Words Paper – The ‘F-words’ in childhood disability: I swear this is how we should think”

  1. A very informative and interesting blog post full of common sense ideas. Definitely some things to think about. I look forward to the next post. Keep up the good work

    1. Great post Ellie
      I completely endorse your comments, just Su sri ed to your blog- great for sharing ideas and happy to help you out should you need any splinting done

  2. I work in adult community, mostly falls prevention and hospital advoidance work. I think the post is a really interesting read and the f’s can and should guide all of our goal-setting with patients, not just paeds. Great reminder for us all about considering goal-setting from the patients point of view. Looking forward to reading more blogs. Sam

  3. Great reflection Ellie. Challenges us all to examine our practice and try to make sure our treatment goals are family centred and functional

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