Advanced Clinical Reasoning for Pediatric Upper Extremity Conditions

The treatment of upper extremity pediatric conditions can be complex and challenging for therapists. Analyzing these conditions requires a good knowledge of development, anatomy and biomechanics to understand the underlying problems. In order to help the therapist plan and focus treatment, this course will outline a clinical problem solving framework that includes identifying the systems involved (skin, fascia, muscle, tendon, nerve, bone), defining the primary limiting factor(s), noting the developmental ramifications and addressing the resulting functional deficits.

Instructors will show how to use this framework to analyze, problem solve and plan treatment for various pediatric upper extremity diagnoses including distal hand conditions, orthopedic upper extremity trauma, neuromuscular involvement, sports injuries/overuse injuries and persistent pain/complex regional pain syndrome. Attendees will learn soft tissue treatment techniques, proximal handling techniques to gain distal motion, postural/core strength assessment & treatment, neuro-mobilization techniques, CRPS treatment techniques, and discuss appropriate use of casting/orthoses.

The course will use break out sessions, lab practice time, small group discussions of sample cases and quiz-show style questions and answers to facilitate new clinical reasoning skills for the attendees.

Required pre-requisites: attendance at Pediatric Hand Therapy and Orthotic Intervention (Splinting) for Musculoskeletal Conditions OR current experience with common pediatric hand conditions and a good working knowledge of UE anatomy.

This course content is not intended for use by any participants outside the scope of their license or regulation.

Course Objectives:

At the end of the course, the attendee will be able to:

  • Identify one of the systems that may be contributing to the primary limiting factor for a patient diagnosed with sports/overuse injury 
  • Demonstrate 2 soft tissue mobilization techniques that would be appropriate for a patient diagnosed with orthopedic upper extremity trauma
  • Demonstrate 2 movement strategies to help gain distal motion in a patient diagnosed with cerebral palsy
  • List 2 treatment techniques that would be appropriate to utilize for a patient with camptodactyly.
  • Given a case scenario, choose 3 treatment modalities to address persistent pain in a pediatric patient
  • Identify 3 elbow issues that might interfere with gaining full motion after an elbow injury or fracture
  • Identify a secondary problem and develop a treatment plan for a patient diagnosed with brachial plexus injury

CE Credits

13 contact hours

This course is accepted by many professional credentialing organizations and state professional regulatory boards. Rules and regulations change frequently without notification, and apply differently to live and online courses. Please check with your state board to confirm accuracy of this list and acceptance of contact hours. Certificate of Attendance will be issued to all participants upon completion of the course and may be used for CEU verification of credits. CE credits vary by state. Please check with your state board/certifying agency to confirm conversion of contact hours to CE. See links below.


Physical Therapy Board of California: The Physical Therapy Board of California recognizes Rehab Education, LLC as an approval agency to approve providers offering continuing competency courses for CA licensed PTs and PTAs. This course is approved for 13 contact hours.

New Jersey State Board of Physical Therapy Examiners: This course has been approved by the New Jersey State Board of Physical Therapy Examiners for 13 continuing education credits, Approval #2001-75. (Course must be taken between 03-24-2020 and 01-31-2022).

NY State Physical Therapy Board: Rehab Education, LLC is recognized as an approved provider of PT and PTA continuing education by the NY State Education Department Board of Physical Therapy. (Course must be taken prior to 05-10-2022)

American Occupational Therapy Association (AOTA) Approved Provider #6177:

Federation of State Boards of Physical Therapy (FSBPT): Federation of State Boards of Physical Therapy (FSBPT): Federation of State Boards of Physical Therapy (FSBPT) / ProCert has awarded certification in the amount of 10 Continuing Competence Units (CCUs) to this activity. Approved CCUs are a unit of relative value of an activity based on its evaluation against a rigorous and comprehensive set of standards representing the quality of an activity. The CCU determination is a valuation applying many factors including, but not limited to, duration of the activity. No conclusion should be drawn that CCUs correlate to course hours. (Course must be taken between 12-31-2019 and 12-30-2021) Please check with your state physical therapy board to determine if they currently accept the Federation of State Boards of Physical Therapy (FSBPT) certification.

  • AOTA Approval States

    These states currently recognize AOTA Approved Providers for OT continuing education either in regulatory language or by formal written communication to AOTA:

    District of Columbia
    New Hampshire
    New Mexico
    New York
    North Carolina
    North Dakota
    Rhode Island
    South Carolina
    South Dakota

    *Disclaimer: Rehab Education LLC provides this list for your convenience. At the time of listing, the following state boards accept courses by virtue of approval by other organizations. It is the responsibility of the participant registering for a course to check with their state board to confirm rules and regulations regarding acceptance of contact hours for live and online courses.

    The following PT Boards accept courses approved by other state PT boards or APTA state associations*:

    North Carolina

    The following PT Boards accept courses approved by other APTA state associations*:

    Rhode Island

    The following PT Boards accept courses provided by AOTA approved providers*:

    District of Columbia
    Rhode Island

    *NBCOT…National Board for Certification of Occupational Therapy (view PDU requirements)

    +HTCC… Hand Therapy Certification Commission  (view recertification requirements)
    Hand Therapy Certification Commission (HTCC): This course is accepted by HTCC towards re-certification.

    State PT Boards
    State OT Boards

Day One

7:30-8:00 Registration/Continental Breakfast
8:00-10:30 Advanced clinical reasoning concept introduction: evaluation basics, systems identification & primary limiting factors (130 min lecture & 20 min. lab practice: Developmental ramifications)
10:30 – 10:35 Break
10:30-12:30 Anatomy/biomechanics of the upper extremity & composite movement patterns
(85 min lecture & 20 min lab practice: Facilitation of simple composite movements)
12:30-1:30 Lunch on your own
1:30 – 2:30 Analyzing and advanced treatment for orthopedic trauma to the upper extremity (50 min lecture and 1 case scenario)
2:30-3:30 Analyzing and advanced treatment for soft tissue and scar restrictions (45 min lecture & 15 min demo and lab practice: Instrument assisted soft tissue mobilization)
3:30-3:45 Break
3:45 – 5:00 Analyzing distal hand conditions (50 min lecture & 10 min for 1 case scenario: identification of systems and limiting factors)

Day Two

7:30 – 8:00 Breakfast and Networking
8:00-9:30 Analyzing and advanced treatment for neuromuscular upper extremity conditions (90 min lecture)
9:30-10:45 Analyzing and advanced treatment for persistent pain and CRPS (complex regional pain syndrome) (65 min lecture & 10 min lab practice of pain management techniques)
10:45-11:00 Break
11:00-12:15 Analyzing sports injury/overuse conditions (55 min lecture & 20 min lab practice: Core assessment, kinetic chain & facilitation of complex composite movements)
12:50 – 1:50 Lunch
1:50 -2:30 Advanced clinical reasoning solidification (75 min small  group discussion of 3 case scenarios)
2:30-3:00 Post-test game-show style quiz. Complete evaluation forms


Catherine Brooks, MPH, OTR, CHT

has been practicing as an Occupational Therapist since 1989. With a career started in New York City at Hospital for Special Surgery, Catherine has extensive experience with pediatric orthopedics, developmental pediatrics and, specifically, Cerebral Palsy. Catherine has presented several research projects and taught instructional courses at peer –reviewed meetings including AAOS, AACPDM and ASSH. Catherine completed the 8 week pediatric NDT (Neurodevelopmental Training) course in 1996 and qualified as a CHT in 1998, bringing together her interests in both pediatric and Upper Extremity rehabilitation. Now based in Southern California, Catherine has worked in adults and pediatrics at UCSD, Children’s Hospital of San Diego and Kaiser Permanente.

Classes taught by Catherine Brooks:

Jill Peck-Murray, MOT, OTR/L, CHT

 jill-peck-murray is a pediatric hand therapist. She worked as an occupational therapist/hand therapist at Rady Children’s Hospital in San Diego, CA from 1982 through 2017. During these 35 years, she gained expertise with special skills in creative splinting/orthotic intervention and developed the hand therapy program for the hospital.

She is currently devoting her time to sharing her knowledge with the therapy community by teaching continuing education courses. She has been teaching Pediatric oriented CE courses nationwide through Rehab Education, LLC since 2007.

Jill has authored numerous journal articles, chapters on pediatric splinting/orthotic intervention in “Orthotic Intervention for the Hand and Upper Extremity” and “Foundations for Pediatric Occupational Therapy”.  She has also co-authored a book entitled “101 Creative Therapy Ideas.

She has presented at annual conferences for professional organizations  (AOTA, ASHT and OTAC).  She is currently the President of the San Diego Hand Special Interest Group.

Classes taught by Jill Peck-Murray: