Q I am a foster mother of two beautiful children, an eight-year-old boy with spastic diplegia and a two-year-old girl with hypotonia and developmental delay of unknown cause. Both receive physical and occupational therapy. My son also gets speech therapy.
How do I determine if they are getting the right type and amount of therapy? Another foster mom says her daughter is getting both sensory integration therapy and visual therapy. Are there any advantages to those types of therapies? Also, could therapy prevent cerebral palsy if started right after birth?
A Disabilities like cerebral palsy and hypotonia are caused by injury to the brain. Therapy cannot prevent cerebral palsy.
Traditional therapies (physical, occupational and speech therapy) are only effective when their goals are appropriate for the child's current needs, abilities and disabilities, and developmental stage. The amount of therapy should promote improvement or prevent deterioration in function and abilities, if possible. Meaningful, measurable goals which are realistically attainable should be set by the parent, therapist and physician ordering the therapy with input from the child, if appropriate. Recreational, social and family issues should also be considered. Community resources should be used whenever appropriate.
Therapy goals in the pre-school and elementary years should focus on communication, self-care, mobility, comfort and prevention of deformity. In adolescence, goals should concentrate on the transition into adulthood independence, pre-vocational skills, self-care and ease of care and comfort.
Since the amount of "hands on" therapy is limited, parents should be taught a home program. According to IDEA '97, if therapy is necessary for the child to benefit from education, the school district must provide it. The district therapists should incorporate therapeutic goals into the classroom so the teaching staff can follow through with the activities. Whenever possible, all therapies-- private, state-funded and school-based--should be coordinated.
You are an integral part of the team and probably the best judge of the effectiveness of your children's therapy. You need to make it clear what you feel the treatment goals should be, assess the progress being made and assist the therapists and pediatrician or developmental specialist in recommending appropriate changes.
There is some skepticism in the medical community about the effectiveness of standard therapies. Studies have been done but the results have been mixed. I share your concern that ineffective therapy may detract from the real needs of your children. In my experience, the majority of parents and caregivers of children diagnosed with cerebral palsy or hypotonia feel therapy is effective for their children.
There is more controversy about nonstandard therapies, such as visual therapy and sensory integration therapy. Some parents try these therapies because traditional therapies didn't meet their child's needs. Unfortunately, nonstandard therapies are often based on oversimplified, pseudoscientific theories that claim a single cause and hence a single intervention to cure the dysfunction. …