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Neuromotor Therapy Program

 Neuromotor Therapy Program
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Children are referred to the Neuromotor Therapy Program at Children's Hospital Boston from within Children's and by outside caretakers to develop a management plan for motor enhancement. Management strategies are then used in the child's local educational and therapy services and are periodically re-evaluated in the Neuromotor Therapy Program.

Evaluations are performed by two child neurologists, Adre du Plessis, MD and Basil Darras, MD and physical therapist, Janet Quigley, PT PCS.

The development of a management plan for these children may include opinions of other consultation services within Children's including orthopaedic surgeons, Brian Snyder, MD and Lawrence Karlin, MD and neurosurgeon, Joseph Madsen, MD.

Once a rational management plan is established and implemented, the child is referred back to their primary neurologist with close follow-up and re-evaluation in the Neuromotor Therapy Program.

The Neuromotor Therapy Program provides consultation services for any child with non-progressive, early life brain injury, including diagnoses of:

  • Cerebral palsy
  • Traumatic brain injury
  • Spinal cord injury
Services

The Neuromotor Therapy Program provides:

  • Comprehensive, multi-disciplinary evaluation of the motor challenges and strengths of children with movement disorders related to early brain injury.

  • Development of a rational treatment plan for motor enhancement considering all aspects of the motor function of the child, including gait, hand function and oral language.

  • Consultation with other services at Children's, including orthopaedics and neurosurgery, as needed to develop optimal management strategies.

  • Re-evaluation of the child's evolving challenges and responses to treatment coordination and scheduling of treatments at Children's.

  • Advocacy for services and coordination of treatment plans with community providers.

  • Family and social support.

    This program does not consult regarding children with primary muscle or peripheral disease or rapidly progressive brain disease, who are served by other programs within the hospital.

    Treatment

    Our goals are to enhance all aspects of motor function in the brain-injured child including gait, hand function and oral language.

    Treatment includes:

  • Oral medications. Children with increased muscle tone or spasticity may benefit from oral medications that relax the muscles.

  • Injected medications. In certain cases, a trial of injected medications such as botulinum toxin (Botox) to specific muscles may be recommended.

  • Implanted medications. Other children may benefit from the use of an implanted pump that delivers a continual infusion of the medication baclofen into the child's spinal fluid.

  • Surgery. Some children may be considered candidates for an operation called selective dorsal rhizotomy, aimed at reducing spasticity in the legs. And for certain children with longstanding abnormalities in muscle function causing abnormal growth of the bones and joints, orthopaedic surgery may be necessary. Communication

    The ability to communicate is critical to the development of the whole child. Children, whose motor difficulties impair their ability to express themselves, experience major developmental and educational obstacles. Specialists in the Neuromotor Therapy Program collaborate with the internationally recognized Augmentative Communication Program at Children's.

    This exciting new field aims to utilize advances in neuroscience and computer technology in order to facilitate the child's access to the "information highway", thereby empowering the child in the classroom and, ultimately, in the workplace.

    In the Neuromotor Therapy Program, specialists aim to maximize specific motor functions that will allow a child to operate advanced assistive communication technology through tools such as "joysticks", computers and head-switches.

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