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!
08 December 2011
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.
26 October 2011
24 October 2011
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!
17 August 2011
07 August 2011
Wheelchair skateboarding - Accessible GamingAccessible Gaming
Wheelchair skateboarding - Accessible GamingAccessible Gaming
Amazing video of a manual wheelchair skateboarder
05 August 2011
Stairlifts
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.
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
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
NEW SERVICE TO OFFER FREE HELP FOR DISABLED PEOPLE
Published at 13:15, Monday, 01 August 2011
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:
Fractures
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.
Whiplash
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.
Some of the most common injuries the face car accident victims are:
Fractures
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.
Whiplash
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!
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
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.
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.
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