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!

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!

Hyperbaric oxygen treatments effective for treating many disabilities

Hyperbaric Oxygen Treatments are effective for treating many disabilities such as Cerebral Palsy, according to an article on www.ehow.com.
Hyperbaric Oxygen Treatments also known HBO therapy was not intended to treat Cerebral Palsy or other brain injuries but when coupled with intensive physical and occupational therapy can be effective, according to the article.
The Hyperbaric Oxygen Treatment Center website, which can be found at http://www.hypertc.com states that the treatment has also been effective for treating Cerebral Palsy, ,Autism, Strokes, Multiple Sclerosis and sports related injuries.

HBO therapy usually involves the patient being put into an inflatable “room” which is just big enough for a person to lie down or sit up in. The air pressure of the room is usually two to three times normal air pressure and it filled with 100% oxygen. The increase in air allows oxygen to flow to the patients organs and body tissue, according to a second article about HBO therapy on www.ehow.com.
The Hyperbaric Oxygen Treatment Center states the one treatment session lasts an hour. Patients should have multiple treatments and the number will determined during an initial evaluation with their choose treatment center.

The cost varies depending on the number of treatments needed and type of chamber used. The website states that patients can read a book, listen to music, talk on their cell phone, play a handheld videogame and/or work on a laptop to occupy themselves while in the chamber.

People who are prone to ear infections, have ear canal or ear wax related problems should not have HBO treatments because the increased air pressures in the chamber can cause patients to feel pressure on their ears. It is recommended that patients try yawning and massaging their ears in order to relieve the pressure. People who are intoxicated or experiencing cold or flu symptoms should not have the treatments because it could be dangerous to them and others who use the chamber after them, according to the website.

People of all ages can have HBO therapy but it is more effective on young children because they are still developing. The Hyperbaric Oxygen Treatment center is located in Cumming Georgia. Many other medical facilities have been known to offer the treatment. People and or family looking into this type of treatment should keep in mind that because it was not intended to treat brain injuries many insurance companies will not pay for it. As noted above the cost varies. According to the first article about HBO therapy on www.ehow.com the cost can range anywhere from $100-$250 per treatment depending on the type of chamber used.
Patients and their families also have the option of purchasing or renting a hyperbaric oxygen chamber, according to the treatment center’s website. Those who are interested in buying or renting a chamber should visit http://www.vitao2.com/index.cfm for details. Please note that a prescription is needed to complete either transaction.

Patients and families looking for further guidance or who are skeptical may want to take the time to read the testimonials of patients and families find on the Hyperbaric Oxygen Center’s website.

For more info visit: http://www.ehow.com/how_4465058_use-hyperbaric-chamber-therapy-cerebral.html
http://www.ehow.com/way_5273455_hyperbaric-chamber-therapy.html
http:// http://www.vitao2.com/index.cfm
http://www.hypertc.com

Rehabilitative Benefits of the Nintendo Wii

by Holly McCarthy on May 14, 2009
This is a guest post on the EasyStand Blog, contributed by Holly McCarthy, who writes on the subject of the sports management degree programs at an accredited university. She invites your feedback at hollymccarthy12 at gmail dot com.

Kids and Adults with disabilities can benefit from recieve rehabilitative benefits from playing Wii, besides having fun!

The Nintendo Wii has been one of the most popular game systems this decade and has even been used in rehabilitative applications for people coping with a variety of ailments. A little over a year ago doctors in Canada thought of using the system, which had been used as entertainment for young spinal cord injury recovering patients, and as therapy for patients after strokes.
What they began to realize is that this system, the Nintendo Wii, could be just what is needed to help with rehabilitation because of its ease of use and friendly interface. There are several benefits of using the Wii in rehabilitative treatments (commonly termed at Wii-hab), a few of which will be explored below.
Balance - Whether the patient is standing or sitting in a wheelchair, the controllers used to play the Wii console require balance and proper form for the best results. Using a standing frame while playing Wii can promote movement while standing, which research has shown to improve bone mineral density and strengthening.
Hand-Eye Coordination - Over time, hand-eye coordination improves through the use of video games. This is especially true of the Wii since the players’ movements are mimicked on the screen.
Entertainment - Therapy becomes more enjoyable when put in the context of a game. People who use a standing frame for Physical or Occupational Therapy can prolong their standing time by “multi-tasking” by playing Wii.
Competitive Spirit - The competitive spirit in patients who may not otherwise be able to compete is awakened. This can be great for increasing social skills as well as self-esteem.
Extension of Therapy to Home ­- While many things that are found in a therapists office are far too cost-prohibitive to be kept at home, the Wii is an affordable method of treatment that can be taken beyond the office and into the home for around $250. Additionally, friends and family can play along and join in the fun.
Helps With Memory, Problem Solving, and Decision Making Skills - All of these skills are honed through the use of video games according to studies, which may or may not be good news for parents. Playing sophisticated games helps with short-term, long-term, and muscle memory. Strategic games require problem solving and decision making skills, all of which help to enhance the experience.
The Nintendo Wii is finding enthusiasts of many abilities these days. Games and hardware have made participating in many activities from the comfort of your own home possible with a small price tag that can bring benefits to those in and out of rehabilitation care.
Have you used the Nintendo Wii for rehab or fun? What games have you enjoyed the most?