Commentary on “Perceptions of Vulnerability and Variations in Childrearing Practices of Infants Born Preterm”

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“How should I apply this information?” This international team of authors is applauded for addressing the effect of preterm birth on childrearing practices across cultural borders related to motor development. The phenomenon known as “vulnerable child syndrome” is associated with parental overprotection and childhood underachievement. This pilot study gave rise to a thoughtful discussion of this phenomenon in other world regions known for their support of physical activity. To apply this information, consideration of cultural differences in parental interaction is to be considered and clearly addressed in plans of care. For instance, the study suggests differences in the length of time parents from one culture carry their children. Plans of care are interpreted and carried out on the basis of cultural mores, which may include the nature of vulnerability. Plans of care may need to include extended family members involved in the child's care. Culturally sensitive caregiver education, both verbal and written, using meaningful terminology may be necessary. Perhaps plans of care could include referrals to others who can aid in translating across cultural paradigms including involvement with local support groups that are culturally sensitive. “What should I be mindful about in applying this information?” The authors remind us that their study contains significant limitations. Their pilot work must be viewed as preliminary and exploratory. However, despite the limitations, the study suggests that prematurity stereotyping is not exclusively a North American phenomenon. Of interest is the finding that parents whose infants were receiving therapy services perceived their infants as more vulnerable. This suggests a need for vigilance as therapists to employ strength-based assessments. These assessments are best if based on evidence and should result in measurable functional goals. Although this study focused on the preterm population, consideration of the role of culture and vulnerable child syndrome could also be relevant to cases where deficits and delays frequently overpower strengths or splinter skills. This finding gives us pause to think about the possibility of our unintentional role in parental overprotection. Future work from these authors building upon this pilot study will be very valuable to our profession, as we continue to embrace, enhance, decipher, and demonstrate cultural competency in pediatric physical therapy. Ana Carolina Mieres, MSPT, PhD University of South Florida Tampa, Florida Gillian Sadhi, DPT Clinical Faculty Practice University of South Florida Tampa, Florida