August 2014

Click on image to Download the complete supplement in its original form PDF

Click on image to Download the complete supplement in its original form PDF

A matter of timing


1Limb-Jordana-nolabel-100x100If an intervention has the potential to treat or prevent lower extremity issues in a child, clinicians and parents are naturally inclined to implement it as early as possible. It makes sense intuitively, and in many cases early intervention is supported by published evidence. But in other cases the picture is less clear.

New research, for example, suggests that early intervention to improve gross motor skills in children with autism spectrum disorder may have the added benefit of helping those children achieve social and behavioral milestones (see “Early focus on gross motor skills may benefit children with autism”). But all that’s actually been established so far is an association between motor skills and social-communicative skills; the potential benefits of early intervention remain hypothetical at this point.

A number of researchers believe that rates of anterior cruciate ligament (ACL) injuries in teens and young adults can be further reduced if preventive training programs are introduced well before puberty (see “Prevention of ACL injuries targets youngest athletes”). Establishing low-risk mechanics at an early age, they suggest, will make it easier for young athletes to maintain or relearn those mechanics after maturational changes have begun to undermine them.

But other experts believe there’s little advantage in implementing training before a child has demonstrated a need for it. And while all agree adult-based training programs need to be adapted for younger children, nobody is quite sure of the best approach.

In some populations, early intervention may not turn out to have an added benefit. In others, early intervention may be an idea ahead of its time. Either way, LER:Pediatrics will keep you informed.

By Jordana Bieze Foster, Editor



  • Prevention of ACL injuries targets youngest athletes

    Some evidence suggests that neuromuscular training before puberty can help further reduce anterior cruciate ligament (ACL) injury rates. But young children respond differently to instruction than their older counterparts, which means early intervention requires some creativity.

    By P.K. Daniel

  • Outcome studies continue to support Ponseti method

    Clubfoot researchers have begun to report long-term data that continue to solidify the superiority of the conservative method over surgical intervention in most cases. But variations to the traditional Ponseti method are arising, particularly in developing countries, and may alter outcomes.

    By Larry Hand


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