13 July 2013

Breakthrough in Stem Cell Research

Recent research has resulted in a bakthrough, with a team in Germany successfully treating a child with cerebral palsy. The young boy, referred to as L.B, had been in a continuous vegetative state since suffering a cardiac arrest in November 2008.

Paralysed with severe brain damage and in a vegetative state, L.B. and his parents believed that his chances of survival were minimal. Up to then, doctors believed his infantile cerebral palsy was untreatable, with hopes founded on finding a way to manage his condition.

However, his parents began an extensive search to find possible treatments which may improve his chances of survival; this led to them contacting Dr Arne Jenson regarding his advancements in stem cell treatments.
Using their son’s umbilical cord blood, frozen at his birth, doctors administered the altered stem cell version of his blood, directly back into his veins and studied the changes in his brain cells. Belief being that the stem cells would migrate and repair the damaged bran tissue.

In the months following his treatment, L.B’s symptoms improved drastically; his muscle spasticity decreased significantly, with further improvements in his speech and movements. Further along his treatment, it is reported that L.B. is able to eat without assistance, speak in small sentences and with help walk.

This new research will give hope to those suffering from Cerebral Palsy and their families. However, pioneering treatments such as these can often come with associated costs, especially as overseas travel may be involved. Making a claim for cerebral palsy compensation can help alleviate any financial pressure, allowing families to invest in a chance at recovery.

If a child suffering from cerebral palsy, experienced avoidable medical negligence during their birth, then the hospital involved may be liable to cover the cost of their continuing care. For more information visit http://www.asons.co.uk or call 01204 521 133.

Research by: Dr Arne Jensen and his colleague Professor Eckard Hamelmann of the Department of Paediatrics at the Catholic Hospital Bochum, their success is reported in the journal ’Case Reports in Transplantation’.

ASONS Solicitors

At Asons Solicitors we deal with a wide variety of Medical Negligence cases ranging from pressure sores, through to cerebral palsy and ectopic pregnancies. If you've been affected by poor medical treatment, contact us today.


07 June 2013

Do You Have a Valid Birth Injury Claim? Medical-Negligence.com

Negligence-related birth injury cases are quite rare in the UK, affecting less than 0.01% of the 700,000 women who give birth in NHS hospitals. Unfortunately these cases are often so severe that the resultant injuries to the child cause permanent disablement, for which over half will require further surgery to improve quality of life long-term and 24-hour care. Birth injury compensation can often help in such instances, offering peace of mind for parents that they can at least cover both medical and care costs during their child's early years.

At Medical-Negligence.com, we offer a free claim assessment service to anyone who feels their child may have been affected at birth by the negligence of a medical professional, without cost or obligation. Our highly experienced birth injury specialists can also help you to understand the litigation process with tailored advice based on the unique circumstances of your case. Visit us at Medical-Negligence.com for advice concerning your legal entitlement to claim, or to arrange a no obligation case assessment.

Record Payouts For Birth Injury Claims

The birth of a child is a wondrous moment, and thanks to the consistent standards of care provided by midwives and doctors, is usually without serious complication. But, recent statistics for 2012 published by the National Health Service Litigation Authority (NHSLA) suggests that hospital negligence is becoming a more widespread problem, with 100 birth injury claims filed last year alone for medical negligence and error. According to press reports, funds to the sum of an additional £185 million were also granted to the NHSLA in February 2012 to help cover the costs of high-value claims for Cerebral Palsy and birth brain injury; the average settlement being around £6 million due to lifetime care and medical costs.

Reasons cited for the increase in high-value claims vary considerably. Health professionals are of the belief that a growing awareness of legal rights and no win no fee claims has prompted a greater number of patients to pursue legal action than ever before, whereas medico-legal experts attribute the problem to staff shortages. The latter would appear to hold some truth given recent estimations by the Royal College of Midwives. Based on findings for 2009-2010 and 2011-2012, the RCM predicts that an additional 3,000 midwives are currently needed to cope with the burgeoning number of births in UK hospitals. And with estimates putting the figure at as many as 20,000 additional births each year for the next decade, the current ratio of midwives to annual births will be unsustainable long-term.

Conditions Associated With Negligence At Birth

“Birth injury” collectively refers to a group of disorders often seen in cases where medical professionals are found to have been negligent in the handing of a difficult labour. One of the most common is Cerebral Palsy; a group of conditions which affect motor skills, co-ordination and posture. Whilst there is no known cause for the condition in unborn infants, our solicitors have encountered many cases where doctors have failed to pick up on signs of the baby in distress, leading to oxygen deprivation.

Failures prior to labour can also present significant problems for an unborn child, particularly if the baby is far larger than expected and vaginal delivery is more difficult. Larger babies are often susceptible to shoulder dystocia, which is caused by the anterior shoulder getting stuck behind the pelvic bone. A Caesarean or episiotomy will usually be ordered to prevent the likelihood of the child becoming stuck during labour, which in turn can lead to injury to the Brachial Plexus if the use of forceps is required, as well as oxygen deprivation due to the process taking far longer than it should. These are failures which, medically, can often be prevented with consistent monitoring, diagnosis and planning, and will usually be grounds on which a claim can be filed.

Do You Have a Claim?

In order to qualify for no win no fee assistance, and have any hope of a successful outcome, there are several criteria which must be satisfied at the time of application. Firstly, there must be sufficient proof that a medical professional has breached his/ her duty of care to the patient, be this through malpractice, error or negligence.

Secondly, it must be demonstrated that no other causal link than this breach in duty could have led to the patient's injuries. Naturally, we don't expect you to be able to gather the required evidence necessary to prove your case, and in many cases, we are able to corroborate these details with a quick claim assessment when you contact us.

If you think you may have grounds for a claim following a mismanaged or difficult labour, and would like tailored advice regarding your options, book a consultation with one of our birth injury specialists via our website Medical-Negligence.com, or call us directly on the dedicated number provided.

03 April 2013

Cerebral Palsy compensation claims

Cerebral Palsy is a devastating injury which occurs at some point early in life, either while the baby is still growing in the womb or shortly afterwards when something disturbs the normal development of the brain or injures the brain tissues. The condition affects the nerve signals between the brain and the muscles and results in the baby or young child having difficulties with movement, posture and coordination. There are differences in severity, so some have only mild disabilities with others more severe.

Sadly it is relatively common, affecting as many as one in every 400 children; so as many as 2,000 babies are diagnosed with Cerebral Palsy every year. Whilst there is no cure for the condition, there are many treatments and therapies that can be used to reduce the impact it has on an individual’s life.

Every year there are compensation claims taken against the NHS relating to Cerebral Palsy due to Medical Negligence and Clinical Negligence. Late last year the family of a young boy won a case against the Princess Alexandra Hospital in Harlow after he was diagnosed with Cerebral Palsy following complications with his birth. The NHS has admitted liability, accepting that an earlier delivery of the baby would have avoided injury and Cerebral Palsy. The boy is likely to need 24-hour care for the rest of his life and his family has been granted an interim compensation payment of £150,000 while his care package is being worked out.

The amount that a successful claimant is likely to receive varies according to many different factors. These include previous financial settlements which bear similarities to the case in question, the extent of the disability, the pain and suffering already experienced and calculations on the level of care needed for the future. It is therefore an amount which is not an exact science. It is not directly calculable and involves the court, to some extent, looking ahead to see how the child will be affected in the near and distant future.

Damages or compensation are divided into two main categories named general and special. General damages are those items which are not exactly quantifiable, such as pain and suffering which we have already mentioned. No receipts or invoices can be produced to show how much the suffering is worth. Therefore the judge in the case has to assess the level of damages based on their previous experience and after listening to submissions from either side.

Special damages are those items that can be calculated exactly and for which receipts and invoices can be produced. So the cost of care, any special equipment that has to be purchased and loss of earnings all fall into this category. For this reason anyone wanting to make a claim would be well advised to keep any bills, receipts etc so they can claim for any outlay incurred.

Interest will be added in a Cerebral Palsy claim onto both general and special damages, though the rules are quite complex. Also, as we have seen in the Harlow case mentioned above, interim compensation may be awarded in some cases. This is where the defendants - in Cerebral Palsy cases usually an NHS trust - have admitted liability or have been found guilty but a compensation figure has not yet been agreed.

Therefore the claimant will get damages and usually a sizeable amount, but it has not yet been clarified. The interim figure will provide an amount to cover them until the case is brought back before the court. It is mainly applied in larger claims which can take some time for a final figure to be decided upon.

24 August 2012

The prospects of treating teens and adults

By Natan Gendelman D.O.M.P  |  http://www.healthinmotionrehab.com  |  http://www.enabledkids.ca

Having worked with children for over 23 years, I’ve had many people come to me for information and advice on treatments that are suitable for teenagers and adults. It’s important to realize that if a loved one is diagnosed with a neurological condition, age can be a primary factor that influences how treatment may be approached as well as the number of treatment programs that are made available. This may be due to a person’s age and how others perceive his prospects for improvement and/or recovery. However, it is important to note that when treating an individual with a neurological condition, nothing is set in stone regarding his potential for improvement. Whether a person is a teen or an adult, his brain has the ability to form new neural pathways (also known as neuroplasticity) which can lead to great improvements in his function.

 For these reasons, it is crucial to understand your loved one’s condition and how that should influence what you should look for in treatment. In doing so, you will be better equipped with knowledge to help him on the road to independence.


Looking at bone formation in teens and adults up to 25-26 years of age

As the first step to understanding your loved one’s condition, it’s important to realize that up until the age of 25-26, the body is still in the process of growing. At this time the ossification and calcification of bones in the body has not yet finished, and you may be able to correct the positioning of joints to help the body gain and improve its function. Depending on a patient’s condition, during this time it is often possible to release the tissues around the joint and normalize its position for increased mobility.


Improving independence for adults 26 and over

Now, once a person passes the age of 26, the growing process has already finished. Since the ossification and calcification of the bones is done, unfortunately you cannot correct and completely normalize the bone’s position since it has already been set. However, at this stage it is still possible to treat a patient and improve the flexibility and mobility of his joints.

Of course, despite any differences between these two stages, the goal of treatment remains the same: to help a person walk away from what he has, and focus on improving his function and abilities so that he may become as independent as possible in his everyday life.


Final thoughts

With this in mind, please remember that these are only guidelines and that nothing regarding a person’s condition or prospects is set in stone. No matter what the prognosis may be, it doesn’t mean that you should give up on treatment or think that it is hopeless. Whether a patient is a child, teen, or adult, a therapist’s overall goal is the same: to improve a person’s way of life and function to the best of his abilities. Good luck, and I wish you and your family all the best with your loved one’s treatment.

If you have any questions, feel free to leave me a comment or email me at natan[at]enabledkids.ca. You can also read more about Fabio’s story here.

Key Terms
calcification: The accumulation of calcium or calcium salts in soft tissues, causing it to become inflexible or unchangeable
The natural process of bone formation

For More Information

22 March 2012

Traveling with your child with special needs

By Natan Gendelman D.O.M.P  |  http://www.healthinmotionrehab.com  |  http://www.enabledkids.ca

Traveling can be a great opportunity to learn about and experience new things together with your child. When the process goes smoothly, it is also a good way to develop closer ties among family and friends. However, this process can also be challenging, especially when traveling with a child that has special needs. Many of the patients and families I treat from overseas have experienced issues with arranging transportation, finding the right food and booking the right accommodations. All of these items need to be arranged well in advance in order for the whole process to run smoothly. As a result, I would like to cover a few things to keep in mind when you’re preparing to travel with your child. Hopefully this will aid you in plans for your own trip with your child, and also generate a discussion about what you’d like to share and learn more about in regards to traveling and accessibility.

Food in foreign countries

Now whether or not a child or adult has special needs, what a person eats can have a huge impact on their health, behaviour and cognitive function. When traveling, this becomes even more important as food sensitivities, allergies and intolerances can all pose risks during your child’s mealtime. As a result, it is important to pay attention to what you and your child are eating, and to ask questions about ingredients and preparation wherever you go. Since the regulations regarding food production change from country to country, even foods which are familiar to you and your family may be grown, produced and processed according to different standards.

For this reason, offer your child items that are light and easy to digest such as plenty of fresh (preferably organic) fruits and vegetables throughout the first few days of your trip. As well, certain foods may contain different ingredients than your child is used to, such as dyes or preservatives. As always, read the labels on the products you buy and eat, and try not to switch drastically from the kinds of foods your child is used to eating.

Accessibility Challenges

Another aspect of travel that you will need to consider is accessibility, especially if your child uses a wheelchair or other specialized equipment on a regular basis. Many countries have facilities that are said to be accessible, but this may be different from what you actually encounter while you are there. Last year when I visited Cuba, I found it very hard to watch an elderly couple struggle to climb a steep flight of stairs, as the plane they were trying to board didn’t have any other means of access. Thinking about what a person using a walker or wheelchair might encounter, it is extremely important to check with your travel agent whether the place you are going will meet your child’s accommodation needs, including facilitating ramps, elevators and a roll-in shower.

Of course, when you decide to go on a trip with your child, it is important to speak with him and help him understand where you all will be going, and what for. There are some great articles by about.com and Friendship Circle I’ve linked to below that give great tips on ways to prepare your child for traveling. By getting him used to the idea of going on the trip ahead of time, you can reduce any anxiety he may have, and prevent him from becoming overwhelmed and overexcited by the experience. I think that is an important step towards a fun and successful travelling experience.

If you have any questions, comments or experiences to share about what worked and didn’t work for you, leave me a comment down below or join our forum discussion. Thanks everyone!

For more information:


Some great articles from Friendship Circle’s blog about things to prepare:


08 March 2012

Improving your child’s sleep habits and digestion

By Natan Gendelman D.O.M.P | enabledkids.ca | healthinmotionrehab.com

Working with children, I often get questions from parents who wish to find a solution to their child’s sleeping issues and digestion problems. It’s important to realize that as a whole, your child’s biological rhythm is what determines how well these two go hand in hand. When a child’s lifestyle works against this natural rhythm, his body is thrown out of sync and issues such as indigestion, restlessness, problems sleeping and lethargy begin affecting his ability to function. By examining your child’s lifestyle and identifying any problem areas, you are taking the first step towards improving your child’s sleeping habits, eating habits, and their influence on what he will be able to learn and accomplish.

In today’s fast-paced society, many of our families have become accustomed to following a rushed lifestyle. Since we’re on the run, we have tea or coffee with close to no breakfast, a light lunch, and then we indulge in a full course dinner accompanied by dessert. Following this eating pattern, we go to sleep and wonder why we do not feel as energized or refreshed as we should be when morning arrives. When it comes to a child, the negative effects of this cycle become even more pronounced as he undergoes key stages of growth and development during this crucial period.

The reason for this is because our biological rhythm, also known as our circadian rhythm, experiences a peak of activity in the morning as the body prepares itself for a new day. Wholesome, solid foods should therefore be consumed early on so as to provide the body with the fuel it needs to function. As the day passes and evening arrives however, the body’s metabolic exchange slows down and begins preparing for sleep. In essence, our habit of eating a large dinner and dessert goes against this natural turn of events, causing our system to work throughout the night rather than rest during this crucial period meant for healing and growth.

Throughout my life, I have always remembered this saying: it is best to eat breakfast as a king, lunch as a prince, and dinner as a pauper. The largest meal of the day should be eaten in the morning, while the lightest meal should happen 4 to 5 hours before bedtime. This ensures that your food consumption will match the rate at which your digestive system functions.

Depending on where you live, your nutritional needs and what foods are locally available, examples of what you should and should not feed your child for dinner may vary from the things we have included below. However, what’s’ important is that the foods you prepare are easy to digest, light and nutritious while still fulfilling any dietary needs.

Some foods to consider

Salad made with seasonal vegetables. Salads without protein or starch are light and easy for a child to digest.

Bread and honey. Honey is known for its calming properties and is great for helping a child sleep. Honey can be eaten alongside dinner, as a spoonful before bed or mixed in with some warm chamomile tea. One thing to be aware of, however, is that pasteurized honey (the kind that stays clear for a long time) has less nutrients than raw honey (the kind that gets cloudy and turns solid after approximately two months) as it has been heated to remove bacteria and extend its shelf life.

Foods to avoid

Red meat and high-protein foods. When having dinner, try to avoid giving your child a lot of heavy foods that are rich in protein. These items are best consumed earlier in the day to help your child feel awake and ready to learn or play. Red meat, for example, takes a lot of work to digest in comparison to fresh fruits and vegetables. It can also inhibit the synthesis of seratonin, which may prevent your child from getting a good night’s sleep.

Potatoes and heavy starchy foods. If your child experiences digestion problems and trouble sleeping, starchy foods such as potatoes and pasta may not be a good idea. While eating a lot of carbohydrates may make your child feel sleepy, they can also cause bloating and gas for his sensitive stomach, and disturb his sleeping habits.

There are many sources out there suggesting a wide range of different foods that can help your child digest and sleep at night. However, make sure to proceed with caution as many of the foods in these guides can trigger allergies or food intolerances. If you have any questions, comments or suggestions, leave a comment down below!

What are your experiences with a child’s digestion and sleep habits?
Discuss this question in our forums >

Before making any lifestyle changes for your child, be sure to consult a health practitioner who is familiar with your child’s condition. Please note that if your child has pollen allergies or is under the age of one year, you should not give him raw honey as it may cause a severe allergic reaction or lead to infant botulism.


08 February 2012

Achieving Everyday Milestones: Dressing and Undressing

Natan Gendelman D.O.M.P  |  www.healthinmotionrehab.com  |  www.enabledkids.ca

From a young age, children are taught essential life skills which become a part of their everyday function. For any parent, fostering this kind of independence is crucial because it motivates and encourages a child to strive for goals and personal development. However, teaching him how to perform these functions successfully can be challenging, as no two children will have the same personality or the exact same condition. In the case of a child with a neurological or developmental disorder, what he can and cannot do at his stage of development may affect how you teach him and what this may entail.

The Importance of Explanation

In the case of teaching your child how to dress and undress himself, how you demonstrate and explain the action to your child is very important. As one of the key factors in the process, you will need to teach a child everything from A to Z. If he does not know how his body functions, explain to him what the head, neck and other parts of are for. Using clothes that are easy to put on and remove, show him where each piece goes and what it used for before demonstrating how to put them on and take them off. Break each movement into small steps before combining them. Then, explain and repeat over and over again. Reinforcing and repeating each action will eventually help a child understand the goal of the action. Despite any difficulties you come across, keep in mind that for any child, the acquisition of new skills is something that happens one step at a time. Be patient, and know that your child will eventually begin to follow.


In this process, remember that your own attitude and mindset are crucial factors in your child’s success. Believe in what he can achieve. Changing thoughts such as “my child is disabled” and “he needs things done for him” to “my child is abled” and “he can do things” is an important step, because nothing can be built on disability and doubt. Rather than have him adapt to his condition, we want a child to overcome his difficulties and come to know how to function on his own. While it may take time, know that any achievements that you child makes will be worth it in the end. Dressing is just a small part of the daily routine which he will have to perform. Make sure you stay positive, and eventually you can show him how to do everything which you would like to become a part of his daily living.
In this way, dressing and undressing can become independent or close-to-independent activities which your child can perform on a day-to-day basis. By taking each challenge one step at a time, you will be able to see just how much your child can accomplish.
If you have any questions or comments, feel free to message me or leave me a comment down below. I’d love to know: what are your experiences with teaching your child how to get dressed?

Additional Resources:

Dressing workbook by CanChild Centre for Childhood Disability Research

01 February 2012

The first steps to improving a child's drooling

By Natan Gendelman D.O.M.P | www.enabledkids.ca | www.healthinmotionrehab.com

For many parents of children with special needs, drooling is a common yet difficult issue to address. When a child is young, it is normal for him to drool as teething stimulates the glands in the mouth. However, drooling later on in life is a bigger problem which may occur due to several reasons including swallowing abnormalities, difficulty moving saliva to the back of the throat, and instability of the jaw. Depending on the cause, available treatments range from medications and surgeries to therapy and treatments. However, it is important to receive an ear, nose and throat examination and identify the cause before deciding on the best way to improve your child’s condition.
Among parents of children with neurological conditions however, many have the same question: how can I improve my child’s drooling without using surgery or medications? To be able to answer this, as mentioned in our previous article you can’t just look at and treat one aspect of your child’s condition. Whether it’s a child’s drooling, vision or limb function, these are issues which cannot be successfully treated without looking at the child’s general condition. From this overview, you will be able to see how an impairment in one area will inadvertently cause impairment in a child’s other functions. Without addressing these issues, a child may fall into a roller coaster of compensatory functions, which will then start snowballing into a series of more serious and complex problems affecting each part of his body.

The importance of trunk control

So what are the first steps to addressing this problem? It all starts with the trunk, which is the core of the body. When looking at ways to improve drooling, one of the first areas to check is whether the trunk has developed properly. With trunk control, a child is able to gain control of his neck, thereby leading to improvements in their facial expression and facial control. By reducing tension in the neck and face muscles, it improves a person’s control of his lips, tongue and drooling, opening the possibility for other treatments, like speech language pathology, to succeed.
For these reasons, it’s important to really look at the global picture of what is happening with your child. Teach him everything, and don’t just be stuck on improving his drooling, speech or hand movement. In taking this approach and going from a general to a more specific perspective, you’ll be able to better address your child’s needs and improvements.
If you have any questions, leave me a comment down below or feel free to email me. Thanks everyone!
So what are the first steps you have taken to improving a child’s drooling?

For more information, visit http://www.scope.org.uk/help-and-information/cerebral-palsy-and/drooling-and-cerebral-palsy

08 December 2011

Why can’t I treat just one aspect of my child’s condition?

By Natan Gendelman, D.O.M.P  |  http://www.enabledkids.ca  |  http://www.healthinmotionrehab.com

Whether a child has Down syndrome, cerebral palsy, acquired brain injury or stroke, every child is unique and has his own individual strengths and needs. While his symptoms may be similar to those generally associated with his disorder, his condition will always be different because of his individual personality and character. These two factors greatly influence how a child’s treatment should be approached, making it important to ensure that treatment is tailored to his specific needs, abilities, age, and stage of development. To progress, it is crucial for each therapy to follow in the footsteps of the one before it, so that treatment remains continuous and is reinforced at each step along the way.

In this regard, our goal in treatment is not to work on a child’s speech or motor function as if they were separate from the rest of his condition. Instead, we need to teach the brain how to perform different tasks, as a child’s function is based on commands which come from the brain. Everything else, such as a child’s symptoms or the tone in his body (hypertone or hypotone), happens as a result of the brain’s function. Being unable to perform a certain task can lead a child to adopting compensation patterns which, in turn, causes other compensation patterns to develop as well. In the end, a child may have to perform several compensatory movements just to do a simple task, and this is something we will need to address during his treatment.
The importance of integrated treatment

To solve this issue, our first goal is to consider a child’s treatment as a whole and ensure that each treatment is connected to one another. The overall focus should be on the function of his entire body, rather than on a single area such as his head or limbs. With every part of the body working together as one unit, it is important to develop a child’s control of his trunk or torso which also stimulates blood circulation and the transport of nutrients to the brain. When the trunk’s function is developed and a child can support the weight of his head and limbs, he will then be able to improve his condition and better respond to what he is being taught in each of his treatments.
These improvements will definitely make a difference in every aspect of your child’s life as he continues to progress in each of his therapies. Of course, we need to realize that speech language should not simply be about trying to get a child to communicate, and occupational therapy isn’t only for getting a child to learn fine motor skills. Everything is considered as a part of a whole–and for these reasons, each individual session will be able to gradually build on each of his achievements. Furthermore, by continuing a child’s treatment at home and incorporating it into his daily activities, your child will be able to reinforce the skills he learns and achieve more as a part of his everyday function.

Teaching normal function: The 3 W’s

Of course, for us to build on this improvement, we need to remember that a child’s development is an ongoing process. As mentioned above, ultimately our goal is not specifically to teach motor or sensorial function–it is to teach a child to function independently, and encourage him to touch, interact, communicate and discover the world around him. The body is a tool which facilitates this interaction, and this process is something which goes on for every second of his life. As a parent, caregiver, family member or therapist, our work continues as long as he continues to learn.
To help you with this process, I recommend that you use 3 W’s: watch, wait, and win. By watch, I mean that you should observe what and how your child is doing, such as what he likes and doesn’t like. By wait, I mean that you should be patient, explain something, show the child how it is done, describe the process, and proceed with the movement or task. The last step is win: as he progresses, the task is accomplished, and soon a child can perform the task independently.

By understanding and following these steps, you will be surprised at just how much your child can accomplish. As he learns, you will learn a lot about your child as well, and be able to see just how successful he can be.

If you have any questions or comments, leave me a comment down below. Thank you!

31 October 2011

London hoteliers eye £2b tourism segment

London hoteliers eye £2b tourism segment

As the London hotel market gears up for the Olympic and Paralympic Games, the question isn’t whether hoteliers will be able to provide the minimum required accommodations for guests with disabilities, but will they be able to capitalize on the more than £2-billion (US$3.2-billion) tourist segment for disabled people that could visit the market as a result.

20 October 2011

What are the risks of giving my child a G-tube?

By Natan Gendelman, D.O.M.P

www.healthinmotionrehab.com | www.enabledkids.ca

For many parents of children with special needs, difficulties in swallowing and moving the mouth can often be a serious issue. If a child cannot eat, it is hard for parents to ensure that their child is receiving the nutrients that he requires. To address this problem, some children have gastric feeding tubes–also known as G-tubes–inserted into their digestive tract through a small incision in their abdomens. By using the tube, it is possible to feed a child certain formulas to fulfill his nutritional needs.

However, as a parent, caregiver or therapist, it is important to know that G-tubes come with certain risks associated with their use. Before deciding on the procedure for your child, you will need to understand how taking this step will affect his ability to interact with the world around him. Since the G-tube is a foreign object inserted directly into his system, it is possible that an injury or health-related issue can occur and negatively affect his condition. Therefore, it is necessary to review what his limitations will include once the procedure has been done, and what they will mean for your child’s daily life.

Possible complications

One of the best ways to be prepared for the procedure is to conduct research on what problems can arise afterwards. Here are a few of the consequences and complications that may happen:

  • Irritation. As one example, it is possible for irritation to occur at the insertion site due to leaking food and stomach acids. This can cause discomfort and also lead to more serious health issues.
  • Mechanical injury. Since the G-tube is inserted directly into the intestine, movement of the tube can cause mechanical injury and damage the digestive tract’s inner walls. This may lead to internal bleeding and peritonitis if the wound becomes infected. Mechanical injury can occur when the position of the tube shifts, so it is important to pay attention to your child’s movements and activity.
  • Peritonitis. Peritonitis is the inflammation of the membrane covering the inside of the abdominal cavity and organs. It is characterized by symptoms including tenderness and pain in the abdomen, fever, nausea, bloating, and difficulties in breathing. This condition may develop when part of the gastrointestinal tract is injured and infected by bacteria.

In addition to being aware of these issues, G-tubes will need to be cleaned or replaced after 5-6 months even when designed for long-term use. As well, it would be a good idea to consult a child health professional who is familiar with your child’s condition for any other complications that may arise as a result of your child’s specific condition.

How G-tubes affect therapy

Some children with G-tubes inserted into their digestive tract may attend treatment programs designed to address and improve their social skills, motor function and communication. Should this be the case, it is important to inform any licensed practitioners who may work with your child about his condition and specific needs. The therapist, for example, will need to be extremely careful when turning him onto his sides and stomach. As well, any other movements such as rolling will have to be done with caution, and careful supervision, as these movements may affect the position of the G-tube and lead to mechanical injuries like I mentioned before.

Final food for thought

With these issues in mind, my final advice would be to review each of the pros and cons of the procedure before making a decision. Conduct as much research as possible, and speak with a few child health professionals who can advise you on the possible effects of the system. As a parent, you are the one who knows your child, his condition, and his needs the best. So choose wisely, and put your child’s needs first.

If you have any questions, concerns or feedback, feel free to contact me by email or leave me a comment down below. Thanks!

05 August 2011


Many people with mobility problems find the prospect of climbing stairs a scary event. Sometimes it seems like an impossible task, thus homeowners have to make tough decisions about living like whether or not to move from the home they love into a bungalow or sheltered accommodation or instead convert their dining room to a bedroom and live downstairs, (assuming they have a bathroom on the ground floor). Of course, there is a third option, which provides safe and secure access to upstairs facilities: Installing and using a stairlift.

The purchase of a stairlift is quite a daunting prospect since it is a lifetime investment that most people have probably never encountered. What should you look for in a stairlift? What facilities are available and which ones are most important to you? There is also the cost factor, how much do you pay to get peace of mind and should you consider second-hand or reconditioned stairlifts?

If you want to go for a stairlift, it pays to have a look at the different types of stairlifts available. Firstly, my recommendation is that whether you buy new or reconditioned that you go to a reputable supplier who can advise you on all of the issues, especially installation.

When considering what type of stairlift you require, most people opt for the seated version, although other types are available including a standing stairlift and one with a large platform to accommodate a wheelchair.

Seated Stairlift

These tend to be the most common type used in a domestic setting. The majority of users are able to walk, but find it difficult to negotiate the stairs. The person must be able to sit safely on the seat during transit and transfer on and off at the top and bottom of the stairs. A swivel seat and lift-up armrests will make transfers onto and off the seat easier.

The swivel seat can be manually or electrically operated. It is preferable that the user can transfer independently; however, in some situations it may be possible for the carer to carry out an assisted transfer in conjunction with a piece of small handling equipment. The ability of the carer to transfer the user at the top of the stairs should be very carefully considered and avoided if at all possible.

Seating Position

Seated stairlifts have the choice of fixed seats, fold-down seats, perching seats and seats which slide forward to assist access in and out of the lift. Some companies will fix the seat at the most appropriate height for the user.

Some of questions you should consider prior to purchase are:

• Will the standard seat provided be the correct size for the user?

• Will the user need a special seat for a child or a harness for a more severely disabled child? A seat unit or moulded seating system will have to be removed before the seat can be folded.

• Which direction will the user need to face? Most seats face sideways, but if the user has a stiff knee he/she may need to face forwards to give them more room.

How will the stairlift be controlled and powered?

Will the user be able to operate the standard controls, usually push button controls sited on the end of the armrest, or is an alternative method required, for example joystick or toggle controls? Will the controls need to be sited in another position? Wander leads allow the user to operate the controls from the most comfortable position or a carer to operate the lift independently. Remote controls, for a carer to operate, are also available from some companies. Lifts are available with an audible signal to alert blind and partially sighted users that the lift is at the top or the bottom of the track.

Maintaining your stairlift

Most major companies guarantee their stairlifts for one year. After this it is recommended that they are inspected every six months and serviced annually. Some companies offer an emergency call-out facility. However, check that they have fully trained service engineers on call 24 hours per day. On completion of your one year warranty most companies will offer to re-guarantee the lift for a charge. It is advisable to check these charges before purchasing.

01 August 2011

NHP to sell tranche of learning disability care homes

NHP to sell tranche of learning disability care homes

North West Evening Mail | News | New service to offer free help for disabled people

North West Evening Mail | News | New service to offer free help for disabled people


DISABLED people can get free help with benefits and other issues affecting their everyday lives through a new advocacy service.

HELPING HANDS: Disability and benefits advisor Julia Everett, volunteer advisor David Bailey, disability and benefits advisor Nanette Pyatt and secretary of the Barrow and District Disability Association Margaret Burrow MBE JOE RILEY REF: 50022703B000

The Barrow and District Disability Association’s new Disability Advice and Benefits Service is now up and running at the School Street base.

Two full-time advisers, Julia Everett and Nanette Pyatt, are providing one-to-one appointments with people.

29 July 2011

Assistive devices, splinting and AFOs

By Natan Gendelman | http://www.enabledkids.ca | http://www.healthinmotionrehab.com

As we’ve indicated before, cerebral palsy is a neurological condition which results from damage to a certain area of the brain. When this occurs, a child’s ability to control specific parts of his body is affected, leading to impaired function and mobility. Since the brain is not sending the appropriate signals to parts of his body, a child will try to function in any way that he can and fight the condition that he is in. In turn, this will cause hyper tone, as we have written about before in our previous blogs.

In the case of a child, having hyper tone may cause certain patterns to occur during development. High tone in the trunk, for example, will lead to high tone in his hands, arms and legs, as well as to improper sensorial development. Now, what happens is that it becomes difficult for him to learn to walk properly, perform grabbing motions, or even bend his hands in the first place. For kids with cerebral palsy, this can result in the emergence of certain patterns like forming crab hands without bending them, or performing robot-like movements where the whole body is moved at once. When these methods of moving are left unchecked, they can have severe consequences on a child’s condition, and what he will be able to accomplish.

The effects of splinting and other devices

With this in mind, many people try to address these problems through the use of assistive devices, splints and AFOs (ankle-foot orthoses). Splints and other assistive devices are often used to maintain an appropriate range of movement in a child’s joint. However, it’s important to note that their usage may cause a chain reaction to occur in a child’s condition. When a child has a splint applied, his brain is not taught the appropriate function to go with the movement. Therefore, while his limb may be held in the correct position, his muscles will be stretched passively--that is, without the child’s active participation. This sends a message to the brain that the device is a foreign body, causing his body to try and fight it. As a result, that is why a lot of therapists find that a child’s tone will go up the moment a splint is taken off.

Making the decision

So, the question is: should we be using splints? Like I’ve said before, each situation has to be dealt with as a separate case which depends on the child’s condition, his ability to move and function, and--very importantly--his age. One key factor which will affect his need for these devices is his weight bearing and movement. A crucial part of joint development, weight bearing plays a necessary role in several movements which are part of a child’s function including sitting, crawling, standing, and walking. If a child places weight on his feet and hands in the process, he will not need a splint because his function will be corrected by his own weight. As he progresses from his knees to standing and then walking, the child then learns how to shift his weight properly. However, if a child is not moving at all, then--again, depending on the case--the use of a splint or other device may prove to be the most beneficial option.

For these reasons, it is important to understand and consider your child’s needs and condition before choosing and implementing splints, AFOs and other devices. Remember, their use will immediately limit certain movements for your child. As a result, it’s a good idea to think twice, do your research and learn how to use them safely and wisely.

If you have any questions or comments about this article, feel free to leave me a message down below or send an email to natan@enabledkids.ca. Thanks everyone, and I hope to hear from you soon!

27 July 2011

Personal Injury

Until it happens to them, people do not realise exactly how a personal injury from a car accident can affect your life. Aspects such as your work, your family, and the quality of your life could be dramatically affected. Obviously, major injuries to your head and spine can be life changing, but even the reproductions minor injuries can have the same effects.

Some of the most common injuries the face car accident victims are:


Possibly the easiest injury to get from a car accident would be a bone fracture or breakage. This can happen to any bone in the body, and car range from a hairline fracture to a full breaking of the bone. This could take months of recovery for the worst of the factures with potentially many operations after the accident.

Traumatic Brain Injury (TBI)

When any force is exerted on the head, damaging the brain, this is known as Traumatic brain injury (TBI), and is usual the results of excessive acceleration or deceleration. The brain becomes deprived of oxygen, and if this were to continue for a prolonged amount of time, potentially irreversible damage will be caused to vital areas of the brain, or even death. These victims could then be in for a long process of rehabilitation therapy, leading on to a permanent carer for them.

Spinal Cord Injuries

The spinal cord is a very delicate part of the human body, and any sudden impact could seriously damage it. Whether the spine is only partially damaged, or severely damaged, the position of the impact could land the victim with a life changing disability.


Whereas fractures are probably the easiest injury to get from a car crash, whiplash is the most common one. This is caused by a sudden “jerk” of the neck, like a whip movement – hence the name, and is usually caused by a car impacting the rear of another. This was first seen as a minor injury, but it has the potential to be a permanent one, and for the victim, leading to limited mobility, as well as being very painful.

If any of the above has happened to you or someone you know, then it is vital that you see a doctor, and then your next port of call should be the solicitors to see if it is worth claiming compensation.

18 July 2011

The Small Places: Is Personalisation inadvertently criminalising car...

The Small Places: Is Personalisation inadvertently criminalising car...: "A while back, whilst researching the requirements for registration as a domiciliary care provider with the Care Quality Commission (CQC), I ..."

17 June 2011

So what’s the difference between cerebral palsy, brain injury and stroke?

By Natan Gendelman | http://www.enabledkids.ca

Cerebral palsy, traumatic brain injury and pediatric stroke are often brought together under the same treatment processes and types of rehabilitation. It is common knowledge for many people who work with kids that the approach to take is often quite similar between the three conditions. However, after working with and observing children who have cerebral palsy, brain injury or pediatric stroke, personally I would disagree with this method and viewpoint. In my opinion, there are many reasons why treatment for each condition should be distinct, and the first thing I would like to examine is what makes each condition different from the next.

Comparing terms

To start with, cerebral palsy can be generalized as a condition that a child is born with. The degree of severity of his condition will depend on how severely the brain is affected, and--by following a chain reaction--on the stages of development he has missed. This will lead to impairment as he grows older if the appropriate function is not gained. Children who have cerebral palsy cannot move through the stages of development because they are not acquiring skills in the normal developmental process. In most cases, a child is taken through his individual milestones by the nervous system. For a child with cerebral palsy however, this progression is absent and this normal development does not exist. Therefore, the skills have to be acquired first, and then repeated until they become automatic. This means that when we work with a child with CP, there is no re-gaining of skills, only learning from scratch. These are things that a child will then apply in his daily life, to become a part of his everyday function.

In contrast, traumatic brain injury and pediatric stroke can be seen as having totally different circumstances. Although it will depend on when these injuries occur, often a child with either one of these conditions would have already gone through at least some of the stages of development. This means that he would have already learned and acquired certain skills before the injury. When dealing with a child in one of these situations (and again, depending on his specific age, severity of condition and other factors), treatment will involve rehabilitation--that is, the re-gaining of movement and function which has been lost because of brain damage. This is what sets conditions such as TBI and pediatric stroke apart from cerebral palsy, and is something that should be accounted for in treatment.

Learning vs. regaining skills in treatment

When working with a child that has cerebral palsy, we need to remember that the child will not be regaining skills; he will be learning ones that he has never had before. Therefore, he has to be taught from A-Z what everything stands for, the individual body parts, the way they move, and how normal function should be. In contrast, a child with a brain injury or who has experienced pediatric stroke will need to focus on this idea of regaining skills, which means we are acquiring skills that take place before the injury has occurred. It is for these reasons that the approach to treatment will need to be completely different for a child with cerebral palsy. Rather than following the same steps that patients follow for the other conditions, the child will need to be shown how to turn, roll over, and be able to build on those skills before moving onto the next step.

As a result, a child’s treatment should differ according to how the child gains valuable life function. The methods of learning for kids with brain injury or stroke should not be the same as those for children with cerebral palsy. We take this approach in my clinic’s specialized treatment program called LIFE, and that is why we call our program an education / rehabilitation system rather than one or the other--the approach will change depending on the child’s needs. Here, we teach kids how to acquire these functions, how to do them, and why. If a child does not understand, we repeat them again and again and again under the child begins to follow. By paying attention to a child’s personality and characteristics as well as to his learning and specific condition, the treatment process becomes much more successful and fulfilling for those involved. It is for this reason that I think treatment for children under each category should be approached with regards to the condition itself.

Of course, whether dealing with kids that have cerebral palsy, pediatric stroke or brain injury, the bottom line is the same: the patient must be the one to work harder than the therapist. That’s the reason why at our clinic, we try have a child do everything he has been taught by himself. In the end, the ultimate goal of treatment is to have a child learn to do things independently. By distinguishing each of these conditions, I hope that more parents, caregivers and therapists will learn from and experience success with their child as he learns and discovers the joys, wonders and surprises held by the world around him.

If you have any questions or comments, feel free to leave a comment down below or email me at natan@enabledkids.ca. Thanks everyone!

16 May 2011

Crying in therapy

By Natan Gendelman - http://www.enabledkids.ca

For many parents, family members and therapists, crying can be a big obstacle to overcome when teaching and working with a young child. While it may be difficult to manage this sort of behaviour, it is important to understand why a child is upset as well as the things you can do in order to see his way of thinking. In my opinion, the key to handling this issue is to try to figure out where the child is coming from and be willing to view things from his perspective. In doing so, you will be able to tell the difference between when he is simply protesting something new or if he is hurt and needs you to stop and assist him in his function.

Seeing from a child’s perspective

For this reason, it’s good to take a step back and observe your child. We often believe that since we are older and “wiser,” our primary goal is to teach a child the things that we know and understand. However, every child is different, and each has his own dreams, wishes and fears. In this respect our first response should be to learn as much from him as he learns from us. The ability to understand a child becomes really important especially when you are working with him to improve his function. In response to unfamiliar situations or tasks, a child will often cry because he does not want to do them. This makes it important to know the difference between crying as a response to new experiences or in response to actual injury. If he is really hurt, you will need to stop and find out what is happening. However, if this is not the case it is important to persist and continue with treatment.

Why is this the case, you may ask? If a child is only protesting, explaining things to him will be much more effective than stopping treatment every time he begins to cry. If you stop, he will automatically assume that crying will be the solution to stop you from making him do certain things. It is a self-defense mechanism, which is why you need to explain what, how and why he needs to do something in order for him to be able to understand. In this way, he will come to comprehend what is being taught and you will be able to continue with his treatment.

The effect of this approach

To demonstrate how effective approach this is, I’ll tell you about one of my experiences with a young girl that had cerebral palsy. As I worked with her, I made sure to explain every function and its purpose to her for each new activity we did together. During the girl’s treatment, her mother told me, “You are the first therapist that she didn’t cry with.” My question to her was: did anyone talk to the girl and explain what she was supposed to do? When the mom said no, it was easy to understand the differences she saw in her child’s learning and behaviour.

Whenever I encounter these situations, I ask myself: why do we have to assume things about a child and try to make him follow them, when we can simply ask a child what’s wrong and then explain what we are going to do? If a child is not willing to do the things which he should, then the approach to take is to explain, follow up, and repeat it again and again and again. This is how a child is able to learn and eventually follow. When we do everything for a child however, instead of simply assisting him as he learns to do things for himself, he starts to assume that everything can be done for him. If this were the case, then why should he have to follow instructions and strive to accomplish more? Without being given a reason for doing things, a child will continue to protest and cry whenever he comes across new situations.

So my final advice to parents, therapists and caregivers alike is this: communicate with your child. Explain why he has to perform certain functions and show him how to do them. It is important to be patient, persistent and understanding, for you are the one who will teach him what’s wrong, what’s right, what’s true and what’s false. As you help to introduce him to the world, remember: your child is bright, and it’s up to you to support and guide him as he continues along the path of development.

If you have any questions or comments, feel free to leave a comment down below or email me at natan@enabledkids.ca. Thanks everyone!

04 May 2011

Trabasack wins NAIDEX Style Award - Wheelchair Lap TraysWheelchair Lap Trays

Trabasack wins NAIDEX Style Award - Wheelchair Lap TraysWheelchair Lap Trays

Have you seen this innovative laptray - is great for disabled travellers, for your IT needs, etc

03 May 2011

Lancs County Council opens advice line for parents of disabled children (From Chorley Citizen)

Lancs County Council opens advice line for parents of disabled children (From Chorley Citizen)

LANCASHIRE parents who care for a child with a disability or other additional needs will be able to find out if they are missing out on money they are entitled to by calling an advice line.

The advice line is being run by Lancashire County Council's welfare rights service and is being staffed by specially-trained welfare rights officers. The line will be open from Monday, May 9 to Friday, May 13.

13 April 2011

Cuts should not derail personal budgets | Society | The Guardian

Cuts should not derail personal budgets | Society | The Guardian

Personalisation of care and support has been a great breakthrough, and it retains broad political and sector support. But there's a danger of it being badly – and unnecessarily – damaged in these austere times.

The development of personalisation in social care is part of a wider shift in our society towards including all people as fully equal citizens. This is long overdue, has had to be fought for, and is far from complete. It has emerged primarily from the efforts and struggles of disabled and older people, with support from their progressive allies in public services.

12 April 2011

Mayo Clinic Finds Tool to Predict Disability Timeline for Progressive MS Patients | Business Wire

Mayo Clinic Finds Tool to Predict Disability Timeline for Progressive MS Patients | Business Wire

Quite an interesting read!

Why treatment should be adapted to the child first, and his condition second

When a child is diagnosed with cerebral palsy or any other neurological disorder, people often accept that there will be certain things which he can and cannot do. Yet, what we often forget is that that this is a child which we are labeling; a child who possess his own character, will, dreams, opinions and personality. Each person thinks, communicates and makes choices in his own unique way, and that is something that both the medical and therapeutic worlds cannot predict. In fact, I think that trying to do so would be a huge, grave mistake, and I apologize to those who do not think this way.

Every child is different

Now, I’m not trying to offending anybody here. However, a lot of times we see a child’s cerebral palsy or disorder first, and the child himself second. How does this change anything, you may ask? Well, if you asked a therapist if they have seen two children with the exact same condition,the answer would be no. That is because every person experiences life in different ways and different forms, meaning that one child’s cerebral palsy will look completely different from the condition of another child.

For this reason we need to remember that there is no template, no cookie cutter, and no pure recipe for treatment which can be applied to every child. Instead what we have to do is learn from each child as much as he can learn from us. Each concept or treatment has to be adapted to his own needs first, and to his condition second. Any minor cerebral palsy can become severe if it is not treated properly through his lifetime, because it is important to adjust to the individual changes taking place with the child himself, along with his growth and development.

Creating connections

With this in mind, I find it funny how we’re always getting stuck on the individual names of the therapies during this process. When we hear about physio, we think that it just treats gross motor skills. Occupational therapy deals with fine motor skills and daily tasks, while speech language therapy only comes into play when working on speech and communication. In reality though, can we teach a child how to move without communicating with him? We can’t, so to be successful in teaching a child, we first have to try our best to connect with him on his level.

When I work with kids, I try and understand where he is coming from, what he is and is not willing to do, and the ways in which he does things. Remember, a child’s movement and function comes from the brain. So if we don’t develop the brain, we cannot develop his function. Developing the brain, or the child’s cognitive function means that when we talk to him, we are essentially teaching him important life skills. In turn, this will affect his intelligence and thereby improve his motor and sensorial function.

In adapting treatment to the child’s needs first and his condition second, you will discover just how successful he can be as he grows closer to achieving independence in his daily life.

Do you have any questions about this article? If you need any help or advice, feel free to drop me an email at natan@enabledkids.ca. Thanks, and I look forward to hearing from you!

To read more articles like this, visit us at www.enabledkids.ca.

17 February 2011

The Sky's the limit

The Sky's the limit has been doing well so much so that I decided that it should have it's own website, so that people can buy the book, write there own review and or view the site to see what it is about.

21 January 2011

Learning about scoliosis and cerebral palsy

Scoliosis, or a change in the curvature of the spine, is a really big issue among those with cerebral palsy. In particular, it can become a serious problem for those with spastic, otherwise known as hypertonic cerebral palsy. In my previous blog I talked about hypertonic cerebral palsy, and mentioned how damage in the brain can lead to changes in a person’s muscle tone. What happens is that once the brain area is affected, the trunk or centre of the body will be impacted as well, with the limbs following suit.

So how does this affect the spine? First off, the curvature of the spine changes because it is accommodating and compensating for all the abnormal tension that is found in the body. The overactive muscles will pull and tear the spine in any direction that it wants to, and this can create a big problem for children. I have personally seen kids whose scoliosis has caused their spine to turn 70, or even 90 degrees.

Now, most of the treatments available for scoliosis deal with only the consequences instead of the cause of the condition. There are procedures such as fusion, which involves placing rods along the spine to maintain proper curvature. I know that for some kids this can be beneficial, and some claim that they feel better after having the surgery.

In my opinion, when the curve of the spine exceeds a certain degree and continues to progress, then yes, it will need to stop. Surgery should be considered as a last resort when there is nothing to maintain a child’s condition. However, if you are teaching your child to move and interact properly and independently, his condition will not progress as drastically because the child’s muscle tone will have normalized, alleviating the stress placed on the spine. In addition, you should look at your child’s age and the stage of development he has reached. Then, if you are offered the surgery, consider the advantages, disadvantages and consequences of the procedure. There will be certain things that your child will not be able to do, so you really need to know what he will be able to achieve post-surgery. Based on this, as well as advice from licensed professionals, you will be able to make an educated decision whose consequences you will be prepared to handle.

If you have any comments, questions or concerns, email me at natan@enabledkids.ca. I look forward to hearing from you!

For more articles like this, visit http://www.enabledkids.ca.

22 December 2010

Should your child be doing stretches?

For a child with cerebral palsy, physical therapy acts as one of the main components in improving his motor skills and developing his independent daily function.
During this process of learning and improvement, a child is educated about the use of his extremities and trunk in an appropriate / correct way. The normalization of motor function is followed by normalization of the muscle tone.

Each treatment and approach has long and short-term goals, which are based on the child’s condition, age and stage of development. One part of the process, which is widely accepted as a “one of the main treatment components,” is stretching. However, the way your child is stretched can affect his progress and what he will be able to achieve in the long term. There are two totally different types of stretching: active and passive, both of which we will cover in this article.

Explaining changes in tone.

As a neurological disorder, the effects of cerebral palsy originate from damage caused to certain parts of the brain. Depending on the area of the brain that is affected, a child’s muscles and tissues can become either hypertonic (high muscle tone) or hypotonic (low muscle tone). His ability to move properly will be affected as well. Once the child cannot move properly, he will develop compensatory movements, which in turn will lead to increased muscle tone.

There are two processes which are taking place in the brain. The first one is called irradiation, and the other one is called concentration. Irradiation is the process when all the cells are employed for one particular movement. This also includes cells which are not necessary for the function. The concentration process starts when we are becoming acquired with the necessary movement or function. This is when only the cells which are needed to work are working. If a child cannot move properly, he is struggling to perform functions anyway. Therefore, the process of irradiation is taking place. This is when a child will have increased muscle tone. During development, a child starts off by learning how to roll, then sit up, turn onto his knees, and then crawl. This process takes place in a certain order so that a child’s trunk and extremities will be adequately prepared for the different functions.

This process is important because the trunk (also known as the body’s core) acts as the “king” of the body. If a child does not have well-developed trunk control, his tone will increase because of the effort he has to put into keeping his balance, while performing certain tasks with his limbs.

Applying stretches in an active way.

Now, I know that my discussion is going to cause a lot of debate, but it is not my goal to start an argument on this issue. In fact, personally I am in favour of stretching. But, I think that stretching has to be done actively (i.e. with the child’s participation), and not in a passive way (i.e. when you stretch a child and he does nothing). During this “‘passive’ stretch” his brain does not learn movement or function, since he is not actively participating in the task at hand. Moreover, for the body this is an invasion and the brain and nervous system start to fight this invasion.

As a result, the muscle tone can increase more over a certain period of time. In other words, the results of the treatment will not be long-lasting.

So when stretching is being applied in practice, we need to remember that the child has to be an active participant. It means that he should not just work to grab his hand or leg to stretch, but that he needs to be educated in how to perform functions such as rolling, crawling, standing and walking--which are all, in fact, active stretches. During the stages of “normal development,” a child stretches his body as he works his way through each function. His brain learns new movements through his discovery of the world. This is how a child learns to move correctly using every part of his body, which will lead him to develop proper tone and function. A child with cerebral palsy is no different, which is why we need to consider these key components when guiding him through the development process.

Steps to take.

With these differences in mind, there are many tips that you may wish to consider in regards to your child’s treatment. One thing to consider is that your child’s stretches should always start with the trunk. Every limb works in conjunction with the rest of the body, so they cannot be exercised on their own. When the trunk has been introduced to fluid, rotational movements as a part of regular function, your child’s tone will follow and gradually improve. Then, once the tone has been released from his trunk, you will be able to teach your child how to roll properly. This will allow him to progress onto the next stages of regular development.

Like we’ve discussed before, it is important to avoid exercises that do not have a real purpose behind them. This is what differentiates an “exercise” from a “function.” In real life, we do not stand or roll without reason; we perform the actions with a certain intent in mind. So, when you work with your child, give him a functional goal, for example: we are going to crawl to the table to have lunch, etc.

In learning these steps alongside your child, you will lower his tone, improve his movement and help him realize just how much he can accomplish.

For more articles like this, visit http://www.enabledkids.ca/

11 December 2010