Irene León

Objective: To evaluate the psychometric properties of the Parental Education in Physiotherapy (PEP) scale, designed to assess the extent to which pediatric physiotherapists implement family‐centered educational practices and caregiver education strategies for families of children under 6 years of age. Methods: This is an instrumental cross‐sectional study based on a digital survey targeting physiotherapists in Spain. A sequential cross‐validation procedure was applied by randomly dividing the total sample ( N = 310) to two equivalent subsamples ( n = 155/155). The final 8‐item set was selected in Subsample 1 based exclusively on the EFA results and theoretical considerations, before the CFA results were examined. The prespecified 8‐item, 3‐factor structure was subsequently evaluated through CFA in Subsample 2. The CFA was estimated using diagonally weighted least squares (DWLS). Convergent validity evidence was examined using average variance extracted (AVE), and discriminant validity evidence was examined using inter‐factor correlations, while associations with the use of technological devices for motor tracking were analyzed as an exploratory external comparison. Internal consistency was estimated using reliability coefficients appropriate for ordinal data. Results: A total of 310 physiotherapists participated (mean age = 36.4 years; 87.4% women). The final 8‐item, 3‐factor model (Collaboration, Capacity‐Building, and Reflection) showed excellent fit (CFI = 1.000, RMSEA = 0.011, SRMR = 0.031), AVE values above 0.50 in all three factors (0.587–0.771), and latent factor correlations below 0.85 (0.40–0.64). Internal consistency was adequate for the three subscale scores. Reliability coefficients for the total composite score were also reported descriptively, although a global factor was not evaluated. Conclusion: The PEP is a brief measure with promising initial psychometric properties for describing and reflecting on family‐centered educational practices and caregiver education in pediatric physiotherapy. Its three‐dimensional structure and digital format may facilitate professional reflection, training, and quality‐ improvement initiatives within family‐centered care models.

Participation in everyday routines (e.g., mealtimes, bedtime, dressing) is a key context for early development and a central focus of early childhood intervention. This study examined the internal structure, reliability and construct validity of the Measure of Engagement, Independence and Social Relationships for children aged 3–5 years (MEISR 3–5) within home routines. The sample included 705 children aged 36 to 72 months (M = 51.01, SD = 10.07) receiving early childhood intervention services across Spain. A confirmatory factor analysis based on McWilliam's theoretical functional domains—engagement, independence and social relationships—showed acceptable global model fit and very high internal consistency. However, convergent validity was only partial, and discriminant validity was not supported, indicating substantial overlap amongst domains. To further examine the dimensionality of the instrument, parcel‐based analyses were conducted in a subsample ( n = 553) and compared correlated three‐factor, two‐factor, bifactor, second‐order and unidimensional models. All models showed equivalent and excellent fit. Bifactor indices ( ωh ≈ 0.98; ECV > 0.90) indicated that most reliable and common variance was attributable to a dominant general participation factor, with minimal unique variance remaining for the specific domains. These findings suggest that the MEISR 3–5 functions as an essentially unidimensional measure at the psychometric level. The total score appears to provide the most robust quantitative indicator of children's participation in home routines, whereas domain‐level scores are better interpreted as clinically descriptive dimensions that can inform goal setting, intervention planning, and progress monitoring in routine‐based practise.

Given the scarcity of specific instruments to assess parental education in pediatric physiotherapy, this study developed the Parental Education in Physiotherapy Scale (Spanish acronym, EPF) and calculated its preliminary psychometric properties, acceptability, and feasibility. A cross-sectional instrumental study was conducted: the EPF was designed based on a specifications matrix and validated by expert judges in two phases. Then it was administered digitally to 63 physiotherapists experienced in treating children under six years of age. They rated it on a 4-point Likert response scale, and qualitative observations on its clarity, usefulness, and acceptability were collected. The validation showed adequate content validity (I-CVI ≥ 0.86; 31/32 items had I-CVI = 1.00) and high inter-judge agreement (global W = 0.659; p < 0.001). In the pilot study, exploratory factor analysis identified three factors (Collaboration, Capacity-Building, and Reflection) that explained 59% of the variance. After refining it, the final version comprised 18 items, showing high internal consistency (ordinal α = 0.944, ω = 0.934). Acceptability was high (100% found it useful; 98.4% said it facilitated reflection; 95.2% found it clear). Overall, the EPF provides preliminary evidence of validity, internal consistency, acceptability, and feasibility, although larger samples and additional analyses are required for its consolidation.

Background/Objectives: International guidelines recommend the combined use of the General Movement Assessment (GMA), Hammersmith Infant Neurological Examination (HINE), and magnetic resonance imaging (MRI) to support early and accurate diagnosis of cerebral palsy (CP). However, their implementation remains inconsistent. This study aimed to map their reported global use and identify associated enablers and barriers. Methods: A scoping review was conducted following JBI and PRISMA-ScR guidelines. Systematic searches were performed in PubMed, Cochrane, PEDro, ProQuest, Web of Science, and Scopus. Eligible studies were charted and thematically analyzed, focusing on tools use and implementation factors at individual, organizational, and system levels. Results: Fourteen articles (seven surveys, seven implementation studies) from seven countries met the inclusion criteria. While awareness of GMA, HINE, and MRI was generally high, routine clinical use was limited—particularly outside structured implementation initiatives. Major barriers emerged at the system level (e.g., limited training access, time constraints, lack of standardized referral pathways) and social level (e.g., unclear leadership and coordination). Conclusions: The limited integration of GMA, HINE, and MRI into routine practice reflects a persistent “know–do” gap in early CP detection. Since implementation is shaped by the dynamic interplay of capability, opportunity, and motivation, bridging this gap demands sustained and equitable action—by addressing system-wide barriers, supporting professional development, and embedding early detection within national care pathways.

Background/Objectives: Family perceptions of family-centered services are important for improving processes and outcomes of services for children with disabilities or developmental risk. The Measure of Processes of Care 20-item version (MPOC-20) assesses family-centered practice from parents’ perspectives. This study examined for the first time the psychometric properties of the first Spanish version of the MPOC-20 in children with disabilities aged 0–18 years. Methods: A total of 659 families from 51 care services across Spain completed the MPOC-20, with participants randomly divided into two samples: one for exploratory factor analysis (EFA) and the other for confirmatory factor analysis (CFA). Results: The results confirmed a two-factor model, with the best fit for the dimensions of providing comprehensive and supportive care and providing information. Internal consistency analysis indicated strong reliability of the factor scores. Conclusions: The Spanish version of the MPOC-20 demonstrated good psychometric properties and is recommended for assessing the quality of family-centered services.

The most used assessment tool to measure family-centered care and the perception of the care process is the Measure of Processes of Care questionnaire. This study aimed to evaluate the psychometric properties of the Spanish version of the MPOC-SP, specifically by assessing the reliability of its item scores, testing whether its factor structure aligns with the original version, and examining differences in scores across professional profiles. The Spanish-adapted MPOC-SP questionnaire was completed by 278 early childhood service professionals across Spain. Analyses assessed internal consistency, construct validity through confirmatory factor analysis, and differences in scores across professional profiles. The Spanish MPOC-SP demonstrated strong psychometric properties, with Cronbach's Alpha values above 0.70 for total and dimensional scores. Confirmatory factor analysis supported the alignment of the data with the specified model. No significant differences in scores were found across professional profiles, indicating consistency in its application. The Spanish version of the MPOC-SP is a reliable and valid instrument for assessing family-centered care. It provides valuable insights for evaluating and improving family-centered practices in early childhood services, thereby contributing to the enhancement of care quality.

Family-centered services are the recommended early intervention approach to develop and deliver services for children with disabilities and their families. This systematic review aims to identify and highlight what barriers service providers in family-centered early intervention perceive that prevent them from providing high-quality services focused on the family and the child's overall well-being. We identified 37 articles that met the selection criteria of the first initial search of 1858 articles. These studies provided insights from both service providers and families. The identified barriers were categorized into eight dimensions: family, child, knowledge, and application of the approach/model, professional beliefs, natural environment, service coordination, working conditions, and current legislation. The main barriers identified were family barriers, insecurities perceived by professionals and difficulties in their ability to provide services, changes in their attitudes and behaviors when they perceive that they are losing their role as experts, lack of knowledge and application of specific practices, and lack of skills needed to engage primary caregivers in natural settings. These findings should inform policy implementation at local and state levels in countries where family-centered service is established in early childhood programs.

Purpose. This study aimed to: (a) translate and cross-culturally adapt the Hammersmith Infant Neurological Examination (HINE) into Spanish; (b) evaluate its intra- and inter-examiner reliability; (c) support a knowledge translation and tool implementation program in early intervention; and (d) evaluate its reliability and implementation for professionals one year after receiving training. Materials and methods. The translation followed the World Health Organization’s recommendations. Reliability was assessed in 25 infants aged between 3 and 15 months with identifiable risks of cerebral palsy (CP). The implementation was also evaluated by analyzing the reliability of professionals without previous experience of the tool by using a pre-survey and a follow-up survey one year after training. The survey covered aspects related to the use of early detection tools of CP and the use of HINE, including attitudes, opinions, and perceptions. Results. An excellent intra- and inter-examiner agreement was obtained for the total score of the HINE intra-class correlation coefficient (ICC = 0.98 in both indices). One year after training, the professionals also showed excellent reliability values (ICC = 0.99), as well as an increase in sensitization and skills in evidence-based practices for the early detection of “high risk” of CP. Conclusions. The Spanish version of HINE is a reliable measure for the neurological evaluation of “high risk” of CP and can be administered after standardized training and without costs to acquire the evaluation. This allows its accessible and widespread implementation in the clinical context.