Canadian Therapist in East Africa: Treatment Impact Using Goal Attainment Scaling

Transcription

1 Canadian Therapist in East Africa: Treatment Impact Using Goal Attainment Scaling Kenya Working Group International Centre for Disability and Rehabilitation Tara Ross, MHSc. SLP (C) reg CASLPO, David Ross, MSc. PT Julie Hard, MSc. PT, Puja Ahluwalia BSc PT, Blythe Dalziel MHSc PT, Bashir Versi MHSc PT

2 Outline Introduction to the Kenya Working Group Purpose of this study Description Results Conclusion and Future Directions How you can get involved

3 Kenya Working Group (KWG) The KWG is a Canadian group formed within the framework of the International Centre for Disability and Rehabilitation (ICDR) at the University of Toronto. Involves the collaboration of McMaster University, the University of Toronto and partners made within Kenya whose focus is on the care of people with disabilities.

4 Purpose The impact of treatment provided during short term medical volunteer trips has been poorly reported. For this purpose a Canadian interprofessional rehabilitation team traveled to Rural Kenya to volunteer using Goal Attainment Scaling (GAS) to measure their therapeutic impact.

5 Description Canadian team of one SLP and three PTs traveled to Kenya for one month to provide therapy within a community based rehabilitation program. 33 patients (eight months and 60 years old) assessed and treated, from which 73 GAS goals were created. Goals were established with all patients and measured using Goal Attainment Scaling

6 Description Speech-Language Pathologist s Role 19 GAS goals created over 8 clients All pediatric clients (6 month- 10 years) Areas of goals included early language development, articulation and parent training Significant variety in caseload, most with significant neurological involvement Assessment practices included case histories, dynamic assessment, culturally appropriate informal screening activities See Carter et al (2005) for a discussion of assessment issues

7 GAS picture Child's Name

8 Results 33 clients with 72 goals (6 no shows) T-score mean: , Standard Deviation: Gas Goal Grades for All Goals 25 Frequency No Show Grade

9 Results Speech-Language Pathology Goals T-score mean across goals: Standard Deviation: client did not return for final evaluation of goals Frequency GAS Goal Grades for Language No Show Grade GAS Goal Grades for Parent Training Gas Goal Grades for Articulation Frequency No Show Grade Frequency No Show Grade

10 Conclusions The results of this pilot study provide initial support for the positive impact of short-term medical rehabilitation volunteer trips in Western Kenya on clinical outcomes as measured by GAS. It will also provide support for Goal Attainment Scaling to be trialed by other organizations to assess the impact that they make within their community-based rehabilitation programs.

11 Limitations and Future Directions Limited therapists prevented separate assessment, treatment and post-treatment evaluation roles For future trips, ideally have base-line measurements Maintenance, progression, and/or regression of clients after the team left Kenya was not possible Follow-up on future trips would help to establish longterm impact of rehabilitation interventions The success of training on the use of GAS goals with local therapists is in the process of being evaluated Therapists, despite barriers, found GAS to be a useful outcome measure and it's use brought about many positive clinical changes

12 How you can get involved Visit our website at Visit the International Centre for Disability and Rehabilitation website for other working groups partnered with rehabilitation professionals throughout the world:

13 References: Carter, J.A., Lees, J.A., Murira, G.M., Gona, J., Neville, B.G.R. & Newton,C.R.J.C. (2005). Issues in the development of cross-cultural assessments of speech and language for children. International Journal of Language & Communication Disorders, 40, Cox R, Amsters D. Goal attainment scaling: an effective outcome measure for rural and remote health services. Australian Journal of Rural Health. 2002;10: Ottenbacher, K.J., Cusik, A. (1990). Goal Attainment Scaling as a Method of Clinical Service Evaluation. The American Journal of Occupational Therapy. 44:6, Roseberry-McKibbin (2008). Multicultural students with special language needs (3rd Ed): practical strategies for assessment and intervention. Academic Communication Associates. Oceanside, CA. Suchdev P, Ahrens K, Click E, Macklin L, Evangelisat D, Graham E. A model for sustainable short-term international medical trips. Ambulatory Pediatrics. 2007;7(3):