Which is a key step in gross motor PT planning for a developing child with spina bifida?

Which is a key step in gross motor PT planning for a developing child with spina bifida?

• A. Define current status for proper program planning (motor level, mobility, precautions, orthoses, AD)
• B. Prescribe orthoses without assessment
• C. Schedule surgery first
• D. Rely on generic therapy protocols

Answer: (A)

Establishing a clear snapshot of the child’s current functioning is the starting point for gross motor planning. Knowing the motor level and present mobility, along with precautions, orthoses, and assistive devices the child already uses, sets the foundation for safe, effective progression. This baseline helps you anticipate what movement patterns are feasible, what support the legs and trunk will need, and where risk of skin breakdown or joint misalignment lies. It also guides equipment decisions—whether a child will benefit from ankle-foot orthoses, standing frames, walkers, crutches, or a wheelchair—and informs the choice of activities and safety precautions as development continues. With this information, goals can be realistic and progress can be measured over time.

Prescribing orthoses without assessment ignores how each limb aligns, how strong the muscles are, and what the skin can tolerate, so it’s not appropriate. Scheduling surgery first falls outside PT planning, which should focus on functional mobility and safety within the child’s current status. Relying on generic therapy protocols fails to account for the variability in spina bifida between individuals, making the plan ineffective or unsafe.