Physical therapy examination is the first element in patient/client

management consisting of obtaining patient/client history,

performing a systems review, and selecting and administering
tests and measures.
The interview process for obtaining pertinent history includes
identifying the family’s concerns and needs related to the child’s
development, understanding the family’s perception of the
problem, and inquiring whether the developmental concerns
impact daily family routines. The family’s expectations, goals, and
desired outcomes for physical therapy are important factors to
identify during the interview process. The review of the child’s
developmental and medical history provides valuable information
and can be obtained through a questionnaire such as a case
history form or through parent/client interview. The possible lack
of reliability and bias of the parent should be considered in
assessing the information gained in the history. When available,
the medical records of a child may provide objective information
regarding precautions, patient health status, previous medical
history, suspected diagnosis, prognosis, medications, and other
factors impacting the child’s health. Other pertinent history,
including information about the family and its genetic history, the
pregnancy, labor, and delivery of the child, and the perinatal and
neonatal events, should be obtained. Therapists can gather a
plethora of information about the child through clinical
observations, often during the interview process. Is the child
motivated to explore and move about in the environment, or is he
or she more of an observer and active listener preferring to
remain close this or her family? If the child is mobile, what is the
quality and symmetry of movement? How does the child’s body
respond to the effects of gravity? How does the child
communicate with the parents and the therapist? Developing a
rapport with the family and child, assuring comfort in the
environment, and being flexible and accommodating to the child’s
temperament, behavior, or special needs is a necessary skill for
the pediatric physical therapist. Selection of appropriate tests and
measures for the examination depends on the purpose of the
 assessment. Kushner and Goat describe three purposes of
assessment:(1) Evaluative measures are used to determine
change overtime or change as the result of intervention, (2)
Predictive measures are used to help identify children who will
have delays in the future or to predict the outcome of the delay,
and (3) Discriminative measures are used to distinguish between
children who have a delay, impairment, functional limitation, or
atypical development and those who do not.7,8Determining the
most appropriate developmental test forth physical therapy
examination is a key component of a valid developmental
assessment.