Publication Date

Spring 2015

Document Type

Project Summary

Degree Name

Doctor of Physical Therapy


Physical Therapy

First Advisor

Russell E. Carter, PT, Ed.D.

Second Advisor

Ann W. Jackson, PT, DPT, MPH

Third Advisor

Roberta O'Shea, PT, DPT, Ph.D.


Background: Although many pediatric patients with non-progression conditions utilize rehabilitation services, clear pathways towards transitioning away from direct service aren’t adequately addressed in the literature. A number of established frameworks for clinical and ethical decision making can be utilized.

Purpose: The purpose of this case report is to illustrate the application of established frameworks in the literature to a particular case of a nine-year-old female patient with mild spastic hemiplegic cerebral palsy receiving weekly home-based physical therapy services, in which the ultimate decision was to reduce services, highlighting the utility and limitations of such an application.

Case Description: This case is a nine-year-old Caucasian female with mild spastic hemiplegic cerebral palsy receiving weekly physical therapy services in her home.

Outcomes: The clinical decision-making process based on the literature and employed in the study was considered successful due to agreement of clinical expertise, supporting relevant literature, and acceptance to implementation by the established stakeholders, including patient and family.

Discussion: The utility of the clinical and ethical frameworks in successfully guiding clinical decision-making were illustrated in this case.