In this section
Conditions treated by physical medicine and rehabilitation
Arthrogryposis refers to a number of different conditions that are marked by joint stiffness usually because of abnormal muscle development. Present at birth, the conditions can affect the motion and independent use of your child’s arm, wrist, leg and hip joints. Some children with arthrogryposis will have difficulty with walking and hand and arm function.
Arthrogryposis care at Children’s
All children with arthrogryposis will need stretching, therapy, casting and splinting. Some children with arthrogryposis may require surgery, but many do well without. At The pediatric rehabilitation team at Children’s offer coordinated care between therapists, surgeons and the child’s school.
Ataxia is a movement disorder found in a number of conditions. Ataxia makes it hard for your child to balance and control and coordinate movement. It usually presents itself in early childhood, when you may notice your child has difficulty walking or slurred speech.
Ataxia care at Children’s
There are no medications or surgical procedures to address ataxia. However, our team can improve your child’s independence and overall function. In addition to physical, occupational and speech therapies our rehabilitation physicians often recommends mobility equipment and weighted garments.
Brachial plexus palsy
About brachial plexus palsy
The brachial plexus is the maze of nerves that provide movement and sensation to your child’s arms and hands. When it is injured, brachial palsy can occur In adults brachial plexus palsy is usually caused by a trauma or injury. In children brachial plexus palsy usually seen at birth and usually associated with difficult delivery or high birth weight. The vast majority of patients with brachial plexus birth palsy get better spontaneously.
Brachial plexus palsy care at Children’s
Rehabilitation medicine sees children with brachial plexus palsy in conjunction with occupational therapy. We recommend special exercises and on going occupational therapy. For some children we recommend splinting and if no spontaneous improvement some children will be referred for a surgical evaluation. Research has shown that if needed surgery in the first year of life can be very helpful for long term arm function.
Brain injury caused by trauma, infection or anoxia
About brain injury
Our brains control our bodies, both consciously and unconsciously. An injury to the brain can cause problems with your child’s movement, cognition and feeding. Brain injuries may be caused by trauma, infection, or anoxia (reduced of oxygen to the brain). Your child’s symptoms could range in affect from mild to severe.
Brain injury care at Children’s
Your child may need help learning or relearning everyday skills. The Children’s team first determines your child's level and then sets goals for your child, that are customized to the individual child and family We’ll design a treatment plan for your child that may include physical therapy, occupational therapy, speech therapy, psychology and neuropsychology, or a combination of those and other treatments.
About cerebral palsy
Cerebral Palsy (CP) is a broad term that includes a group of physical disabilities that interfere with your child’s motor and possibly cognitive development. It is a lifelong condition that affects your child’s brain and its communication with muscles. This leads to trouble with walking, other gross and fine motor activities and sometimes learning and eating.
Cerebral palsy at Children’s
CP is the most common causes of motor disabilities in children. The team of experts at Children’s is skilled at supporting you and your family in all aspects of care. Our focus is on maximizing your child’s abilities and fostering his or her self-esteem and independence.
About delayed walking
Although all children are different, most are able to pull themselves up to standing between eight and twelve months of age. In general, children take their first steps not long after their first birthday. When a child does not walk by 18 months it is best to have the child evaluated by a specialist. There may be no underlying problem but is important to check the child’s bones, muscles and nervous system.
Delayed walking care at Children’s
Children’s pediatric rehabilitation team is skilled and experienced in diagnosing the causes of delayed walking. Your child’s treatment plan depends, of course, on the underlying reason for the walking delay. We may partner with Children’s orthopedists or neurologists to determine the best course of action. This may include physical therapy, braces, and in rare cases, surgery.
About developmental delays
Children can experience a number of developmental delays. This means they lag behind in reaching developmental milestones, involving intellectual, social and physical function. Many children catch up over time and this is why birth to three therapy can be very helpful. However, some developmental delays are more serious in nature and are the first sign of underlying genetic or medical condition.
Developmental delay care at Children’s
The Children’s rehabilitation team sees children with suspected developmental delay. Our team helps to determine if there is an underlying condition and if needed refers to specialists to assist in accurate diagnosis. Regardless of the cause, each child is given a unique treatment plan that may include speech, physical, and occupational therapy as well as bracing and equipment.
Drooling is the inability to contain saliva in your mouth. It is frequently seen in infants and typically outgrown. Persistent drooling can be seen in children with cerebral palsy and a variety of neurologic and muscular conditions. Most of these children do not make excessive saliva but have trouble closing their mouth or swallowing the saliva.
Drooling care at Children’s
Children’s rehabilitation doctors see a wide variety of children with neurologic and muscular conditions. We sometimes start medication or speech therapy for drooling in the rehabilitation clinic. Other times we recommend a more detailed evaluation be performed at the salivary management clinic.
Dystonia can be caused by a number of different conditions. Dystonia is characterized by repetitive twisting motions and postures. Dystonia can be worse when your child is excited, sick or trying to do a task. Children with dystonia often have speech difficulties or trouble swallowing, walking or using their arms. Dystonia affects each child differently, involving different muscle groups and producing symptoms that range from mild to severe.
Dystonia care at Children’s
At Children’s, dystonia is treated by our rehabilitation doctors. As dystonia affects each child differently, our team designs a treatment plan specifically aimed to meet your child’s individual needs. The plan may include oral or injectable medication, use of splints and/or physical therapy. In more severe cases, surgery may be indicated.
Read more about our tone management and spasticity program.
About foot drop
When your child has difficulty lifting the front part of his or her foot, it is referred to as foot drop or, sometimes, drop foot. It is usually a sign of an underlying brain, nerve or muscle problem. It can be caused by a variety of different conditions that affect those parts of the body. Some cases are temporary and others are permanent conditions. Both require evaluation and treatment.
Foot drop care at Children’s
For many children, a brace or splint may be necessary. We may also recommend physical therapy and stretching to help strengthen muscles. In more extreme cases, surgery may be required. Children’s has all of the specialist necessary to effectively care for your child.
About Guillain-Barré syndrome
Guillain-Barré syndrome is a disorder that affects your child’s nerves. It can cause tingling sensations as well as weakness, numbness, trouble speaking, eating, breathing,and emptying the bowel and bladder. Its cause is unknown, but it often follows an infection.
Guillain-Barré care at Children’s
Treatment for Guillain-Barré syndrome at Children’s is a coordinated effort with neurology and rehabilitation and sometimes critical care. The rehabilitation team works closely with other specialists during treatment, and we help to coordinate physical, occupational, and speech therapy treatments. In the hospital and later at home.
Hypotonia refers to a decrease in your child’s muscle tone. It can occur throughout the whole body or be focused on a specific group of muscles, such as the trunk. Infants with hypotonia can appear “floppy,” and sometimes they have difficulty with head and muscle control. If your child has hypotonia, he or she may have delayed motor skill development, decreased strength, poor posture, drooling, swallowing difficulties, and speech impairments.
Hypotonia care at Children’s
Children’s rehabilitation doctors will evaluate your child’s tone and if needed will work closely with neurology and genetics to determine the cause. Your child’s treatment plan may include physical, occupational and speech therapy, as well as bracing and equipment. We can help your child meet his or her milestones.
Myopathies are diseases that causes muscle weakness. Some are inherited and are present in children at birth. Others are acquired later in childhood and can be caused by medication.
Myopathy care at Children’s
As myopathies vary widely, so do treatment approaches. Most children with myopathy need physical, occupational and speech therapy. Many times we also recommend bracing and equipment. We also help to coordinate care and evaluate the need for visits to other specialist such as cardiologists, pulmonologists and sleep specialists.
Neuropathy refers to a number of conditions affecting your child’s nerves. These can result in pain, weakness and disability. Neuropathies can have any number of causes, including trauma, infection, lifesaving medication and underlying conditions.
Neuropathy care at Children’s
Treatment of neuropathies varies widely. Typically, at Children’s, we use therapy, bracing, equipment and sometimes medication. Our goal at Children’s is to improve the quality of life and independence of children with neuropathy and other neuromuscular conditions.
Simply put, spastic muscles are stiff, tight and difficult to control. Spasticity can interfere with your child’s ability to walk, move, eat and/or talk. Your child may also experience pain, involuntary movements. In the long term bone and joint deformities result from spasticity.
Spasticity care at Children’s
Children with spasticity respond well to speech, occupational and/or physical therapy. Our therapists help stretch and strengthen the muscles. They also recommend equipment and adapations to make day to day things easier. Our team helps to tailor therapies. Often we recommend braces and medication. Options for medication include those taken by month and sometimes injections such as phenol nerve blocks or botulinum toxin injections. Sometimes surgery such as intrathecal baclofen pump or selective dorsal rhizotomy is recommended.
Read more about our tone management and spasticity program.
Spina bifida is the most common permanently disabling condition for children in the U.S. The infant’s spinal column doesn’t develop properly in the womb. Typically there is leg weakness, incontinence and brain abnormalities. This can cause problems with overall development, walking and cognition.
Read more about spina bifida from the Spina Bifida Association.
Spina bifida care at Children’s
Children’s pediatric rehabilitation medicine team works closely with our hospital’s neurosurgeons, urologists, neuropsychologists and orthopedic specialists to develop the right treatment plan for your child. The Children’s rehabilitation team is committed to optimizing your child’s independence and quality of life.
Read more about Children’s spina bifida program
Spinal cord injury
About spinal cord injury
The spinal cord is a bundle of nerves that carries messages between the brain and the rest of your child’s body. Spinal cord injuries involve bruises or tears to the spinal cord. These can be caused in numerous ways, including injuries from birth, car accidents, violence, and tumors. Spinal cord injury can impair your child’s ability to walk, use his/her arms, eat, breath and empty his/her bowel and bladder.
Read more >>
Spinal cord injury care at Children’s
Treatment for a spinal cord injury depends on the type and severity of your child’s injury. Most children will require intensive physical and occupational therapy during the course of their recovery. Our team partners with Children’s neurosurgeons, oncologists, orthopedists, urologists and therapists to ensure your child gets the care he or she needs. Our goal is to maximize your child’s independence and quality of life.
Although people tend to think of strokes as occurring in older adults, infants and children can suffer from stroke too. These strokes can be ischemic (meaning they are caused by a cut-off in blood flow) or hemorrhagic (meaning they are caused by bleeding). Strokes cause damage to the nervous system, which may affect your child’s ability to think, speak, feed and move.
Stroke care at Children’s
Children who have had a stroke may need to relearn everyday skills or they may need help reaching new developmental milestones. At Children’s, we work closely with your family to develop a treatment plan that meets your child’s individual needs. The plan may include physical therapy, speech therapy, occupational therapy and neuropsychology.
For many children, walking on their tip-toes is just a normal part of development as they learn to walk. Most outgrow it as they get older. However, toe-walking can also be a symptom of a more serious condition, such as cerebral palsy, muscular dystrophy or other nerve and muscle diseases.
Toe-walking care at Children’s
The Children’s rehabilitation doctors are specially trained to help determine the cause of your child’s toe-walking. They will also recommend appropriate treatment which may include physical and occupational therapy, use of leg braces, splints, a series of casts and sometimes botulinum toxin injections. In more serious cases, where other treatments don’t work, we may suggest surgery.
About transverse myelitis
Transverse myelitis is caused by inflammation of the spinal cord. This can lead to weakness, numbness, trouble speaking, eating, breathing,and emptying the bowel and bladder. These problems will improve over time, but not everyone has a complete recovery.
Transverse myelitis care at Children’s
Treatment for transverse myelitis is a coordinated effort between Children’s neurology and rehabilitation. The neurology groups treats the underlying condition and rehabilitation focuses on strengthening and regaining skills lost. We work closely with the physical, occupational and speech therapists to customize your child’s treatment plan, and assist in the transition from the hospital to home and school.
Some children experience muscle weakness. This can be due to a condition they were born with and that can cause developmental delays as they grow up. As a parent, you know your child best. If you suspect your child has abnormal muscle weakness or delayed development, you should have him or her evaluated by a physician, which can be your child’s primary care doctor or one of our pediatric rehabilitation clinicians.
Read the CDC’s developmental milestones checklist.
Weakness care at Children’s
Our pediatric rehabilitation team is specially trained to help asses, diagnose and treat developmental milestone delays and muscle weakness. Typically treatment includes physical, occupational and speech therapy. The Children’s rehabilitation team will also prescribe bracing and other equipment as needed. We may also assist with school adaptations and community resources.