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