To Örebro University

Introduction To support clinicians who treat children with upper-limb differences, we must first understand how these children are treated around the world.

Study Design A descriptive survey was carried out in this study.

Objectives The aim was to describe how treatment for children with upper-limb difference is provided in different parts of the world.

Methods A web-based survey was used to gather data. The survey was shared on the Handsmart website, through providers and members using snowball sampling.

Results Sixty-eight respondents from 18 countries, with most being occupational therapists and prosthetists, participated. All respondents reported that they provide prosthetic treatment and most fit a passive prosthesis before 1 year of age.

Respondents from 13 countries reported having governmental funding for the provision of care for people with upper-limb loss. Intervention is guided by the presentation of the limb as well as availability of funding and other resources. In 12 countries, no treatment other than fitting of prostheses is provided for the children. The children who do not receive a prosthesis continue to see an occupational or physical therapist for other treatment (other devices, follow-up). Respondents stated that they would like to see clear treatment guidelines used by multidisciplinary teams to fit children and that treatment should include regular follow-up.

Conclusions Children are treated differently in various parts of the world based on different funding, family support, and therapy resources. Further studies should encompass a geographically representative sample of children’s clinics.

Clinical Relevance This study provides information regarding treatment practices for children with upper-limb loss/difference in various parts of the world; prosthetic treatment is common for children, although ages for fitting vary among clinics and countries. Results will contribute by supporting clinicians to provide better treatment for children with upper-limb loss/difference.