memory and adhd

Wait… What Did You Say? Memory in the ADHD Student

Making memories is an important part of being human, and our beloved camera phones seem to make the process that much easier! However… our cameras aren’t the only ones doing the work. What about when you have to remember that long 10 digit phone… oh wait… we don’t have to do that anymore either! I suppose a modern day challenge would be to remember all those tedious passwords we have to keep!

But that’s neither here nor there!

Our awesome brains deserve a little credit, too, actually a lot of credit for that (grey) matter (just a little brain joke for ya!)

While memory is a challenge for all of us, it can be an exceptional challenge for a student with ADHD. In order to understand this, we will look at the 3 basic stages of memory.

Three basic stages of memory:

Encoding: Information enters into our memory systemmemory and adhd

Storage:

  • Short-term memory (STM) : 20-30 Seconds: Information that is transferred from the STM enters into the HIPPOCAMPUS! When we repeat information over and over again it’s like sending it through the hippocampus several times!
  • Long-term memory (LTM): Can last a lifetime

Retrieval:

  • How you store depends on how you get those memories back OUT
  • Organization is key here (i.e. using the alphabet to categorize things or remembering numbers in chunks)

Something happens around you that you can see, hear and/or touch. This sensation lingers in our short-term (working) memory for about 20-30 seconds. For example, when you are having a conversation with someone and they are talking, you may be thinking of what to say next (thanks to your working memory).

Kids use their working memory all day in the classroom to follow instructions, remember where they need to be, and to keep track of their belongings and assignments (just to name a few). Kiddos with ADHD tend to struggle more with these tasks, which can make learning difficult, specifically reading comprehension.

Let’s say a teacher says, “Go to your desk, grab your book and a pencil, go the center, and finish the worksheet.” That can be a lot to remember for a child who has a deficit in this area and can be misinterpreted as purely inattention.

“How can you plan ahead if you don’t use working memory to keep your goal in mind, resist distractions and inhibit impulsive choices?” says Matthew Cruger, PhD, neuropsychologist with the Learning and Diagnostics Center at the Child Mind Institute in New York.

Here are 4 ways to help teach ways to integrate learning for kids with ADHD:

  • Teaching mnemonic devices: “Never Eat Soggy Waffles” : North, East, South,West
  • Creating visuals
  • Use songs or a melody to learn concepts
  • Ask follow-up questions

Sometimes it can be hard to tell whether a child has a memory deficit or if it is a by-product of ADHD or a Learning Disorder. Receiving formal testing can be beneficial to tease them apart or better identify how they influence one another.

504 or IEP

504 Plan or IEP: Which Is the Best Vehicle for Your Child?

 

 

Today’s guest blog by Pam Labellarte, Special Education Advocate,  explains how to navigate accommodations plans when your child receives a diagnosis.

Before we can even address the question of whether a 504 plan or an IEP is the best vehicle for your child, we need to unravel the process required to get your child identified as a student with educational needs that cannot be addressed through the general curriculum, without support of additional accommodations and/or services.

Your Child Has a Diagnosis, Now What?

You get the news from your child’s teacher, your pediatrician or after your child has been evaluated by a neuropsychologist…your child has a disability. Maybe it’s a Learning Disability, Attention Deficit Hyperactivity Disorder (ADHD), or any one of several other disabilities that is limiting your child’s academic progress. Your first inclination is to ensure your child is provided whatever supports are necessary to maximize his potential. But, you are at a loss as where to begin. If your child’s teacher has not taken any further action, the first step is to connect with your school district’s Special Education Director/Coordinator. The initial request for consideration for services should be a letter hand delivered, sent certified mail or an email with a letter attached.

The “Special Education Maze”:

You are now about to enter what is often called “the Special Education Maze”. Understand, Special Education is NOT a PLACE. Special education services are driven by the needs of the individual child. Therefore they are delivered in a variety of places, sometimes within the classroom and other times outside the classroom in a smaller setting. It is critical that the initial and any future contact with the school district be documented in writing. This means documenting any important verbal conversations that occur between you and the school district staff, with an email confirming the conversation. By law, once a school district receives written requests from a parent regarding special education, they are required to respond within specific timelines, hence, the importance of written documentation.

Important Steps to Take to Receive Special Education Services:

Upon receipt of your written request for consideration of special education services for your child, the school district is required to respond to you in writing within 14 school days whether they believe your child should be evaluated. If they agree, a meeting will be scheduled to identify specific areas to be evaluated. Often referred to as the “Domain Meeting”, it the place where the school team and the parents review the major areas or “domains” to be evaluated, such as achievement, cognitive, communication, etc. The Domain Meeting is one of the most important meetings you in which you will ever participate, because you and the school team will determine which areas need to be evaluated and how (formal evaluations, informal assessments, observation, review of records, etc.). In order for the process to continue you have to provide “informed consent”, agreeing to allow the specific evaluations/observations to be conducted only after you understand what information they will provide. If a critical area is not addressed it may negatively impact the services provided to your child.

Developing the IEP:

Once you have provided consent, the school staff has 60 school days to complete all evaluations and observations, publish their findings and conduct an eligibility meeting. Most parents do not realize they can request that the draft reports be provided in advance of the eligibility meeting (three school days prior is sufficient time). If you wait to review the reports at the meeting, how can you hear the information (much of it foreign to you), digest what you have heard and then make “informed” decisions about your child’s programming? Once your child is found eligible the school district has 30 days to develop and implement an Individual Education Plan (IEP).

IEP or 504 Plan?

What if your school district has responded to your request in writing that they do not believe that your child has a disability requiring special education services provided under the Individuals with Disabilities Education Act (IDEA). But, they are willing to consider developing a 504 Plan to provide accommodations to your child. Would a 504 Plan be appropriate? How do they differ? Which would provide your child the most appropriate support?

Click here for a Section 504 and IDEA Comparison Chart (obtained from the National Center for Learning Disabilities) that provides details regarding the differences in the two laws. Don’t make any quick decisions until you understand the basic difference between the two educational programs.

Click here to view the webinar: Getting the Best IEP for Your Child!

medication for mental health in kids

When is it Appropriate to Seek Medication Management for Mental Health Symptom Reduction in Children?

 

 

 

For many families, the conversation about medication management to reduce mental health symptoms in children is off the table before the realities of this intervention can be explored. Medication can be a beneficial intervention, in tandem with therapy, to translate the skill development from the clinical setting into positive behavioral changes in the natural environment.

When is medication recommended to manage mental health symptoms in children?

Medication might be recommended as a therapeutic approach early on in treatment depending on the severity of the presented concerns and the impact of these symptoms on the child’s overall quality of life. For instance, if the child struggling with impulsivity and reduced focus/attention is doing poorly in school, if he has challenges reading social cues in peer relationships, and is he is internalizing negative feelings of self as the result, medication may be recommended sooner rather than later to improve client’s overall level of functioning.

The goal of social work intervention is to address the socio-emotional concerns through teaching client awareness into the triggers that precipitate the maladaptive behaviors (i.e. distracting thoughts/stimuli that reduce focus, decisions that elicit anger that snowballs into a meltdown, etc.) and the skills to modify their behavior. In some cases, the client can demonstrate and prove comprehension of the skills presented but in practice, have a hard time implementing the learned coping strategies in real-life scenarios. If the child’s quality of life and overall functioning remain to be negatively impacted despite intellectualization of how to handle their emotions or redirect their behavior, medication might serve as the glue to carry these compensatory strategies into reality.

To decide if a medication consultation is right for you, use this checklist:

  • Does my child struggle with implementing the therapeutic skills they learn in treatment?
  • Despite involvement in therapy, is my child’s quality of life negatively impacted socially, academically, personally?
  • Has there been an increase in the frequency and duration of symptoms (i.e. more meltdowns per week, more redirections to re-regulate body to remain calm, etc.)?
  • Does my (the parent) and my family’s quality of life continue to be negatively impacted with frequent impulsive reactions, mood dysregulation, or hyperactive nature of the child?

Consult with your pediatrician and therapist if you have any questions about if medication would be a right fit for your child. And remember, just because you may decide to try medication does not mean that it is a magic bullet fix or that it has to be a life sentence. Ongoing therapeutic intervention in addition to medication can be the right course of treatment for some children.


mental illness in children

The Rise of Mental Illness in Children

 

 

The Journal of Pediatrics published a recent article that childhood developmental conditions including ADHD and Autism are increasing at a rate of 16% from 2001 to 2011 (Read a review of this article on the CNN blog, The Chart, here). Although this might sound astounding and like this should be an area of concern, the researchers have posited that this actually might be a positive.

In all likelihood, these rates were probably the same. What we have now is an increased awareness of a variety of developmental disabilities as well as increased acceptance of such conditions. Having increased acceptance is extremely positive in that now we are able to provide support and services to help these children that otherwise would not be available.

Here are some tips for parents for children who might have a neurodevelopmental condition like ADHD or Autism:

  1. Seek out a good, comprehensive evaluation in order to first help identify the specific condition that the child might present with.
  2. Identify your treatment team. Your team will consist of multiple individuals including teachers, therapists, administration, and special education teachers. Make sure the team is all on the same page and aware of the specifics that the child presents with.
  3. Seek out resources and information to help support you and your family. There are multiple, empirically supported organizations that provide parents and family members with not only support but also resources to help the child out.

Although the rates of a variety of neurodevelopmental conditions are on the rise, it is likely that these conditions have always been as prevalent as they are today. The social stigma associated with the conditions is no longer as strong, and these children are now able to receive specific services and interventions that would be beneficial for them.




ADHD in boys and girls

ADHD in Girls v. Boys

 

 

 

 

Although there are many features of ADHD that may overlap between genders, studies have shown there to be characteristics that differ among boys and girls. Neither of these characteristics are exclusive to the gender, but these are generally the characteristics seen in girls and boys with an ADHD diagnosis:

 ADHD Features in GIRLS:

  • Tend to show more symptoms of inattentiveness vs. hyperactivity
  • Are more likely to be diagnosed later in their academic career
  • Some adult women are not diagnosed until their child goes through the process and is diagnosed themselves!
  • Have a higher likelihood of being under-identified and under-treated
  • Display more symptoms of inattention, daydreaming, and memory problems
  • May be initially misdiagnosed
  • Tend to go under the radar during early school years
  • Tend to be slower learners and less motivated
  • Are at-risk for self-esteem issues, mood issues, and substance abuse
  • Adolescent-aged girls have lower self-efficacy and coping skills
  • Have a higher tendency to internalize problems
  • Are easily overwhelmed
  • Have difficulty with time management

 ADHD Features in BOYS:

  • Have a 2:1 ratio diagnosis of boys to girls
  • Are more likely to be detected and diagnosed early on in the school–age years
  • Show more symptoms of hyperactivity and behavioral problems
  • Have higher rates of impulsivity
  • Have Higher incidents of externalizing problems associated with ADHD symptoms (i.e. aggression, trouble getting along with peers)
  • Have trouble sitting still or disruptive in the classroom
what is an orthotist

What is an Orthotist?

 

 

 

Pediatric physical therapists and physicians often rely on the help of orthotists and prosthetists to help with patients’ mobility needs. Sometimes, children come to physical therapists with gait and postural deviations (toe-walking, in-toeing, scoliosis, etc) and other conditions where exercises and muscle retraining simply are not enough. In those cases, we often ask for the help of an orthotics and prosthetics (O&P) specialist. Braces and artificial limbs are important to facilitate movement and promote independence.

When we refer children to an orthotist, it means we think that some aspect of their movement and growth could be helped out by an external medical device. An orthotist is a critical part of the rehabilitation and therapy process. Orthotics help correct alignment and improve function of childrens’ neuromuscular or musculoskeletal system. Orthotists evaluate what a child’s functional needs are and will design and construct the orthotic devices as needed. An orthotist is a certified healthcare professional who is knowledgeable in human anatomy and physiology, biomechanics, and engineering. As movement specialists, physical therapist rely heavily on the help of orthotists to achieve the mobility goals for our clients.

Some conditions that may require help of an orthotist:

Not sure if your child will have orthotic needs? Come see a physical therapist and we can point you to the right medical professional depending on your needs.

Click here to read our run-down of the best over the counter foot orthotics.

night splints

The Quick Guide to Night Splints for Children

 

 

 

For many children who are idiopathic toe-walkers, physical therapists often take the conservative approach. We have many things in our arsenal to help children improve without undergoing costly and painful surgery. Outside of stretching and strengthening exercises, we might recommend ankle foot orthoses (AFOs) for day time and/or night time wear. Depending on the child’s range of motion measurements, walking mechanics, and underlying pathology, different types of orthotics might be recommended. We often work closely with orthotists (professionals who design medical supportive devices such as braces) to make sure each child receives the individualized care and equipment he needs to gain full function and optimal alignment.

Here are reasons why your physical therapist might have recommended night splints for your child:

  1. The main goals of physical therapy interventions for toe-walkers are to increase ankle dorsiflexion range of motion and to decrease possible contractures that are associated with the condition. Physical therapy exercise programs include stretching the calf muscles, strengthening the trunk muscles, manual therapy, treadmill training, balance training, and ankle mobility training. Sometimes, in stubborn cases of toe-walking, orthotics are needed to maintain the range of motion gained throughout daily exercise sessions.
  2.  If you’ve ever tried to stretch your pre-schooler’s muscles, you know that children can be active and fidgety. They don’t tolerate passive stretches as well as adults and might complain of boredom, pain, or ticklishness. The most effective stretches are those held for a prolonged period of time at a joint’s end range. Night splints allow for increased stretch time at the ankle joint, because the child is sleeping or resting when they are in place.
  3. The best time to gain range is when a child is relaxed. Since children relax more during sleep, even more range can be gained through passive stretching using a night time AFO.
  4. This is where the night-time splint comes in. While the daytime AFO is a rigid orthosis that keeps your child’s ankles from plantarflexing (pointing down) past neutral while he walks, the night time AFO is a much more dynamic system. Night splints can be adjusted as the ankles gain more range into dorsiflexion. They provide a low-load, prolonged-duration stretch that helps with contracture reduction and counters high tone.
  5. In the literature, night splints have been found to be effective for contractures at a variety of joints, and can be useful in brachial plexus injuries, cerebral palsy, and muscular dystrophy.

As pediatric physical therapists, we rarely recommend over-the-counter orthotics for your child’s orthopedic needs. By consulting with an orthotist, we make sure each child is fitted to the most comfortable and developmentally appropriate custom foot wear for his condition. Usually, children who adhere to a strict physical therapy program and who receive the right orthoses can see a complete change to their posture and gait mechanics in as short as 6 months’ time.

Click here to view our gross motor milestones infographic!

References:
Cincinnati Children’s Hospital Medical Center. Evidence-based care guideline for management of idiopathic toe walking in children and young adults ages 2 through 21 years. Cincinnati (OH): Cincinnati Children’s Hospital Medical Center; 2011 Feb 15. 17 p. [49 references]

types and presentations of cerebral palsy

Types and Presentations of Cerebral Palsy

In last month’s blog about cerebral palsy (CP), I talked about the neurological condition and what can be improved by working with a physical therapist. This week, I am going to delve deeper into the condition and explain why some kids with CP are so different from one another.

Cerebral palsy has many classification systems. Medical professionals use these systems to understand and manage a child’s symptoms and help plan their treatment.

As stated previously, cerebral palsy describes a brain lesion that occurred in utero or around the time of birth.   Much like a brain injury, CP can be classified based on severity level, location of lesion, body part affected, change in motor control, and how gross motor function is affected.

Classification of CP Based on Level of Severity:

This is a common method of categorizing children with CP, used by doctors and parents alike, though it provides relatively little information. Parents and doctors use this classification system as a simplified communication tool to describe the exact level of impairment.

  • Mild: Having mild CP means a child can move independently and without assistance from people or equipment. He can complete his daily activities without any limitations.
  • Moderate: A child with moderate cerebral palsy will need braces, medical interventions, and adaptive equipment to do functional things, such as walking and keeping up with peers.
  • Severe: A child who will require a wheelchair and who will need quite a bit of assistance to accomplish daily activities is said to have severe CP. Often times, severe cases have multiple equipment needs, and simple things such as eating or sitting alone can be a challenge.
  • No CP:  Some children display cerebral palsy signs though the brain injury occurred after the time of birth, and therefore is classified under traumatic brain injury or encephalopathy.

Classification Based on Topographical Distribution (Body Part Affected):

When trying to plan treatment protocol for a child newly diagnosed with CP, many therapist and pediatricians like to know which body parts are affected and how they are affected. Is one limb weakened (paresis) or paralyzed (plegia)? How many limbs are affected that way?

  • Monoplegia/monoparesis – Only one limb is affected.
  • Diplegia/diparesis – When the legs and the lower body are more affected than the arms
  • Hemiplegia/hemiparesis – The arm and leg on one side of the body are affected.
  • Paraplegia/paraparesis – Only the legs are affected.
  • Triplegia/triparesis – When 3 limbs are affected, or 2 limbs and the face
  • Double hemiplegia/double hemiparesis – All four limbs are affected, but one side of the body is more affected than the other.
  • Tetraplegia/tetraparesis – All 4 limbs are affected, but three limbs are more affected than the fourth.
  • Quadriplegia/quadriparesis – All four limbs are impacted.
  • Pentaplegia/pentaparesis – All four limbs involved, as well as the neck and head.

Classification Based on Motor Control:

What is motor control? It is the body’s ability to voluntarily control limb and joint motion.  Muscles are controlled by the nervous system and abnormal contractions (too much or too little) often occur with brain lesions. Cerebral palsy is often a complex condition. It is possible to have variable muscle tone or a mixture of motor control presentations.

Spastic CP – indicates increased muscle tone, the most common type of cerebral palsy.
Non-Spastic Cerebral Palsy – characterized by low muscle tone or fluctuating muscle tone, or involuntary movements.

When muscle tone is affected, the movements and power needed to move the joints are often affected as well.

Hypertonia/hypertonic – describes increased muscle tone and is often associated with spastic cerebral palsy.  The child may present with stiff limbs, muscles that seem tight, or decreased ability to open his hands or straighten a limb.
Hypotonia/Hypotonic – often used to describe low muscle tone, and can be seen in diagnoses outside of CP. A child’s limbs or trunk may seem hard to control and “floppy.”

Some children’s cerebral palsy can actually be mixed in presentation, where some limbs are affected by spasticity and others are non-spastic.

Classification Based on the Gross Motor Function Classification System (GMFCS):

The last system of categorizing CP is a five-level system that describes the severity of impairment and limitations a child experiences with the condition.  Higher numbers mean a child is able to achieve less activities on his own.

GMFCS Level I – the individual walks without limitations
GMFCS Level II – walks with some limitations, including long distances, running, jumping, and balancing.  They may need devices when first learning to walk, up to age 4, and may need wheeled mobility when travelling long community distances.
GMFCS Level III – walks with an adaptive device.  Assistance is needed to walk indoors and wheeled mobility needed outdoors.  The individual can sit independently or with some external support.
GMFCS Level IV – the child is independent with powered mobility (motorized wheelchair) though need support when sitting. He may be unable to push himself in manual wheelchair.
GMFCS Level V – the individual shows significantly limited head and trunk control. Much of his mobility will need assistive technology or physical assistance.

A more expansive copy of the GMFCS system can be viewed here.

Why so many classification systems?

Most cerebral palsy specialists, health professionals, and parents will need guidance and direction when approaching a child with cerebral palsy. Knowing whether or not a child has low or high tone will determine equipment needs. Knowing the severity level will help physicians plan out need for future treatments and care options.  Understanding whether a child has spastic or non-spastic CP will help tell neurologists and neurosurgeons which part of the nervous system is affected. Having a better grasp on the type and location of lesion will help the medical team prepare for long term associated conditions of cerebral palsy, such as hip dislocation, scoliosis, joint contractures, or seizures.   It is important for therapists to know whether a child with CP has difficulties with muscle tone, muscle control, hand-eye coordination, balance, stiffness, or muscle strength.

The Gross Motor Function Classification System (GMFCS) is used by researchers and clinicians alike and is applicable to all types of cerebral palsy. While other classification systems describe what a child is limited by, the GMFCS places more emphasis on what a child can accomplish. Therefore, parents can use this system to understand how their children will progress over time.

Classification is very important in the treatment of the young child with cerebral palsy, and multiple classification systems help therapists and specialists create individualized plan of care for those children and families impacted by the condition.

Reference:
Types and Forms of Cerebral Palsy. MyChildTM at The Cerebral Palsy Organization website. Available from: http://cerebralpalsy.org/about-cerebral-palsy/types/; 2014 [accessed 18 March 2014]

How to Recognize Childhood Depression

 

How can you tell the difference between your child just having a rough day or week versus a more serious mood issue? We all have the occasional bad day, but when a child’s mood or behavior changes so significantly that it begins to interfere with their overall quality of life, depression may be present.

In addition to persistent feelings of sadness, key indicators of childhood depression are as follows:

  • Anger and irritability
  • Changes in sleep patterns (sleeps more or less than usual)
  • Changes in weight (gain or loss)
  • Difficulty focusing or concentrating
  • Social withdrawal or isolation
  • Guilty or worthless feelings
  • Feelings of hopelessness, helplessness
  • Loss of interest in previously enjoyed hobbies or activities
  • Low energy and fatigue
  • Heightened fear of being rejected
  • Crying and other vocal outbursts
  • Physical symptoms (i.e. stomach aches or headaches that are not responsive to other modes of treatment)
  • Thoughts of death or suicide

For example, if your child has previously loved school and valued completing homework and now has become resistant towards going to school and failing to complete assigned tasks, this would be a red flag that something deeper is going on with your child.  Your child does not need to meet every criteria listed above in order to meet depression diagnostic standards.  If depressive symptoms are present for at least 2 weeks, it is important to contact your medical and/or mental health care provider. Factors that may contribute to depression include family history of depression, interpersonal conflicts, or life event changes. The good news is that depression responds to mental health treatment. Cognitive-Behavioral therapy alters the ways in which a child views the world. Children and their therapists can address underlying messages and assumptions that the child has about him/herself and the world in order to re-create a more positive and realistic framework from which to function within. Depression is more than just feeling sad; it is a low-mood state that affects all aspects of daily life and functioning.



What a Diagnosis of Cerebral Palsy Means for Your Child

For new parents whose children are diagnosed with Cerebral Palsy (CP) and parents whose children with CP are nearing school age, understanding the diagnosis, prognosis, and the interventions available is often their top priority.  Being a first-time parent is challenging enough, and for many parents looking for answers, a medical diagnosis provided by a doctor often leads to more questions.

What having Cerebral Palsy means for your child:

Cerebral Palsy is a broad term used to describe a neurological condition that impacts physical functioning in children. The presentation of CP in individuals affected is highly varied in terms of severity, symptoms, and deviation from typical development.  The condition itself is explained by a brain lesion that occurred in utero or around the time of birth (such as an in-utero stroke, brief oxygen deprivation before birth, or a birth trauma to the young brain).   The neuromuscular system is affected, leading to motor impairments that hinder a child’s voluntary muscle control. Put simply, a child’s ability to control his trunk and move his body parts become limited.

Muscles and our brain’s ability to control them are a huge part of our physical function, from our vision and speech, to our sense of balance. This impaired control and coordination of voluntary muscles affects children in a variety of ways, depending on the location, timing, and severity of the brain lesion.  Much like a brain injury can affect a mature individual’s ability to control his limbs, a lesion in the immature brain often leads to decreased postural control and delayed physical development.  The lack of motor control is not always, but is often correlated with cognitive delays and learning disabilities, speech delays, visual or auditory impairments, and seizure disorders.

There are many misconceptions in the general community about children with CP.  Many people think CP is associated with mental delays and poor independent functioning. This is simply not the case for everyone with cerebral palsy.  Cerebral Palsy is often classified in different ways based on the movement disorder (stiffness, rigidity, low tone, uncontrollable movement, etc) observed. No matter the diagnosis or presentation, a team of healthcare professionals is absolutely essential to improve the lives of children and families affected with cerebral palsy.  It is important to begin a treatment program as early as possible to ensure a child develops to his or her full potential.  Sometimes, a child with CP may need surgery, orthotics, assistive technology, early intervention therapy, or medications, to improve their function and independence.

The role of the physical therapist:

One of the first steps to take after receiving a diagnosis of cerebral palsy is to discuss with your pediatrician and your child’s medical team about the interventions currently available and the interventions needed long-term. Often times, physical therapy becomes an indispensable part of a child’s medical care. Physical therapists will develop a plan of care based on the child’s abilities.

Our goal as physical therapists is to improve a child’s independence by doing the following:

  • Teaching him to move and play while protecting his joints from abnormal movements/postures
  •  Helping him strengthen muscles that are weak, keep stiff joints mobile, and stretch out muscles that are tight
  •  Fitting him for special equipment to help him stand, walk, and participate in school and life activities as needed
  •  Working with his family and caregivers on adaptive techniques and changes to their home or school environment, to allow him to interact with other children and participate in daily tasks
  •  Addressing his limitations and movement disorders by improving his posture, walking mechanics, endurance, and pain
  •  Accommodating for his changing needs as he matures and as new challenges arise, and
  •  Providing the child and his family emotional support, healthcare references, and professional insight to help him transition into adulthood.

Every child with cerebral palsy develops differently. The importance of early therapy is to help a child live up to his full potential with this neurological condition.

Reference: Olney SJ, Wright MJ. Cerebral palsy. In: Campbell SK, eds 3. Physical Therapy for Children. Philadelphia, Pa: WB Saunders Co, 2004 :625-664.