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Improvement in motor function is more likely to occur when the goals of therapy are specific and measurable and established in partnership with the child’s parents and other caregivers. Intensive amounts of physical therapy may confer no advantage over routine amounts of therapy, and long-term therapy may confer no advantage over short-term therapy. Provision of a home exercise program, with instruction of family members and caregivers in therapeutic exercises and age-appropriate activities to meet the child’s goals, is generally indicated. This program can include recommendation of participation in sports to increase endurance, strength, and self-esteem in a natural setting with peers. Aquatic therapy, hippotherapy (horseback-riding therapy), and participation in karate, gymnastics, and dance classes in integrated or special classes also can be considered to meet the child’s therapeutic goals. Parent and caregiver education by all therapists is critical in effective partnerships with families for imple-mentation of therapy programs. Some programs such as patterning have little ef-on functional skills and are inappropriate for children with motor disabilities. Scientific legitimacy has also not been established for sensory integration intervention for children with motor disabilities. Prescribing therapy services for children with motor disabilities clearly cannot be based entirely on sound scientific evidence. As the knowledge base is expanded related to the effectiveness of therapy interventions, evidence-based practice described as using the best available evidence, along with clinical judgment, and taking into consideration the priorities and values of the individual patient and family in a shared decision-making process, as outlined by the Institute of Medicine, is advised.

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