Communication between physician and physical and occupation therapists: a neurodevelopmentally base prescription.

Children with neuromuscular handicaps require the coordinated services of physicians and physical and occupational therapists. Physicians must be familiar with at least one therapy framework along with its major treatment techniques in order to understand how therapy can help a specific child and to follow the child's progress. The physician can use the same framework to structure his or her own motor system observations. Physician-therapist coordination is formalized in a written referral communication (prescription) which must be logical and clear. It should include these six elements: diagnosis, family picture, description of observed movement abnormalities, functional goals, precautions, and intensity of therapy. The description of movement abnormalities can be based on neurodevelopmental treatment principles. Such a description will contain information on three focal areas: postural tone, movement patterns, and reflexes and reactions.