Patients must be periodically re-evaluated for a clinicalfunctional check-up, to detect any complications, and to update the rehabilitation program.
If follow up shows that the goals are achievable through intensive rehabilitation treatments, they should be proposed.
On 12/12/2012, in our Hospital in Palidor, the multidisciplinary Day Hospital activity for children with disabilities began.
It is aimed at children and adolescents affected by genetic or acquired diseases that cause complex, high-needs disabilities.
The goas is to provide early and integrated multidisciplinary care and to link hospital care with community-based care, improving continuity of care and reducing hospitalizations.
The team consists of various specialists who are motivated and skilled in caring for children wit medical complexity
Associated Disorders
• Intellectual disability
• Epilepsy
• Muscle hypertonia, dystonia and other movement disorders
Global developmental delay and intellectual disability in patient with brain injury are very common.
Today, the concept of intelligence takes into account the adaptive intelligence
Generalintellectualfunctioningisdefined bythe Intelligence Quotient (IQ),obtained throughassessment with one or more standardizedtests.
Adaptive intelligence: The ability of a person to function independently and socially responsibly in daily life. Adaptive intelligence is assessed through adaptive skills, which include conceptual, social, and practical skills.
IT’S CRUCIAL TO UNDERSTAND STRENGT
H POINTS
WEAKNES
S POINTS
EPILEPSY
ETIOLOGY
IDIOPATHIC
Nostructural brain injury or other neurological signsor symptoms.Possible geneticpredisposition
SYMPTOMATIC
Theseizuresarethe result of oneormore structurallesions.
CRYPTOGENIC
Theseizuresarepresumed to be symptomatic, but no identifiable causescan befound
impact of AED on cognitive function and quality of life (Klein M 2003)
Antiepilectic medication can impact cognitive functions
New AEDs may impact less on the cognitive level (no studies yet)
• Pediatric Neuropsychiatric: diagnosis and medical managementof developmental disorders
• Physiotherapist: Assessment and rehabilitationprogram
• Psychologist : Cognitive and behaviour assessment
• Speech therapist: Communication and Learning SkillsAssessment
• Psychopedagogue: designs and implements special educational plans for children
• Occupational Therapist:Assessment and Intervention in DailyActivities
REHABILITATION
EARLY REHABILITATION INTERVENTION
Neuroprotection, a term initially used to characterize substances capable of preventing cell death, now encompasses all interventions that promote normal development and prevent disabilities, including organisational, therapeutic and environment-modifying measures, such as early stimulation programs (Bonnier, 2008).
Neuroplasticity is particularly pronounced when the process of neural multiplication and migration is largely completed, but the arborization of dendrites and axons and the process of synaptogenesis is still occurring (Kolb, 2001)
2-3 months
6-8 months
Perinatal insult
Time of detection and intervention
EARLYDetection & Diagnosis of (High-Risk of) Cerebro! Palsy
INTERNATIONAL RECOMMENDATIONS
JAMAPedlatrics I Review 2011
Early,Accurate Diagnosis and EarlyIntervention in CerebralPalsy Adanc s in Diagnosis and Treatmn
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