UW Medicine Valley Medical Center, Children’s Therapy (VMC-CT) has experienced difficulties with consistent service delivery schedules for their clients. Long waitlists, absences, and scheduling and insurance constraints have impeded client ability to receive standard, continuous therapy. Thus, this critically appraised topic (CAT) paper addresses a research question developed in conjunction with Kari Tanta, PhD, OTR/L, FAOTA, the Rehabilitation Manager at VMC-CT, to understand the most effective methods of service delivery: episodic therapy (i.e. high frequency over a short duration) or continuous therapy (i.e., low frequency over a longer duration). The following research question was developed: Is episodic pediatric care as effective as continuous care for children (birth to 21 years old) with orthopedic conditions or developmental delays? From a review of twenty articles and one master's thesis, it appears that this modest amount of evidence (most from children with cerebral palsy) is inconclusive regarding which service delivery model is more effective. Thus, therapists can feel confident that scheduling treatment around reasonable real-world constraints will still provide no less effective care for their clients.

Due to increased clinician concern regarding scheduling issues, Dr. Tanta felt that two knowledge translation activities would be appropriate: a concise handout outlining our CAT findings for use at a staff in-service, and a case study article from VMC-CT, combined with our CAT evidence, for dissemination to the greater clinician community. As a means of assessing the impact of this article, we will track how many times the article is accessed. Based on the results of this CAT paper, it is clear that future research should focus on a broader array of diagnoses, and clinics should seek to track outcomes after changes in service delivery.

Publication Place

Tacoma, Washington


University of Puget Sound

Faculty Advisor

George Tomlin, PhD, OTR/L, FAOTA

Project Chairperson

Publication Date



Capstone Project





Degree Program

Occupational Therapy

Degree Level

Master of Science


Occupational Therapy


University of Puget Sound

T7_Newman-page1.pdf (213 kB)
Capstone Approval