Magazine article The Exceptional Parent

The Team Approach to Assessment and Treatment of Spasticity

Magazine article The Exceptional Parent

The Team Approach to Assessment and Treatment of Spasticity

Article excerpt

No single spasticity treatment is appropriate for every individual and no treatment is perfect. Because there are options, parents, individuals with spasticity, primary care physicians and other professionals must work together as part of an effective treatment team.

Team approach

The family and the individual are the central part of the treatment team. After them, it is important to have a solid clinical team. Indeed, a multidisciplinary clinical team approach is the most effective method for evaluation, goal-setting and treatment planning. It makes sense for specialists from related health care fields to meet with the individual with spasticity and parents or care providers to make treatment decisions. The clinical team needs to confer regularly to reevaluate the individual's condition and modify goals and treatment plans as appropriate.

At typical medical centers serving individuals with spasticity, several different specialists participate, including (but not limited to):

* a neurosurgeon to examine and surgically treat conditions affecting the nervous system -- brain, spinal cord and nerves;

* an orthopedic surgeon to examine and surgically treat conditions affecting the musculoskeletal system -- bones, joints, muscles and tendons;

* a physiatrist to examine and treat via non-surgical interventions such as medication, therapies (physical, occupational, speech) and adaptive medical equipment.

Other specialists who often figure prominently on the clinical team roster include pediatric neurologists, psychologists, developmental pediatricians.

The clinical team also includes:

* the child's pediatrician, who can provide critical insight into the original diagnosis and subsequent treatments and general health;

* a physical therapist to assess gross motor skills -- sitting, walking, movement patterns, posture, balance -- and suggest treatment;

* an occupational therapist to assess fine motor skills -- eating, dressing, grooming, other activities of daily living -- and suggest treatments;

* a social worker to assess family needs as well as the personal and social needs of the individual with spasticity. Speech language therapists, nurses and nutritionists may be part of the team as well.

Usually, each clinician meets with the person with spasticity either individually or with another clinical team member. Clinicians may also meet with parents or care providers. …

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