Forms of Therapy and Treatment options after pediatric stroke..
The Family Role in therapy. Parents and families have the primary role in their child’s development. Your child's therapy team collaborates with the family to promote development and implement an individualized intervention program for your child.
Families should be supported through coordination of services, advocacy, and assistance to enhance the development of their child. Families have often shared daily living tips on how to create therapy for sensory, speech or occupational therapy through at home play and activities. Many helpful tips and articles for daily living can be found on our Pinterest Page to explore.
Families can ask the questions on how to coordinate therapy into day to day living with. Frequently asked questions can include:
Understanding your insurance. Private and public health insurance programs cover payment for certain therapy, but the services and reimbursement may vary and families should become familiar with the benefits provided by the policy or program in advance.
Families should be supported through coordination of services, advocacy, and assistance to enhance the development of their child. Families have often shared daily living tips on how to create therapy for sensory, speech or occupational therapy through at home play and activities. Many helpful tips and articles for daily living can be found on our Pinterest Page to explore.
Families can ask the questions on how to coordinate therapy into day to day living with. Frequently asked questions can include:
- How to positioning your child during daily routines and activities How to adapt toys, items for play and daily routines
- What mobility options with equipment are available
- How to Facilitate safety for the home and community
- What information can you provide to other members of the family, daycare, school districts on how to best support your child.
Understanding your insurance. Private and public health insurance programs cover payment for certain therapy, but the services and reimbursement may vary and families should become familiar with the benefits provided by the policy or program in advance.
Early Intervention- Birth to Three...
Early intervention programs provide specialized health, educational, and therapeutic services during the first three years of life for children who have developmental delays or disabilities. Children who are considered “at risk” of developing a delay may also receive services. The most common intervention services for children after stroke are physical therapy, speech and language therapy, and occupational therapy. These services are mandated by a federal law called the Individuals with Disabilities Education Act (IDEA). The law requires that all states provide early intervention services for all children who qualify, with the goal of enhancing the development of infants and toddlers.
Intervention is vital during this very early time because a child learns and develops at the fastest rate during these first few years. It’s important not to miss out on this crucial part of your child’s development. The goal is always to help your child achieve the highest possible functioning and interaction at home and in the community. An early intervention program can also be a huge support and guidance to your family. There is a lot to know about early intervention, we have covered the basics to help as you get started.
As you begin contacting different offices, we have found it helpful to keep a binder for records of conversations. In time, you will want to add other information to your file, such as: Letters (from doctors, therapists, etc.); Medical records and reports; Tests and evaluations results; Notes from meetings about your child (IFSP and IEP records.) Not only will this serve a purpose in the ongoing advocating about your child's overall care but as well will prove helpful while working with your insurance provider and ensuring the coverage to expect with the different therapies and services being utilized.
What to expect from an evaluation:
Your child needs to be evaluated to determine if he or she is eligible for early intervention services. This evaluation is of no cost to you because it is funded by the state and federal government.
You will be asked to sign a consent form prior to the evaluation and share information about your child’s development, health and medical history. You will be asked to provide information about your family’s resources, priorities and concerns. This information is necessary to help the early intervention team develop a plan that meet the needs of your child and family.
A team of professionals will work with you to evaluate your child’s development in five areas:
Physical: Reaching for and grasping toys, crawling, walking, jumping.
Cognitive: Watching activities, following simple directions, problem-solving.
Social-emotional: Making needs known, initiating games, starting to take turns.
Communication: Vocalizing, babbling, using two- to three-word phrases.
Adaptive: Holding a bottle, eating with fingers, getting dressed.
Once your child has been tested and determined to be eligible for early intervention services, you will meet with the early intervention team to develop a plan of services, called the Individualized Family Service plan. The IFSP contains goals, or outcomes, that you and other members of the team will identify based on your family’s concerns, priorities and resources. Services will be identified to help your child and family meet the IFSP outcomes.
Examples of early intervention services:
If your child has a disability or a developmental delay in one or more of the above developmental areas, then they will likely be eligible for early intervention services. Those services will be tailored to your child’s individual needs and may include:
Services may also be available to benefit your family as a whole. Family-directed services are meant to help family members understand the extra needs of their child and how to enhance their development.
Intervention is vital during this very early time because a child learns and develops at the fastest rate during these first few years. It’s important not to miss out on this crucial part of your child’s development. The goal is always to help your child achieve the highest possible functioning and interaction at home and in the community. An early intervention program can also be a huge support and guidance to your family. There is a lot to know about early intervention, we have covered the basics to help as you get started.
As you begin contacting different offices, we have found it helpful to keep a binder for records of conversations. In time, you will want to add other information to your file, such as: Letters (from doctors, therapists, etc.); Medical records and reports; Tests and evaluations results; Notes from meetings about your child (IFSP and IEP records.) Not only will this serve a purpose in the ongoing advocating about your child's overall care but as well will prove helpful while working with your insurance provider and ensuring the coverage to expect with the different therapies and services being utilized.
What to expect from an evaluation:
Your child needs to be evaluated to determine if he or she is eligible for early intervention services. This evaluation is of no cost to you because it is funded by the state and federal government.
You will be asked to sign a consent form prior to the evaluation and share information about your child’s development, health and medical history. You will be asked to provide information about your family’s resources, priorities and concerns. This information is necessary to help the early intervention team develop a plan that meet the needs of your child and family.
A team of professionals will work with you to evaluate your child’s development in five areas:
Physical: Reaching for and grasping toys, crawling, walking, jumping.
Cognitive: Watching activities, following simple directions, problem-solving.
Social-emotional: Making needs known, initiating games, starting to take turns.
Communication: Vocalizing, babbling, using two- to three-word phrases.
Adaptive: Holding a bottle, eating with fingers, getting dressed.
Once your child has been tested and determined to be eligible for early intervention services, you will meet with the early intervention team to develop a plan of services, called the Individualized Family Service plan. The IFSP contains goals, or outcomes, that you and other members of the team will identify based on your family’s concerns, priorities and resources. Services will be identified to help your child and family meet the IFSP outcomes.
Examples of early intervention services:
If your child has a disability or a developmental delay in one or more of the above developmental areas, then they will likely be eligible for early intervention services. Those services will be tailored to your child’s individual needs and may include:
- Assistive technology (devices a child might need)
- Audiology or hearing services
- Speech and language services
- Counseling and training for a family
- Medical services
- Nursing services
- Nutrition services
- Occupational therapy
- Physical therapy
- Psychological services
Services may also be available to benefit your family as a whole. Family-directed services are meant to help family members understand the extra needs of their child and how to enhance their development.
Connecting with an Early Intervention Service in your community...
Your child’s pediatrician can put you in touch with early intervention programs in your community, or many states have online information and further explanations for parents detailing the early intervention services in each state. Every effort is made to provide services to all infants and toddlers who qualify for services, regardless of family income. Services cannot be denied to a child just because his or her family is not able to pay for them.
Under IDEA, the following services must be provided at no cost to families: Evaluations and assessments, the development and review of the Individualized Family Service Plan, and service coordination.
Each state has varying policies when it comes to services not covered under IDEA. Some services may be covered by your health insurance, DDA Services or by the Medicaid Waiver program. Your family service coordinator will disclose and discuss all information regarding costs associated with any of your child's care once they have been determined eligible.
Early Childhood Technical Assistance Center; ECTA: National Directory
Under IDEA, the following services must be provided at no cost to families: Evaluations and assessments, the development and review of the Individualized Family Service Plan, and service coordination.
Each state has varying policies when it comes to services not covered under IDEA. Some services may be covered by your health insurance, DDA Services or by the Medicaid Waiver program. Your family service coordinator will disclose and discuss all information regarding costs associated with any of your child's care once they have been determined eligible.
Early Childhood Technical Assistance Center; ECTA: National Directory
Physical Therapy..
Pediatric physical therapy (PT) promotes independence, increases participation, facilitates motor development and function, improves strength and endurance, enhances learning opportunities, and eases challenges with daily caregiving.
Physical therapists will use their expertise in movement and apply clinical reasoning through the process of examination, evaluation, diagnosis, and intervention. Physical Therapy will address the child’s general strength and abilities in the areas of gross motor skills and mobility.
Pediatric physical therapy may include any of the following services as part of your child's plan of care:
Physical therapists will use their expertise in movement and apply clinical reasoning through the process of examination, evaluation, diagnosis, and intervention. Physical Therapy will address the child’s general strength and abilities in the areas of gross motor skills and mobility.
Pediatric physical therapy may include any of the following services as part of your child's plan of care:
- Developmental activities
- Movement and mobility
- Strengthening
- Motor learning
- Balance and coordination
- Recreation, play, and leisure
- Adaptation of daily care activities
- Tone management
- E-Stim
- Use of assistive technology
- Posture, positioning, and lifting
- Orthotics, AFO’S, SMO’S
Occupational Therapy..
Occupation refers to all of the “jobs” that make up our daily life, whether you are child or an adult. Occupational Therapy (OT) will evaluate your child’s ability to perform self care, play, and school skills at an age-appropriate level.
The goal of OT is for the child to participate as actively and fully as possible in all areas - self care, play, and school skills.
Through a comprehensive evaluation the OT can begin to identify issues that interfere with the child’s performance. This may include problems with strength, abnormal muscle tone, eye-hand coordination, visual perceptual skills, and sensory processing skills.
Pediatric OT’s may use a variety of approaches in assessing and treating children, including neuro-developmental treatment (NDT), sensory processing, motor learning approaches, constraint therapy, kinesiotaping, therapeutic listening programs, sensory integrative (SI) therapy, vision related therapies and feeding related therapy. Therapy is child directed and based on activities that are meaningful and purposeful to that specific child.
Your child’s therapist may also incorporate various tools and adaptive equipment to increase independence. Examples can include specialized feeding utensils, adaptive scissors and writing utensils, hand splints, and adaptations to clothing such as zipper pulls, button hooks, and Velcro.
The goal of OT is for the child to participate as actively and fully as possible in all areas - self care, play, and school skills.
Through a comprehensive evaluation the OT can begin to identify issues that interfere with the child’s performance. This may include problems with strength, abnormal muscle tone, eye-hand coordination, visual perceptual skills, and sensory processing skills.
Pediatric OT’s may use a variety of approaches in assessing and treating children, including neuro-developmental treatment (NDT), sensory processing, motor learning approaches, constraint therapy, kinesiotaping, therapeutic listening programs, sensory integrative (SI) therapy, vision related therapies and feeding related therapy. Therapy is child directed and based on activities that are meaningful and purposeful to that specific child.
Your child’s therapist may also incorporate various tools and adaptive equipment to increase independence. Examples can include specialized feeding utensils, adaptive scissors and writing utensils, hand splints, and adaptations to clothing such as zipper pulls, button hooks, and Velcro.
Speech Therapy..
Speech-language pathologists (SLP) evaluate communication skills and treat speech and language disorders. This can include receptive and expressive language, auditory processing, memory, articulation, fluency, oral-motor development, and feeding skills. The speech pathologist may also screen a child’s hearing and make a referral for further evaluation if needed.
Speech disorders include:
Language disorders can be either receptive or expressive:
Strategies:
Speech disorders include:
- Articulation disorders: difficulties producing sounds in syllables or saying words incorrectly to the point that listeners can’t understand what’s being said.
- Fluency disorders: problems such as stuttering, in which the flow of speech is interrupted by abnormal stoppages, repetitions (st-ststuttering), or prolonging sounds and syllables (ssssstuttering).
- Resonance or voice disorders: problems with the pitch, volume, or quality of the voice that distract listeners from what’s being said. These types of disorders may also cause pain or discomfort for a child when speaking.
- Dysphagia/oral feeding disorders: these include difficulties with drooling, eating, and swallowing.
Language disorders can be either receptive or expressive:
- Receptive disorders: difficulties understanding or processing language.
- Expressive disorders: difficulty putting words together, limited vocabulary, or inability to use language in a socially appropriate way.
Strategies:
- Language intervention activities: The SLP will interact with a child by playing and talking, using pictures, books, objects, or ongoing events to stimulate language development. The therapist may also model correct pronunciation and use repetition exercises to build speech and language skills.
- Articulation therapy: Articulation, or sound production, exercises involve having the therapist model correct sounds and syllables for a child, often during play activities. The level of play is age-appropriate and related to the child’s specific needs. The SLP will physically show the child how to make certain sounds, such as the “r” sound, and may demonstrate how to move the tongue to produce specific sounds.
- Oral-motor/feeding and swallowing therapy: The SLP will use a variety of oral exercises — including facial massage and various tongue, lip, and jaw exercises — to strengthen the muscles of the mouth. The SLP also may work with different food textures and temperatures to increase a child’s oral awareness during eating and swallowing.
Bracing and Orthotics..
When a child first receives a diagnosis and treatment plan it will most often include a recommendation for bracing or orthotic intervention. This usually proves to be a learning process for both the parents and the child.
It’s natural for parents to question the need for bracing and the benefits it will serve. As you learn more about orthotics and their potential role in the life of your child, you will come to know that orthotics can be a valuable resource for improving overall physical health and emotional well-being.
The Benefits of an Orthotic
Ankle Foot Orthotics (AFO’S) are commonly prescribed in children with neurological disorders such as stroke and Cerebral Palsy. Simply put, an AFO (sometimes called a brace or splint) provides support to help a child maintain a foot/ankle position, encourage mobility and overall improve stability and success.
Helping your child adjust emotionally
Even when an orthotic is properly fitted, in a fun design - your child may still experience frustration in wearing one. Most treatment plans require the orthotic to be worn continually, day and/or night. Be understanding that they may be somewhat apprehensive. Children don’t want to stand out from their peers, so it can be difficult to wear an orthotic because it is noticeable to others.
To help a child adjust:
It’s natural for parents to question the need for bracing and the benefits it will serve. As you learn more about orthotics and their potential role in the life of your child, you will come to know that orthotics can be a valuable resource for improving overall physical health and emotional well-being.
The Benefits of an Orthotic
Ankle Foot Orthotics (AFO’S) are commonly prescribed in children with neurological disorders such as stroke and Cerebral Palsy. Simply put, an AFO (sometimes called a brace or splint) provides support to help a child maintain a foot/ankle position, encourage mobility and overall improve stability and success.
Helping your child adjust emotionally
Even when an orthotic is properly fitted, in a fun design - your child may still experience frustration in wearing one. Most treatment plans require the orthotic to be worn continually, day and/or night. Be understanding that they may be somewhat apprehensive. Children don’t want to stand out from their peers, so it can be difficult to wear an orthotic because it is noticeable to others.
To help a child adjust:
- Be positive and explain how much the orthotic helps. Encourage your child to think of it as a something that makes them stronger, faster and safer.
- Talk with and prepare your child with answers for when others may ask about their orthotic.
- Share pictures and stories of other children or adults, that also wear orthotics.
Finding the perfect "fit"- Shoes & Orthotics
The struggle is most often real in finding the perfect shoe for your child to wear over their orthotic.
Some may only need to wear an orthotic on one foot, thus making a difference in shoe sizes and an increased challenge in purchasing shoes.
Consider checking out these recommended brands by parents:
Nordstrom (will sell separate sizes in same shoe)
Keeping Pace
EasyUp Shoes
Hatchbacks
New Balance
Stride Rite – Wide
Plae – with XL Tabs
Nike Flyease
BILLY Footwear
The struggle is most often real in finding the perfect shoe for your child to wear over their orthotic.
Some may only need to wear an orthotic on one foot, thus making a difference in shoe sizes and an increased challenge in purchasing shoes.
Consider checking out these recommended brands by parents:
Nordstrom (will sell separate sizes in same shoe)
Keeping Pace
EasyUp Shoes
Hatchbacks
New Balance
Stride Rite – Wide
Plae – with XL Tabs
Nike Flyease
BILLY Footwear
Constraint Induced Movement Therapy (CIMT)..
Constraint-induced movement therapy (CIMT) has applied to adult stroke patients with some beneficial results. The therapy is thought to increase the neural connections in the area of the brain that controls the affected side. Because of the success in adults with strokes, this therapy is now being applied to children.
CIMT is an motor therapy program for children with limited function in one of their arms. CIMT is often given in an intensive series of lessons over 2 to 3 week period and frequently in a fun environment that motivates the child to use the affected side. CIMT is for children who are able to cooperate with others during one-on-one and group therapies. Talk to your therapist about your child’s right age to participate in this form of therapy.
The non-affected arm is put in a long arm cast, usually for about two to three weeks. During this time, your child will do intensive training of the arm that has limited motor function. Therapists will help your child use the affected arm often, repeating the same motion over and over, shaping the desired movement.
Research continues to show that this can increase the awareness and quality of movement required for two-handed activities.
CIMT is an motor therapy program for children with limited function in one of their arms. CIMT is often given in an intensive series of lessons over 2 to 3 week period and frequently in a fun environment that motivates the child to use the affected side. CIMT is for children who are able to cooperate with others during one-on-one and group therapies. Talk to your therapist about your child’s right age to participate in this form of therapy.
The non-affected arm is put in a long arm cast, usually for about two to three weeks. During this time, your child will do intensive training of the arm that has limited motor function. Therapists will help your child use the affected arm often, repeating the same motion over and over, shaping the desired movement.
Research continues to show that this can increase the awareness and quality of movement required for two-handed activities.
Find a program...
To find a program in your area talk with your child's medical team or refer to a compiled list below. Based on insurance, location and your child's diagnosis, coverage varies so we encourage you to check with your insurance provider regarding this as a treatment option. Programs local to the Pacific Northwest Region:
Seattle Children's Hospital CIT Program:
Learn more about CIT (PDF) at Seattle Children's.
Seattle Therapy Network CIT Program:
Helper Hands Camp
Oregon's Doernbecher Children's Hospital:
CIMT Program
Additional programs throughout the US that have provided a Constraint Induced Movement Therapy program for children, have been listed below. We continue to grow these listings from feedback from families that have used these services. If you know of a program not mentioned, please contact us so we may add to the listings to share among families. Email us at [email protected]
(AL)Children's of Alabama
(CA)Glendale Adventist Medical Center
(CA) Kidspace
(GA) Power House Therapy 2019 Camp Flyer
(IL) Camp Kid Power 2019 Camp Flyer
(MA) Boston Children's Outpatient
(MA) Boston Ability Center's Constraint Induced Movement Therapy Camp - 2019 Camp Flyer
(MO)Minnesota Gillette Children's
(MO)Kenny Rogers Children’s Center
(NC) UNC Children's Hospital Helping Kids with Hemiplegia
(NC) Crossway Pediatric Therapy 2019 Camp Flyer
(NJ)Camp Helping Hands, 2019 Flyer
(NY)Rehabilitation Institute of Chicago
(NY) St Mary's
(OH)Cincinnati Ohio Children's
(OH)Cleveland Clinic Children's
Seattle Children's Hospital CIT Program:
Learn more about CIT (PDF) at Seattle Children's.
Seattle Therapy Network CIT Program:
Helper Hands Camp
Oregon's Doernbecher Children's Hospital:
CIMT Program
Additional programs throughout the US that have provided a Constraint Induced Movement Therapy program for children, have been listed below. We continue to grow these listings from feedback from families that have used these services. If you know of a program not mentioned, please contact us so we may add to the listings to share among families. Email us at [email protected]
(AL)Children's of Alabama
(CA)Glendale Adventist Medical Center
(CA) Kidspace
(GA) Power House Therapy 2019 Camp Flyer
(IL) Camp Kid Power 2019 Camp Flyer
(MA) Boston Children's Outpatient
(MA) Boston Ability Center's Constraint Induced Movement Therapy Camp - 2019 Camp Flyer
(MO)Minnesota Gillette Children's
(MO)Kenny Rogers Children’s Center
(NC) UNC Children's Hospital Helping Kids with Hemiplegia
(NC) Crossway Pediatric Therapy 2019 Camp Flyer
(NJ)Camp Helping Hands, 2019 Flyer
(NY)Rehabilitation Institute of Chicago
(NY) St Mary's
(OH)Cincinnati Ohio Children's
(OH)Cleveland Clinic Children's
Therapeutic Horseback riding and Hippotherapy Programs..
Therapeutic horseback riding has been around for years. Riding not only builds on self-confidence, but as well, the physical benefits of riding for children with disabilities is huge. Riding can assist in improving balance, strengthening muscles and improving coordination.
Hippotherapy is a form of speech, physical and occupational therapy or treatment using a horse as a healing medium. The characteristic movements of the horse are used to carefully render sequential sensory and motor input and improve sensory processing and neurological function
Find a Therapeutic Horseback Riding Center (National Listings)
American Hippotherapy Association (National Listings)
Hippotherapy is a form of speech, physical and occupational therapy or treatment using a horse as a healing medium. The characteristic movements of the horse are used to carefully render sequential sensory and motor input and improve sensory processing and neurological function
Find a Therapeutic Horseback Riding Center (National Listings)
American Hippotherapy Association (National Listings)
Botox Treatment for Spasticity..
Spasticity, or muscle stiffness, is a common problem for children after stroke who have been diagnosed with cerebral palsy. Spastic muscles are tight and make all movement difficult. Consequently, spasticity can interfere with many motor activities including sitting, walking, feeding, talking and play.
What is Botox?
Botulinum-A Toxin is a substance made by bacteria. This toxin can be purified and used safely and effectively to reduce spasticity in specific muscle groups. Botox works by blocking the chemical signal between nerves and muscles that makes the muscle contract or tighten. This provides reliable relief from spasticity symptoms including pain and muscle stiffness.
The benefits of Botox can include:
To get the best effects from Botox your child's physician will inject the botox directly into the affected muscle group. Since this procedure involves multiple needle injections, all efforts are made to minimize anxiety and discomfort. Talk to your child's doctor about the ability to administer the below in making a child more comfortable during the process.
The procedure. If requested, versed is given prior to the start of the procedure. Once the physician is ready to administer the Botox, they will identify which muscle groups need to be injected. These areas are cleaned with alcohol and the “freeze spray” is applied. They will then administer the Botox using a small needle. The number of injections will depend on the size of the muscle and the total number of muscles to be injected. The actual injection procedure will take just a few minutes. After the injections are completed you will be given specific instructions regarding follow up.
Most start to see results from the Botox within a week, with maximum results between three to four weeks after the injections. Usually, Botox provides relief of spasticity in the injected muscle for over three months at which time you may begin to notice a gradual fading of its effects. It is important to know that this treatment is only temporary and to continue with your child's therapy program and rehab team to continue working together for the greatest overall success.
What is Botox?
Botulinum-A Toxin is a substance made by bacteria. This toxin can be purified and used safely and effectively to reduce spasticity in specific muscle groups. Botox works by blocking the chemical signal between nerves and muscles that makes the muscle contract or tighten. This provides reliable relief from spasticity symptoms including pain and muscle stiffness.
The benefits of Botox can include:
- Significantly improved gait pattern.
- Improvement in positioning and range of motion.
- Decreased pain in stiff muscles.
- Reduction of spasticity and greater ease in stretching.
- Improved tolerance of AFO/SMO Orthotics.
- Possible delay in surgery until the patient is older.
To get the best effects from Botox your child's physician will inject the botox directly into the affected muscle group. Since this procedure involves multiple needle injections, all efforts are made to minimize anxiety and discomfort. Talk to your child's doctor about the ability to administer the below in making a child more comfortable during the process.
- Ethyl Chloride: All patients will have a “freezing spray” used on the area to be injected.
- Oral versed-If requested by the family, this drug is given prior to the procedure by mouth to reduce anxiety and provide amnesia for the procedure. When versed is given, vital signs are taken before and after the procedure and additional monitoring may be required. The medication takes about 20-30 minutes to take effect.
The procedure. If requested, versed is given prior to the start of the procedure. Once the physician is ready to administer the Botox, they will identify which muscle groups need to be injected. These areas are cleaned with alcohol and the “freeze spray” is applied. They will then administer the Botox using a small needle. The number of injections will depend on the size of the muscle and the total number of muscles to be injected. The actual injection procedure will take just a few minutes. After the injections are completed you will be given specific instructions regarding follow up.
Most start to see results from the Botox within a week, with maximum results between three to four weeks after the injections. Usually, Botox provides relief of spasticity in the injected muscle for over three months at which time you may begin to notice a gradual fading of its effects. It is important to know that this treatment is only temporary and to continue with your child's therapy program and rehab team to continue working together for the greatest overall success.
Serial Casting..
Serial Casting is a treatment to achieve long-term correction of range of motion, improvement in walking and to delay or prevent future surgery. When a child walks on their toes, the goal of casting is to make the ankle muscle grow longer through positioning and activity. Serial Casting should not be a painful process.
What to expect during the casting process:
During serial casting, joints that are limited in range of motion are immobilized with a well-padded plaster and fiberglass cast. The casts are applied and removed on a weekly basis. With each series of casts, the affected joint or joints are gradually set in a more correct alignment until the desired range of motion is achieved.
The casts extend over the child’s toes to provide a stable base of support while realigning joints, allowing muscles to strengthen and teaching children to correct their center of weight for a more effective walking pattern. Children are encouraged to participate in all of their typical daily activities while wearing their casts. The regular movement helps strengthens the muscles they need for correct walking alignment. Talk with your child's physical therapist as they can provide specific exercises for your child to do at home while casted.
There is not a typical amount of time for the casting process because each child’s muscles change at different rates, and your child's rehab team will indicate the best length of time for the casting process. Typically programs can range from 4 weeks to as long as 16 weeks for the best results.
At the end of serial casting, the child is given ankle-foot orthoses (AFOs) for daytime use and AFOs set in dorsiflexion for night use so that alignment is maintained and not lost while the child is sleeping. The AFOs brace the lower limb (e.g., lower leg, ankle and foot) and maintain the alignment that was gained during the serial casting process.
What to expect during the casting process:
During serial casting, joints that are limited in range of motion are immobilized with a well-padded plaster and fiberglass cast. The casts are applied and removed on a weekly basis. With each series of casts, the affected joint or joints are gradually set in a more correct alignment until the desired range of motion is achieved.
The casts extend over the child’s toes to provide a stable base of support while realigning joints, allowing muscles to strengthen and teaching children to correct their center of weight for a more effective walking pattern. Children are encouraged to participate in all of their typical daily activities while wearing their casts. The regular movement helps strengthens the muscles they need for correct walking alignment. Talk with your child's physical therapist as they can provide specific exercises for your child to do at home while casted.
There is not a typical amount of time for the casting process because each child’s muscles change at different rates, and your child's rehab team will indicate the best length of time for the casting process. Typically programs can range from 4 weeks to as long as 16 weeks for the best results.
At the end of serial casting, the child is given ankle-foot orthoses (AFOs) for daytime use and AFOs set in dorsiflexion for night use so that alignment is maintained and not lost while the child is sleeping. The AFOs brace the lower limb (e.g., lower leg, ankle and foot) and maintain the alignment that was gained during the serial casting process.