Title

The Development of Expertise in Pediatric Rehabilitation Therapists: Changes in Approach, Self-knowledge, and Use of Enabling and Customizing Strategies

Document Type

Article

Publication Date

7-2007

Journal

Developmental Neurorehabilitation

Volume

10

Issue

3

First Page

223

Last Page

240

URL with Digital Object Identifier

http://dx.doi.org/10.1080/17518420701302670

Abstract

PURPOSE: To examine the clinical decision making of novice, intermediate, and expert pediatric rehabilitation therapists from various disciplines.

METHODS: Two qualitative studies were conducted. Thirteen therapists took part in a study using the critical incident interview technique and 11 therapists took part in a study using the 'think aloud' technique. Therapists were classified as novice, intermediate, or expert in developmental level based on a cluster analysis of data collected using a multifaceted battery of assessment tools. Data were analyzed using a grounded theory approach.

RESULTS: Expert and intermediate therapists differed from novices with respect to content, self-, and procedural knowledge.

CONCLUSION: With increasing expertise, therapists use a supportive, educational, holistic, functional, and strengths-based approach; have heightened humility yet increased self-confidence; and understand how to facilitate and support client change and adaptation by using principles of engagement, coherence, and manageability. Expert therapists use enabling and customizing strategies to ensure a successful therapeutic session, optimize the child's functioning in the mid-term, and ensure child and family adaptation and accommodation over the longer-term.