What are Some Therapy Options?
General Comments on Therapy Services
Children may receive specialized assessments by therapists to help determine prognosis or need for treatment. These assessments may be performed by therapists in a clinic, hospital, early intervention program or at a school. Some therapies focus on gross and fine motor skills, some focus on activities of daily living, some on communication and others on developing recreation or vocation. Assessments and interventions will focus on range of motion, strength, motor control, balance, coordination, functional skills, endurance and mobility, including walking (gait). Following medical or surgical treatment, therapy can enhance motor function and speed recovery. This may include instruction in methods to transfer in and out of bed, use of equipment such as braces, splints, wheelchairs, walkers and exercises for stretching, strengthening and improving function. Therapy programs may be recommended to optimize communication and feeding.
As children age, the focus of therapy changes. For example:
Children with cerebral palsy are delayed in acquisition of motor skills to varying degrees, but usually reach their maximum potential for independent mobility by age 6. The focus of therapy changes from development of motor skills to promotion of health and achievement of independence with adaptations as needed.
Short-term intensive therapy is often used to address specific issues such as recovery from surgery, self-care and use of technology.
As children grow and develop, the need for individual therapy is reduced. They may become more responsible for performing individual exercises, and activities to move toward their goals. Therapists can design a home or school program incorporating education, recreation, social inclusion and participation in extracurricular activities (e.g. athletics). When possible, activities should be enjoyable and lay the foundation for lifelong health, function and participation. It is important to realize that the therapist should be considered a ‘coach’ and continued work at home will lead to the best result.
As individuals mature, they may require support services such as personal assistance services, educational and vocational training, independent living services, counseling, transportation, recreation/leisure programs and employment opportunities, all essential to the developing adult.
People with CP can go to school, have jobs, get married, raise families and live in homes of their own. Most of all people with CP need the opportunity for independence and full inclusion in our society.
A physical therapist will focus on helping children with strength, balance, flexibility, and the coordination required for motor skills and functional mobility including rolling, sitting, crawling, and walking. They also select, fabricate, modify and train children and families in the use of adaptive equipment.
Occupational therapists focus on the development of fine motor skills and on optimizing upper body function and improving posture. An occupational therapist helps a child master the basic activities of daily living, such as eating, dressing, and using the bathroom alone. Fostering this kind of independence boosts self-reliance and self-esteem and also helps reduce demands on parents and caregivers. They can also address difficulties with feeding and swallowing. They will use exercise, facilitated practice, alternative strategies and adaptive equipment to promote independence.
Speech and Language:
Speech and language therapists (also known as speech therapists or speech-language pathologists) diagnose and treat the communication disorders associated with CP. They use a program of exercises to teach children how to overcome specific communication difficulties. A speech therapist works with your child on the receptive (understanding) part of speech and language as well as the expressive part. Speech therapist help improve your child’s ability to speak clearly or communicate using alternative means such as an augmentative communication devise or sign language. They may also help with difficulties related to feeding and swallowing. Speech interventions often use a child’s family members, teachers and friends to reinforce the lessons learned in a therapeutic setting. This kind of indirect therapy encourages people who are in close daily contact with a child to create opportunities for him or her to use their new skills in conversation, learning and play.
Psychologists can help children and families cope with the special stresses and demands of CP. In some cases, psychologist may also oversee therapy to address unhelpful or destructive behaviors. The two most common forms of therapy that psychologists provided for children with cerebral palsy are behavior therapy and cognitive therapy. Psychologists may also evaluate cognitive function such as evaluation for learning disability, intellectual disability, ADHD and autism.
Vision and Hearing Aids:
Depending on how your child’s eyes are affected, he or she may need eyeglasses or surgery to correct vision. Some children will benefit from consultation with a vision specialist to determine what types of adaptions in their environment will optimize the use of their visual skills. This is particularly important for children with visual field defects, cortical vision impairments and low vision.
Hearing aids may help correct hearing problems and children with hearing impairment should be followed by an audiologist who can monitor hearing status and prescribe/adjust hearing aids. Consultation with a hearing specialist may be important to determine environmental modifications in the classroom and home environment that will help the child with impaired hearing have optimal function.
A variety of orthotics, braces or splints, may be recommended for your child. These may be used on your child’s legs, arms, hands or trunk. Some of these supports are used to help function, such as improved walking, sitting or standing. The purpose of other types of orthotics is for additional stretching or positioning of a joint.
Is it cerebral palsy or something else?
Visit the My Child Without Limits support community and find the resources you need to get answers.
Dystonia Medical Research Foundation
Metachromatic Leukodystrophy Foundation
Pelizaeus-Merzbacher Disease Foundation