Treadmill therapy (exoskeleton assisted) for cerebral palsy

A  study using the Lokomat robotic assisted treadmill was conducted at University of Munich, Germany. The results are very exciting because they are exactly as we would have expected based on the research of BRIGHT.

The study shows that assisted gait training improves Gross Motor Skills in a very short period of time (just three weeks of periodic training).  It also shows that results improve with more intense training.

This strengthens the case of BRIGHT that a fully autonomous exoskeleton that will allow 24×7 training would be the ideal treatment approach for Children with CP.  Children that are more severely impaired would stand the most to gain because current systems like the Lokomat are bulky and require the child to exercise in a controlled environment.  This is demotivatational and impractical and therefore, only when more sophisticated exoskeleton suits which allow the child freedom to interact in a natural setting will the child be motivated to “train” intensively and thus achieve improvement through re-routing of the brain through neuroplasticity.

Robotic-assisted treadmill therapy improves walking and standing performance in children and adolescents with cerebral palsy

Abstract

Objective

Task-specific body-weight-supported treadmill therapy improves walking performance in children with central gait impairment. The aim of the study was to investigate the effect of robotic-assisted treadmill therapy on standing and walking performance in children and adolescents with cerebral palsy and to determine parameters influencing outcome.

Methods

20 Patients (mean age 11.0±5.1, 10 males and 10 females) with cerebral palsy underwent 12 sessions of robotic-assisted treadmill therapy using the driven gait orthosis Lokomat. Outcome measures were the dimensions D (standing) and E (walking) of the Gross Motor Function Measure (GMFM).

Results

Significant improvements in dimension D by 5.9% (±5.2, p=0.001) and dimension E by 5.3% (±5.6, p<0.001) of the GMFM were achieved. Improvements in the GMFM D and E were significantly greater in the mildly affected cohort (GMFCS I and II) compared to the more severely affected cohort (GMFCS III and IV). Improvement of the dimension E but not of D correlated positively with the total distance and time walked during the trial (rs=0.748, p<0.001).

Conclusions

Children and adolescents with bilateral spastic cerebral palsy showed improvements in the functional tasks of standing and walking after a 3-week trial of robotic-assisted treadmill therapy. The severity of motor impairment affects the amount of the achieved improvement.

Keywords: Driven gait orthosis, Body-weight-supported treadmill therapy, Task-specific learning

Abbreviations: DGO, driven gait orthosis, CP, cerebral palsy, GMFM, gross motor function measure, GMFCS, gross motor function classification system, BWSTT, body-weight-supported treadmill therapy

    • Ingo Borggraefe

      Affiliations

      • Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children’s Hospital, University of Munich, Germany
      • Corresponding Author InformationCorresponding author. Tel.: +49 89 5160 7851; fax: +49 89 5160 7745.

      email address

,

    • Jan Simon Schaefer

      Affiliations

      • Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children’s Hospital, University of Munich, Germany

,

    • Mirjam Klaiber

      Affiliations

      • Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children’s Hospital, University of Munich, Germany

,

    • Edward Dabrowski

      Affiliations

      • Children’s Hospital of Michigan, Division of Physical Medicine and Rehabilitation, Wayne State University School of Medicine, Department of Pediatrics, Detroit, MI, USA

,

    • Corinne Ammann-Reiffer

      Affiliations

      • Rehabilitation Centre, Affoltern a. Albis, University Children’s Hospital Zurich, Switzerland

,

    • Beat Knecht

      Affiliations

      • Rehabilitation Centre, Affoltern a. Albis, University Children’s Hospital Zurich, Switzerland

,

    • Steffen Berweck

      Affiliations

      • Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children’s Hospital, University of Munich, Germany

,

    • Florian Heinen

      Affiliations

      • Department of Paediatric Neurology and Developmental Medicine, Dr. von Haunersches Children’s Hospital, University of Munich, Germany

,

Wilmington Robotic Exoskeleton

Here is a video of the Wilmington Robotic Exoskeleton.  The WREX is an orthosis for enhancing movement of the upper extremities in people with neuromuscular disabilities

This unique assistive device aids in activities of daily living for a variety of pathologies such as muscle disease, cerebral palsy, spinal cord injury, multiple sclerosis and amyotrophic lateral sclerosis – which effect upper limbs. It also serves as a cost effective exercise/therapy device for people recovering from stroke and other debilitating injuries.

Exoskeletons – An Interview With Prof. Daniel Ferris

As we have suggested in our article Exoskeleton Suits for Cerebral Palsy – The Idea, Professor Ferris also shares the idea that soon Exoskeletons could be used to help rehabilitate those with Cerebral Palsy.

There is a very good article about the possible use of Exoskeletons for therapeutic purposes at this link http://www.exoskeleton-suit.com/FerrisInterview.html.

The link is an interview with Professor Daniel Ferris who is a world renown expert on the subject of exoskeletons.

Exoskeleton Suits for Cerebral Palsy – The Idea

The Iron Man movies have made Exoskeleton Suits a popular idea.   However, Exoskeleton Suits don’t only have to be for fighting and the military.   With the use of computer assistance, an Exoskeleton Suit can serve the purpose of a physical therapists’ that works 24×7.

Here is my idea:

1.) We know that brain plasticity is possible.

2.) We know that re-training the brain does not come easily (otherwise brain specializations like pattern recognition achieved over of millions of years of evolution could easily be wiped out).  In fact, there is the 10,000 hour rule.  Which says that to master some special skill requires 10,000 hours of dedicated practice.  “Mastering a skill” is just another way of saying the brain has been “re-trained” and has developed new specializations.

3.) There is scientific proof this occurs as MRI’s have been used to look at the brains of concert violinist’s and it is clear that they recruit new areas of the brain, that would not be associated in order to master their skill.

4.) Now look at a typical CP patient who has suffered an anoxic brain injury and damage to the basil ganglia.  The issue for these patients is metering of movement.   They can start their muscles, but have a difficult time to  modulate movement.   The result is compensating strategies of either extension or contraction.  Movements appear uncontrolled.   Ask them to pick up a cup of water and what is likely to happen is the cup of water will end up on the floor.  Because of this, frustration sets in quickly, typical PT and OT therapy becomes a lesson in frustration and defeat.   Before long, therapy time becomes an hour to avoid… hardly the recipe to achieve the 10,000 hour rule to master a skill!!

5.) Enter the Exoskeleton Suit.   If an intelligent Exoskeleton Suit can be built, then therapy can become a 24×7 activity.  With an intelligent design, no longer will a simple movement like grasping a cup be a frustration, it will be a success.  With success, comes confidence and motivation.  The intelligent design will allow the Exoskeleton Suit to provide just enough assistance to ensure successful movement, however, with each passing day, the amount of assistance the suit is providing can be scaled back, ever so slowly, such that the user does not even realize that with each passing day they are doing more and more of the work themselves.

6.) Before long, maybe just weeks, it is my opinion that the patient would have retrained the brain through plasticity and the motion regulating function of the basil ganglia would have been taken over by some other area of the brain.

Looking at all the possible thearpies, the Intelligent Exoskeleton Suit, is the #1 priority for the Bright Foundation.  We believe it can be the key to a full and speedy recovery.

We request that any others interested in this idea to please contact us.

Anti-cholinergic drug treatment for kids with Extrapyramidal brain injuries

Much of the information we have received concerning drug treatment comes from one of our most experienced Scientific Advisers, Mike Johnston.  Trails are underway to study the effects of anti-cholinergic drug treatment for kids with  Extrapyramidal brain injuries.Below is a summary of Mike’s research interests and some interesting ideas that he has.  In addition a very good website on drug treatment can be found here (the website is paid for by the drug companies):http://www.wemove.org/kidsmove/
Michael V. Johnston, M.D.
Research Scientist

Dr. Michael Johnston is a research scientist at Kennedy Krieger Institute. He is a professor of Neurology and Pediatrics at the Johns Hopkins University School of Medicine.

Biographical Sketch

Dr. Johnston attended Franklin and Marshall College before going on to medical school at the University of Pittsburgh, from which he graduated cum laude in 1971. His postdoctoral training at the Johns Hopkins Hospital included work in Pediatrics, Neurology, Pharmacology, and Pediatric Neurology. After teaching positions and research work at the University of Michigan Medical School and University of Michigan Hospitals, Dr. Johnston returned to Baltimore in 1988. Today he is Senior Vice President and Chief Medical Officer at Kennedy Krieger Institute, as well as director of both KKI’s Division of Neurology & Developmental Medicine and KKI’s Neuroscience Laboratory. Dr. Johnston is an attending physician at both Johns Hopkins Hospital and Kennedy Krieger Children’s Hospital.
Research Summary


Dr. Johnston and his group, including Drs. Mary Blue, Mary Ann Wilson and Alec Hoon, perform clinical and basic laboratory research focused on developing therapies to reduce brain injury in infants and children as well as to promote recovery by enhancing brain plasticity. His laboratory was one of the first to describe the mechanisms through which the neurotransmitter glutamate triggers brain injury from lack of oxygen, trauma and other insults. If administered early enough, drugs that block the effects of glutamate on one of its receptors called the NMDA receptor can totally prevent brain injury in infants.

His group also recognized that the major role that glutamate plays in injury during development is related to the important role it plays in normal development. During development, glutamate released from nerve terminals helps to refine the synaptic connections that link neurons into circuits. These mechanisms are enhanced during development to shape circuits in response to environmental stimuli and formation of memories, a process called “neuronal plasticity.” When the brain is injured, these circuits can be damaged by too much glutamate, much like a computer’s chips can be damaged by a power surge during a thunderstorm.

Because injury and plasticity are two sides of the same processes in brain development, Dr. Johnston’s research has grown beyond mechanisms of injury into processes that control brain plasticity. For example, he studies how cerebral cortex is reassigned in response to injury, which is the major mechanism for recovery of function from stroke and other disorders. Even learning and long-term memory are based on these same mechanisms, since it depends on neurons exciting each other with glutamate and changes in synaptic connections. Numerous disorders associated with mental retardation are caused by genetic flaws in these systems, and Dr. Johnston recently completed a project focused on a defect in a neuronal signaling process involved in a form of X-linked mental retardation.

So Dr. Johnston’s initial pursuit of ways to reduce brain injury in infants and children with medications has led to a broader understanding of processes involved in plasticity and recovery from injury. The immature brain’s glutamate signaling system, which is enhanced compared to the adult in order to shape its complex neuronal circuitry, proves to be its “Achilles’ Heel” when it is injured. Accordingly, Dr. Johnston’s research has proved to be relevant to a broad range of neurodevelopmental disabilities including cerebral palsy, mental retardation, lead poisoning, genetic metabolic disorders, and epilepsy as well as brain injury from lack of oxygen and trauma.

Robot-aided Neuro-rehabilitation

Professor Neville Hogan’s work with Robot-aided neuro-rehabilitation

Using robots to assist the rehabilitation process will inevitably provide more precise, objective, and detailed data on what actually happens during recovery. That will in turn lead to a better understanding of the key biomechanical and neurological (and perhaps even psychological) factors required for successful rehabilitation. A better understanding of the biology of recovery will lead to better ideas of how technology can help rehabilitation. It promises to be an exciting future.

Neville Hogan, PhD

Recent Publications:

Current Treatment Links

 
Current Treatment Links
This section of the website contains links to many of the webs unlimited supply of resources. We have made an effort to screen the links we have posted. However we can not endorse the content of any website. Please use the information you receive from the web or any other source with common sense.  One of the amazing things that we have found is that we have collected literally hundreds of e-mails that support one treatment or another passionately.  Often they contain personal success stories.  We know people that swear by HBOT, g-therapy, Feldenkrais, FGF, cell therapy, etc. etc. The all share a passion for their favorite therapy. As we receive all these e-mails we have to ask ourselves, what treatments to provide our kids. If I tried them all, we would be broke and have traveled the world three times! Therefore, at BRIGHT we prefer to ask the question what are the common factors about all these treatments that are helping these people and why does one treatment help some and not others.  How can we isolate these factors, focus and enhance them to help others? That is really the quest of the BRIGHT Foundation. I hope that you will join us in the journey and share your knowledge.
Here are a couple of gold star, must see website. The menu above will take you to many additional site on more specific topics.

Kid Power: This is the one website to visit for current treatments!! A huge amount of extremely useful information. explanation and links to 100s of treatments, as well as travel info, the Sensory toys, etc. etc. A powerhouse of a website!

MUMS

Julie J. Gordon, MUMS, National Parent-to-Parent Network, 150 Custer Court, Green Bay, WI, 54301-1243, 1-877-336-5333 (toll free) 920-336-5333 920-339-0995 (Fax)

Email: mums@netnet.net Web: http://www.netnet.net/mums/

The Christopher Reeve Paralysis Foundation: Christopher Reeves vision embodies our vision exactly. Christopher’s goal is very clear. He wants to walk again. In order to accomplish this he has decided to make it happen with his own means. He organized a group of the best scientists in the world and he raised millions of dollars to fund his own research. His research is not bogged down by governmental reviews and paperwork, because he is funding it he can move ahead quickly and focused towards a cure. Read Christophers motivating letter of hope here.

CAN Foundation Cure Autism Now: This website and groups serves as an excellent model for what we can achieve. In just five short years they have raised over $5 Million dollars and made significant strides towards a cure for Autism. Lots to learn from this group

We would like to highlight a website from Dina. Dina has mild spastic diplegia CP and has first hand experience with many of the existing treatments we provide links to on our website. Dina has developed her own website and she writes a particurly powerful letter to Medical Professional and Parents of children with CP. It is interesting to hear Dina’s first hand experience and she can provide many valuable lessons for those of us that are trying to make choices for our young children. I also need to give Dina credit for many of the links that we have in this section of the website as she was responsible for getting many of them on the net years ago. Thanks Dina!!  Click on the following link to visit Dina’s site http://www.geocities.com/Heartland/River/1463/  be sure to her My Story and A Letter to the Medical Profession
Traditional Treatment
In this section I would like to highlight links to some of the best sites focusing on traditional treatments.

Physical & Occupational Therapy

NDT: Neuro-Developmental Treatment

The Bobath Centre The founders of NDT. The website gives an excellent understanding of the principles of this form of treatment direct from the founders

BOEHME WORKSHOPS is a clinically based continuing education provider. They specialize in providing training, video-tapes and text books with a specialized focus on children and adults challenged by both congenital and acquired injuries to the central nervous system. These guys have trained many of the professionals. Great for families to learn directly from the pros or for pros to brush up on technique.

Neuro-Developmental Treatment Association (NDTA)is the professional certification organization. We called them and they helped us to find qualified instructors in our area. Very helpful folks.

ICE is also a professional organization providing training seminars and videos. We have no experience with them.

Vojta therapy (reflexlocomotion)

Vojta therapy (reflexlocomotion) is a highly specialized type of physical therapy that is designed to primarily enhance the motor development of a child. The treatment has added benefits of improvements in cognition, fine motor, breathing, and digestion. Vojta therapy is quite well known and well received across
Europe and Japan and is expanding around the globe. The Vojta training centers are based in Germany and the Czech Republic. The method originated in the1950’s by a pediatric neurologist, Dr. Vaclav Vojta and is still being improved upon. Vojta therapy is based on responses and reflexes to specific stimuli
provoking muscle chain reactions as they appear in a typical child’s motor development. The treatment encourages those responses through specific positions and pressures applied.

SARA 4 Kids, LLC (Specialized Alternative Rehabilitative Approaches for Kids)Thanks to Sue Iwanski for contributing the Vojta information

Vojta Therapy Website 

 

General Links
Below is a collection of links in alphabetical order from our own research and from other great websites such as Kid Power,  and Pediatric Stroke Network

If you are the owner of any copyrighted material on this website, please contact us. It is not our intention to use any copyrighted material without permission.

Cerebral Palsy
National Institute of Neurological Disorders and Stroke Cerebral Palsy Info: NINDS is the US governments funding center. Almost all research is funded by NIH. This website gives a general explanation of CP and some of the research areas funded. As you will see, there is no mention of funding for a cure to brain injury. The focus is on treating the medical complications that occur because of the brain injury. ie Seizures and Spasticity.

ACUPUNCTURE

Acupuncture
Sedona Healing Arts

ADELI SUITWe do not have direct experience with this therapy. An adapted Russian astronaut space suit designed to put the body in proper alignment and to provide feedback between the muscles and the brain. 

Adeli Suit
Cerebral Palsy and the Adeli Suit
Cosmonaut Cerebral Palsy Therapy
Euro-Peds
Poland: Space Suit Technology

ALEXANDER TECHNIQUE – We do not have direct experience with this therapy.  A reeducation of the mind and body on how to use the correct amount of effort for each task performed in a day. It helps to relieve tension and can help with ease of movement, coordination, and balance.

Alexander Technique
The Alexander Technique
Teachers of The Alexander Technique
The Complete Guide to the Alexander Technique

AMINO ACID THERAPY – We do not have direct experience with this therapy.  Use of specially selected combinations of amino acids designed to control the exchange processes in the damaged brain cells.

Amino Acid Therapy
Amino Acid Therapies

AQUATIC THERAPY – We do not have direct experience with this therapy.  Physical & Occupational therapy that is performed in a pool heated to between 92 and 96 degrees. These warm temperatures help to decrease spasticity and along with the buoyancy of the water helps the therapist get the patient into positions that are not tolerable for them during land based therapy. This therapy assists in improving range of motion, cardiovascular endurance, balance, strength, proprioception, tactile stimulation tolerance, relaxation, ambulation and pain management. This therapy can be used along with land-based therapy to best meet a patients needs. Listed below are a few of the indications where aquatic therapy could be utilized: developmental delay, cerebral palsy, traumatic brain injury, diabetes, post orthopedic surgery, back pain, Down’s Syndrome, PDD, ADD, autism, sensory and vestibular involvement.

Aquatic Therapy
Aquatic Physical Therapy
A.R.N. Education
CMH PT/OT Services
MRH Aquatic Therapy Pool 
Aquatic Resources Network

AUDITORY INTEGRATION THERAPY – We do not have direct experience with this therapy.  AIT involves several components including some audiological work, behavior analysis and management, educational issues, and after-care counseling for the client and family. The most satisfactory results can be obtained when a multi-disciplinary team approach is used for the administration of the AIT program. SAIT recommends a multi-disciplinary team which could include (but is not limited to) specialists in the fields of audiology, psychology, special education, and speech/language.

Auditory Integration Therapy
Auditory Integration Training
Family Village Auditory Integration Therapy
SAIT–Society for Auditory Integration Techniques
AIT–A Checklist for Parents

 

BACLOFEN THERAPY – We do not have direct experience with this therapy.  Baclofen Pump–used for treatment of severe spasticity. A Baclofen Pump is implanted into the body that delivers a does of Lioresal Intrathecal directly to the spinal cord. It relieves spasticity with low dosages. Low incidence of side effects because the medication does not get into the blood stream

Intrathecal Baclofen Therapy
Inplantable Infusion Pump
Intrathecal Baclofen Overview
Intrathecal Baclofen Pump Page
Intrathecal Pump Implant (“Spinal Morphine Pump”) FAQ’s
Baclofen Pump Helps Spasticity in Children
Factsheet: Baclofen and the Baclofen Pump
Intraethecal Baclofen Therapy
Oral Baclofen Therapy
Use of Intrathecal Baclofen Therapy in Management of the Brain Injured Patient

BOTOX – We do not have direct experience with this therapy.  Botulinum Toxin–Injected into spastic muscles to weaken them. During the period that these muscles are weakened increased therapy helps to reach a greater range of motion and to increase strength in the non-spastic muscles. Helps to decrease scissoring of legs and decrease spasticity even after the Botox injections wear off. Effects are only temporary and injections have to be repeated about every 6 months to a year.

Botox
Botox Injection for Laryngeal Spasmodic Dysphonia
Botox: New Treatment in the Management of Childhood Spasticity
Botulinum Web
Use of Botulinum-A Toxin in the Management of Muscle Spasticity 
Botox Update 
Botulinum Toxin A in the Management of Spastic Gait Disorders in Children and Young Adults With CP 
Factsheet: Botox  
The Use Of Botulinum-A Toxin In The Management Of Muscle Spasticity

CONDUCTIVE EDUCATION – An education system used to develop problem solving skills in people with physical disabilities. Seeks to make it easier for persons to function at their maximum potential in society and teaches them to find their own solutions. Promotes self confidence and motivation.

Conductive Education
Ability Camp–Centre for Conductive Education
Beginning Steps to Independence Inc.–San Jose
Conductive Education Information Home Page
Listing of Conductive Education Centers
Moira Centre–Real Conductive Education
National Institute of Conductive Education
SPICE–Spokane Institute of Conductive Education

CONSTRAINED INDUCED THERAPY -  therapy used for stroke patients consisting of restraining the unaffected arm/hand so the patient is forced to use the affected arm/hand. This is thought to retrain the brain to be able to use the affected hand/arm.

CI Therapy
An Application of Upper-Extremity Constraint-Induced Movement Therapy in a Patient With Subacute Stroke
Constraint-Induced Movement Therapy: A New Family of Techniques with Broad Application to Physical Rehabilitation–A Clinical Review
Constraint-induced movement therapy for focal hand dystonia in musicians
Constraint-Induced (CI) Movement Therapy or Extremity Constraint Induced Therapy
Constraint-Induced Movement Therapy (CIMT): Strong Evidence Supportive of the Habit Retraining Model
Constraint-Induced Therapy: Ready for Prime Time?
Getting a Grip by Revving the Brain
Stroke rehabilitation – constraint-induced movement therapy
Stroke Victims Get Second Chance

CRANIO-SACRAL THERAPY - Cranialsacral therapy is the evaluation and enhancement of the wave like pulsations of the cerebral spinal fluid. Helps to steady the gait and to properly align the body.

Cranio-Sacral Therapy
Cranial Sacral Therapy
Integrative Healing Arts
Myofacial Release
CranioSacral Therapy: Alternative Medicine Therapies
The Craniosacral Therapy Association of the UK
National Down Syndrome Congress: Position Statement On
Osteopathic Center

DANCE – We do not have direct experience with this therapy.  Can help children of all ages and has many rewarding benefits such as: increased self esteem, better motor planning skills, socialization and group interaction skills, increased self awareness of personal and surrounding spaces, and an excellent avenue for also using verbal skills with song and dance!

Dance  
 

EEG BIOFEEDBACK – We do not have direct experience with this therapy.  A learning strategy that enables persons to alter their brain waves by making information about their brain wave characteristics available to them so that they can learn to change them. Electrodes attached to the head measure brain wave activity while you move certain muscles. Learn to use certain parts of the brain to move certain muscles.

EEG Biofeedback
Biofeedback Certification Institute of America
Cascade Center for Family Growth
A Comparison of EEG Biofeedback and Psychostimulants in Treating Attention Deficit Hyperactivity Disorders
Controlled Study of the Effects of EEG Biofeedback on Cognition and Behavior of Children with ADDs and Learning Disabilities
EEG Biofeedback in the Schools
Effects of EEG Biofeedback
Frequently Asked Questions
Future Health, Inc.
Neurological Processes of the Brain
For more information on EEG Biofeedback contact:
Pittsburg State University EEG Biofeedback Lab
Hughes Annex
113 Cleveland
Pittsburg, KS 66762
(316) 235-4593
EEG@pittstate.edu

EMG BIOFEEDBACK – We do not have direct experience with this therapy.  Used to train alternate cells of the brain that are not damaged to take over the task for damaged ones in brain damage such as stroke, head trauma, and cerebral palsy.

EMG Biofeedback
Changes in the hemiparetic limb with training
Center for Bladder Control
EMG Biofeedback and Strength Training
EMG & Oral Pharyngeal Dysphagia
How Effective Is EMG Biofeedback in the Treatment of Incontinence?
Mechanisms involved in neurite growth inhibition
Treating chronic hemiparesis with modified biofeedback
For a free information packet about biofeedback call the University of Miami School of Medicine at (305)585-6351

FELDENKRAIS – It provides environments for the nervous system to learn through touch and movement and develops sensory awareness to help people recognize habits of movement and posture

Feldenkrais
About the Feldenkrais Method
The Feldendrais Guild of North America
Feldenkrais Resources

FES/FUNCTIONAL ELECTRICAL STIMULATIONWe do not have direct experience with this therapy.  The principle behind this treatment is to deliver small electrical signals imitating the nerve impulses that have been blocked by brain or spinal cord injury. This therapy can be used with stroke victims, brain and spinal cord injuries, cerebral palsy and multiple sclerosis.

FES
Center for Functional Electrical Stimulation
Efficacy of Neuromuscular Stimulation in Enhancing the Upper Extremity Motor and Functional Recovery of Acute Stroke Survivors
Electrical Stimulation
FES Information Center
FES List
Shoulder Pain and Dysfunction in Hemiplegia: Effects of Functional Electrical Stimulation
Stimtech Electrical Stimulation Products

HIPPOTHERAPY/THERAPEUTIC HORSEBACK RIDING – We do not have direct experience with this therapy.  Therapeutic Horseback Riding–Therapy done while the person is on horseback. Helps with balance and can reduce spasticity. Also is great for increasing self-esteem.
The Camelot Center
Graduate Certificate Program in Hippotherapy
Hippotherapy
Hippotherapy
Hyperion Farm, Inc.–Hippotherapy
The NARHA
Pal-O-Mine Equestrian
STRIDES
Taking a ride helps learning to walk— Hippotherapy
Therapeutic Riding
Therapeutic Horseback Riding and the Feldenkrais Method

Hyperbaric Oxygen Treatment

HBOT – Pure oxygen delivered under increased atmospheric pressure in order to force more oxygen into the bloodstream.   HBOT has a huge interest among special needs parents globally. There is also a growing market that has sprung up around the world to fill the treatment demands of these parents.  The web has largely been responsible for the rapid spread of anecdotes from one parent to the next about the success of HBOT.  This in-itself is a very important and wonderful thing.  However, now if you search the web for the words “HBOT” or “cerebral palsy treatment” quite often you are directed to a commercial website promoting HBOT.  Even HBOTs biggest supporters will agree that HBOT is not a cure and not without risks.  Therefore, The BRIGHT Foundation wishes to give the webs best analysis of HBOT.  In the coming days (maybe weeks), The BRIGHT Foundation will work to try to give you a balanced understanding of the pros and cons of HBOT.  Please stay tuned.

In the mean time here a small sampling of links related to HBOT.

American College of Hyperbaric Medicine
UHMS
Kevin Fickle
H.B.O. and Cerebral Investigations In Stroke
HBO Patient Handbook
HBO Public Discussion List
HBO 4 R Kids
HBO Stories
HBOT for Developmental Disabilities including RS and CP
HBOT Online
HOT4CP
H.O.T. 4 R CP Kids Foundation
Hyperbaric Oxygen Therapy–Questions & Answers
Listing of HBO Centers
New Uses for HBO
Ocean Hyperbaric Center
Harch Hyperbarics
Dr. Harch’s Letter on HBO

Several of these links can also be found at the excellent site Kid Power.  You can also receive information from Mums, the cost for the MUMS information packet is $20.00.  

Julie J. Gordon, MUMS, National Parent-to-Parent Network, 150 Custer Court, Green Bay, WI, 54301-1243, 1-877-336-5333 (toll free) 920-336-5333 920-339-0995 (Fax)

Email: mums@netnet.net Web: http://www.netnet.net/mums/

MANUAL THERAPY – We do not have direct experience with this therapy.  the therapist puts the muscles into a state of relaxation before stretching begins. They treat both soft tissue and joint structures.

Manual Therapy
Early American Manual Therapy
Manual Therapy Research
North American Institute of Orthopedic Manual Therapy

MEDEK – We do not have direct experience with this therapy.  A physical therapy program for infants and young children. Works on helping to develop the gross motor skills of these children with a rigorous routine of therapy.

Medek
Medek

MUSIC THERAPY – We do not have direct experience with this therapy.  the use of music as therapy for the treatment of neurological, mental, or behavioral disorders.

Music Therapy
Canadian Association for Music Therapy
Helping Stroke Survivors Communicate
Music and the Learning Environment
Music Therapy
Prelude Music Therapy

NEURO THERAPY (IAHP, NACD)- We do not have direct experience with this therapy.  You can use a program from The Institutes, NACD program, or a trained independent neurodevelopmentalist. The Institutes uses a very rigorous program. Some parents find this very hard to follow. NACD is an offshoot of The Institutes and is less restrictive than IAHP.  A local therapist or an independent who travels to your area are probably the most convenient options.

NDT
Can-Do
Help With Learning
The Institutes for the Achievement of Human Potential
The National Academy of Child Development

ORAL BACLOFEN – We do not have direct experience with this therapy.  helps alleviate the signs and symptoms of spasticity. Is not effective for everyone.

Oral Baclofen
Baclofen
Oral Baclofen
Second Thoughts
We Move Baclofen Information

ROLFING – We do not have direct experience with this therapy.  The manipultion of the soft tissues or myofacial system to allow for proper alignment and organization of the whole body in gravity. Helps loosen up spastic muscles and smooths out gait patterns and helps keep the spine aligned.

Rolfing
Frome Physical Therapy
How Does Rolfing Work

SAMONAS SOUND THERAPY – We do not have direct experience with this therapy.  Provides a slight massage to certain areas of the middle ear (stapedius and tympanic muscles) opening the systmm to sounds previously shut out or never accessed. If the sounds that are made available to the auditory system are not threatening, then the stimulation of the auditory system and growth in this area and all of the related systems can be achieved. If the sounds are a source of continued irritation or if the system is overstimulated, then these very same sounds can become another source of shutting down of the auditory system. Hence, the use of sound therapy must be done with wisdom and caution, making sure that there are not adverse reactions, at least long term adverse reactions.” –taken from “Samonas Sound Therapy” by Kay Ness, Copyright 1999.

Samonas
Samonas Sound Therapy
The Whole Idea

THERAPEUTIC ELECTRICAL STIMULATION – We do not have direct experience with this therapy.  Therapeutic Electrical Stimulation–is a low level electrical stimulation that does not contract the muscles but is enough to get blood to flow to them in hopes of helping stimulate muscle growth. The electrodes are worn at night during sleep when the body rejuvenates itself the most, in order to get optimum benefit. The electrodes are placed on the atrophied muscles in hopes to get them to grow and counteract the over active spastic muscles or to just get hypo tonic muscles to gain strength. A person has to be evaluated by a qualified therapist and approved before they can begin therapy. Patients are followed closely while on the TES and reevaluated at least every six months to mark progress and determine if placement of the electrodes is providing the desired effect.

TES
The TASC Network
Myles Medical, Inc.–TES Electrodes

YOGA – Used to stimulate the cognitive and motor development of special needs children.

Yoga for the Special Child
TheraYoga

General Lnks:
Hits Links
382 Help for brain injured Children
http://www.hbic.org/index.html
241 Enabling Devices – Toys for Special Children
http://www.enablingdevices.com/
136 Family Village — Wisconsin Resources
http://www.familyvillage.wisc.edu/comm/wisconsin.html
122 MUMS National Parent to Parent Network
http://www.netnet.net/mums/
108 NDT Books & Videos
http://www.boehmeworkshops.com/cgi-bin/store/commerce.cgi?product=media&cart_id=850083_43115270263_8269

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Cerebral Palsy Treatments & Research

Where we stand today:Our belief is that we are both blessed and burdened by our current scientific situation.  The good news is that very few scientists and very little funding is currently being applied directly to understanding treatments for children with Brian Injury.  This is good news because it means that we are just beginning to explore the possibilities for our children.It is the BRIGHT Foundation’s belief that neither mainstream medicine nor alternative therapies offer a substantial effort to truly understand and help our kids.  It is with this assumption that make the claim that significant hope exists.  Amazingly… the answer is there… but no one has really been looking for it.Our Approach:1.) Survey all mainstream and alternative therapies.  Document on this website exactly what is the current state of knowledge.

2.) Locate the experts globally and enlist them to become scientific advisers

3.) Encourage the experts to document their theory publicly and engage in an open discussion to advance the state of knowledge for the kids

4.) Provide a forum for this discussion both via the website and by organizing real life conferences and projects

5.) Educate and Unite parents to encourage their professionals to operate openly and cooperatively with the goal of advancing the state of knowledge

6.) Work with public and private sources to generate funding to support the most promising areas of treatment

7.) Create a global database of children with brain injury, their treatments and their progress

Techniques such as NDT, Feldenkrais, the IAHP approach, the NACD approach, the Euromed approach, Conductive Education, and Constraint Induced Therapy all draw their partial success on the proven fact that the brain is extremely plastic.  They are in the Neural Re-Organization Camp. A group of supporters argues that natural plasticity is not enough – this is the Re-Generation Camp. They argue from a very common sense point of view that you must treat the injury before you treat the symptoms. For them the injury is the initial injury to the brain. The symptoms are the abnormal movement patterns resulting from that initial injury. This is the argument between brain re-generation Vs. brain reorganization. They argue that it can’t be a bad thing to repair or replace damaged brain cells. 

The key question is whether additional brain cells actually result in improved function. Also is the cost of re-generating those cells, both in terms of time, effort, money and risk might be better spent on other forms of therapy and actually achieve greater results leveraging the brain’s natural redundancy of cells. 

At the far end of the spectrum people are traveling to developing countries and injecting their children with unproven stem cells and growth proteins. This is a very risky and expensive approach. Under more controlled circumstances one of our scientific advisors is injecting stroke victims with live brain cells. The good news is that the cells seem to take root and grow with-out adverse effects such as tumors. The bad news is that dramatic improved functional results do not appear to immediately follow. 

A less invasive approach to re-generation of brain cells is promoted by the Hyperbaric Oxygen community. Otherwise know as HBOT, it has been around for many years as a treatment for brain injury. It also has greatly fallen out of favor among the professional medical community. It is still used extensively for treatment of neurological conditions in Russia, China, and even the UK. However, if you talk to professionals from these countries it is seen as a secondary treatment and does not nearly receive the same hype that it is now receiving in the USA were centers can charge as much as $200 per treatment and encourage parents to take multiple series of 40 treatment sessions. 

So if re-generation is not the answer and re-organization therapies have limitations, does that mean that the current approaches can only take a brain injured child so far?  We believe the answer is yes and the data supports it. Every study that we have read, every parent that we have talked to, every young adult that has been through all the therapies has clearly shown the limitations of the existing treatments. Thus our search is to find the next evolution of approach that will take our kids further than the current approaches allow.

——————–

Below is a summary of our understanding of the latest science as of January 2002.  The above theory builds on this theoretical foundation.

1.) Based on the work of all those mentioned in this document, we are confident that significant functional improvement after brain injury is a realistic goal.

2.) We believe that Reorganization (Plasticity) and Pharmaceuticals (Stem Cells and Growth Factors) present the two best areas offering means to achieve functional improvement.

3.) Given the current pace of progress in pharmaceuticals, we believe that plasticity models may yield better short term approaches. (Macklis, Merzenich)

4.) We recognize the importance of self motivation in the learning process and understand why traditional medical therapy models often fail. (Cayo, Urban)

5.) The severity of the injury is obviously a critical factor in determining the effectiveness and focus of the treatment. (Urban, Macklis)

6.) Focused assistance on the targeted functional areas is the key to recovery. (Hogan, Ulrich, Taub, etc.) However, treatment must be based on understanding how that injury results in a “undesired” movement pattern becoming the stable attractor. Opportunities must be presented and facilitated to allow new more desirable patterns to de-stabilize the undesirable pattern and become the stable pattern. (Thelen, Ulrich)

7.) Plasticity is not time dependent. (Taub, Hogan) However, once abnormal patterns become stable they become very difficult to replace. (Thelen, Ulrich) Therefore, early intervention is critical. With the first year of life being the most important. The second year less so, and so on.

8.) Functional achievement and intervention strategy needs to be matched to appropriate developmental opportunity windows. (For example, unsupported walking can not be expected until sufficient muscle strength is achieved) (Thelen, Ulrich)

9.) Measurement and understanding of the factors leading to undesirable patterns is the key to developing a treatment program. Stable patterns are almost always the optimized solution to the interplay of all factors (neurological, physiological, environmental, etc.) The intervention program should provide focused intervention to the factors that are allowing an undesirable pattern to emerge. (Thelen, Ulrich, Hogan, Taub, Merzenich)

10.) The complexity of the functional skill and degree of stability that the abnormal pattern has achieved, are the two factors determining the level of intensity and duration needed in order to de-stabilize the undesirable pattern and establish the desirable pattern. (Thelen, Ulrich, Hogan, Taub, Merzenich)

Currently our major difficulty in our home program is that as parents we do not understand in detail the complex interplay of factors driving undesirable patterns to become the stable patterns. Therefore, we have not been able to develop optimal intervention techniques to overcome some of Alissa’s more undesirable patterns.

Personally, I believe a possible next step is to improve our ability to measure the degree to which critical variables are having a normal or abnormal influence on development. However, I am not sure how to go about identifying, isolating and measuring the critical variables.

Admittedly, the options presented in the literature for effective intervention strategies are extremely limited. (A representative list includes hands on therapy which can be very powerful in the hands of an experienced therapist but limited with the parent, robotic assistance which is limited by the complexity of the functional skills needing focus in a typical infant hypoxic injury, tread mill gait training which can only be used after the child has met certain challenging developmental milestones, Constraint Induced Therapy which is best applied to a child with Hemiplegia. This list is very limited and significant work needs to be done to increase the assistive tools that are available to parents and therapists)

Finally, none of the above research cited has specifically addressed global hypoxic brain injuries and very little has addressed rehabilitation in the context of the childhood developmental phase. The research has been verified on Stroke, Downs Syndrome, Spinal Cord injury, TBI and generally in adulthood. However, we have not found significant research on the more complex situation of a injury resulting from global hypoxic injuries early in life. However, based on the principles of dynamics systems theory we believe that the results of the research can be effectively extended to the more complex situation of a injury resulting from global hypoxic injuries early in life. This position is shared by Hogan and Taub and Ulrich is currently conducting research to verify this position.

Below is a detailed accounting of the historical progression of our research.

Next, I will retrace our journey over the last 12 months to help your understand how we have come to the our current state of understanding. We stated by contacting an old college room mate of mine, Nathan Urbanref1 who went onto to research basic brain function. He gave us a good foundation of understanding the complexity of the problem we faced given the nature of Alissa’s Injury. (Alissa suffered an hypoxic injury due to amniotic fluid embolism in mom, apgars of 1 @ 1 min and 2 @ 5 min, CT scan at 4 months showed calcification in the basil ganglia, MR was good at 8 months but showed mylination at low end of scale, microcephaly, feeding disorder, 100% g-tube feed). Nathan also stressed to us the importance of understanding the nature of how people learn. The importance of the natural sequence of learning. And finally, the importance of self motivation in the learning (and rehabilitation) process.

Nathan, directed us to the work of Mike Merzenich of UCSF ref2 ref3 who promotes plasticity as a key mechanism for brain re-organization. Mike stressed to us that our challenge was more complex than those he has worked successfully with, which included children with language learning deficiencies.

Next we found the work of the Christopher Reeves foundation ref4. What impressed us about the work of the foundation was the focused research that was happening with a clear goal to allow Christopher to walk again before his death. Here we spoke with John McDonald who explained the differences and commonalties between spinal cord injury and hypoxic injury. We learned the value of muscle conditioning via Electrical Stim and the role that passive movement of effected limbs seems to play on creating spinal and neural representation that serve as a building block for further recovery.

Next we learned of the work of Ed Taub in stroke victims ref 5 ref6, again we learned the differences between stroke and Alissa’s injury. Ed’s work on CI confirmed that directed, intense therapy on specific muscle groups produced functional improvement.

Around this time we studied the work of Glenn Domanand theInstitutes For Advancement Of Human Potential (IAHP) ref7. In general we found that many of their principles were quite in line with what we were learning from the scientists, so we were very hopeful about working with them.   When we started this foundation we ran into many more success stories and parents who would swear by the program.  We highlight just one of these success stories in our case study section. ref7a.    The overwhelming support that some parents give to the IAHP continues to intrigue us.  We hope that we will be able to report personally on the IAHP some day soon.

We looked at Conductive Education, and other intervention programs. We found that all of them seemed to have some common threads that made sense to us.

Based on these threads and the science we developed a set of guiding principles that we used to help us to focus: These principles are summarized here:

1.) Based on the work of all those mentioned in this document, we are confident that significant functional improvement after brain injury is a realistic goal.

2.) We believe that Reorganization (Plasticity) and Pharmaceuticals (Stem Cells and Growth Factors) present the two best areas offering means to achieve functional improvement.

3.) Given the current pace of progress in pharmaceuticals, we believe that plasticity models may yield better short term approaches. (Macklis, Merzenich)

4.) We recognize the importance of self motivation in the learning process and understand why traditional medical therapy models often fail. (Cayo, Urban)

5.) The severity of the injury is obviously a critical factor in determining the effectiveness and focus of the treatment. (Urban, Macklis)

6.) Focused assistance on the targeted functional areas is the key to recovery. (Hogan, Ulrich, Taub, etc.) However, treatment must be based on understanding how that injury results in a “undesired” movement pattern becoming the stable attractor. Opportunities must be presented and facilitated to allow new more desirable patterns to de-stabilize the undesirable pattern and become the stable pattern. (Thelen, Ulrich)

7.) Plasticity is not time dependent. (Taub, Hogan) However, once abnormal patterns become stable they become very difficult to replace. (Thelen, Ulrich) Therefore, early intervention is critical. With the first year of life being the most important. The second year less so, and so on.

8.) Functional achievement and intervention strategy needs to be matched to appropriate developmental opportunity windows. (For example, unsupported walking can not be expected until sufficient muscle strength is achieved) (Thelen, Ulrich)

9.) Measurement and understanding of the factors leading to undesirable patterns is the key to developing a treatment program. Stable patterns are almost always the optimized solution to the interplay of all factors (neurological, physiological, environmental, etc.) The intervention program should provide focused intervention to the factors that are allowing an undesirable pattern to emerge. (Thelen, Ulrich, Hogan, Taub, Merzenich)

10.) The complexity of the functional skill and degree of stability that the abnormal pattern has achieved, are the two factors determining the level of intensity and duration needed in order to de-stabilize the undesirable pattern and establish the desirable pattern. (Thelen, Ulrich, Hogan, Taub, Merzenich)

We studied and tried Hyperbaric Oxygen Treatment. We talked to many doctors about the possible mechanisms at play. We treated Alissa twice, both times for approximately 40 sessions.  Once at 4 months and we did not notice positive results.  However, due to the great amount of positive comments on HBOT on the internet, we decided to try it again at 1.5years.  Again, we personally did not see the benefits that were so often stated on the internet.  As one of the few parents on the internet that seem to be willing to say anything other than great things about HBOT we have often been criticized by HBOT professionals and proponents.  In an effort to be truly open minded BRIGHT has recruited one of the most outspoken supporters for HBOT, Pierre Marois, MD, FRCP(C) to BRIGHT’s Scientific Advisory Board.  With the help of Dr. Marois and others, we hope to help answer the really important questions.  What types of CP is HBOT most effective on?  Why does HBOT help some children and not others?, etc. To help readers understand a little more of the colorful, but very unproductive debate over HBOT, we have compiled some of the written debate in this reference. ref8  Going forward we be working with Dr. Marois and others to shed more light on the benefits of HBOT. 

We studied the work of the Autism community. What we took away from them was the fact that only a few short years ago, Autism was viewed as untreatable. Now in Wisconsin, Autism is treated with intensive Behavioral Modification programs for 40 hours per week and paid for by Medicare ref9. We set this as one of our goals, “to develop a similarly accepted treatment program that would be accepted and paid for by insurance”.

We met the founders of Project ALS ref10. They have raised millions for research into ALS. Like Christopher Reeves they have funded their own directed research team and seen great results. We have a strong desire to have the same resources and influence as the Christopher Reeve and the Estess Sisters but regarding hypoxic brain injuries.

We then turned our focus to the work of Stem Cells and Neruotrophins. We contacted Jeff Macklis of Harvard ref11, Clive Svendsen of UWM ref12, and Doug Kondziolka of Pitt ref13. In particular I talked with Doug about the first implantation of Neural Cells into the adult brain. Doug’s study proved that cells could be implanted in the brain safely. It also showed using FDG Pet that the area around the implantation showed increased metabolism. Doug and I quickly came to the same conclusion that this did not imply that the implanted cells grew. It only implied that something caused increased metabolic activity. We agreed that it could be a placebo effect caused by the stroke victims desire to recover and hope that the surgery has done something to help them. Also, it appears that the implantation of cells triggered the production of neurotrophins. Finally, the most important finding of this study is that even with new brain tissue, rehabilitation was needed to teach the cells how to be functional. This conclusion has been the most powerful finding that has come out of my stem cell research. It is shared by all those that I speak to… new cells are not enough, you must teach them to regain any function lost.

Along those lines I contacted Neville Hogan of MIT ref14 I found the following paper to be particularly enlightening ref15. Neville has worked on robotic assisted therapy. His work is wonderfully “application” focused. He arrives at all his conclusions by data. I find he approaches the task with a refreshing enthusiasm and confidence, suggesting that initial successes in stroke victims should be extendable to more complex situations. Suggesting “were there is a will there is a way”. His work has confirmed a few important things. 1.) That current therapeutic tests are too course to measure fine improvements. 2.) That focused assisted exercise provided improved results over general therapy. 3.) That improvements tend to come only in the targeted muscle groups. Along those same lines the work done by Beverly Ulrich on treadmill assistance for children with downs syndrome proved the exact same three items.

So how to teach? I turned back to one of the original factors I knew to be critical – “Understanding how people learn”. For this I turned to Esther Thelen ref16 and Beverly Ulrich ref17 and their work with Dynamics Systems Theory. I was very comfortable with the Dynamics Systems Theory approach to learning and understanding how it could explain the abnormal movement patterns that develop in brain injured children. Our next step hopefully, is to use their work to produce an effective “predictive model” to take our therapy program to the next level. So that is were I am today.

Member Introductions

Introductions of BRIGHT Discussion Members

Abel: Parents: Tracy & Abel

Abigail: Parent: Heidi

Amir: Parents: Fezia & Asger

Alissa: Parents: Matt & Leslie


Allison: Parents: Michelle & Tony

Andrew: Parents: Laura & Loren

Andy: Parents: Kristi & Bruce

Anton: Parent: Maryrose

The Bennett Family

Cameron: Parents: Sue & Dan

Dominic: Parents: Helene & Gerry

Dustin: Parent: Christiana

Elizabeth: Parent: Kimberly

Eric: Parent: Andrea

Erin: Parents: Sharon & Danny

Erin: Parents: Jennifer & Andy

Gerard: Parent:Ilse & Francis

Jessica: Parent: Karen Hopkins

Jon-Jon: Parent: Sherry

Joshua: Parent: Wendy

Justin: Parents: Amy & Rob

Kaitlyn: Parents: Jessica & Charlie

Kitty: Parent: Jane

Laura: Parent: Val

Laurel: Parents: Rochelle & Bob

LeAnne: Jessica & Mak

Leiby-Henyu

Lloyd: Parents: Steve & Wendy

Mia & Diamond: Parent: Lynn

Megan: Parents: Thad & Debra

Rene: Parents: Lisa & Paul

Samuel: Raynou & Steve

Sara: Parents: Amy & Jim

Sarah: Parent: Brandie

Sebastian: Parents: Louis & Anna  

Timmy: Parent: Julia

 

Abel: Parents: Tracy & Abel (Updated 03/03)

Abel is a nine year boy who has Spastic Quad Cerebral Palsy due to fetal distress, meconium aspiration, asphyxia, resulting in several brain hemorrhages and edema. He began having seizures and kidney failure on day 2. He was intubated for 4 days and released from NICU after 10 days. His kidneys are fine. He has a g-tube, asthma, GIRD, a subluxed left hip, cortical blindness and seizure disorder. The asthma and seizures are under control.

Abel is a happy boy who is intelligent. He does not speak or walk independently or use his hands (fine motor) He has been out of school for three years. He gets homebound schooling and daily therapy. He rides an adaptive bicycle. He has a Hart walker and a Rifton walker a supine and prone stander. He plays a piano keyboard daily and we are building a pool for him to swim. The school system is going to provide him with a Dynovox and he will soon have a power chair. He swims with the dolphins in Key Largo one week out of the year. He started calling my name after the first week of the dolphin therapy. Amazing!

I do not have him on any particular program and I want to know more about how to get him on G-therapy. I might go to the NACD for a consult. I am planning on taking Abel to a two week intensive program at the Upledger institute where they do Cranial Sacral Therapy combined with other disciplines. I do give him Phosphitydaserine-complex and DMAE which has improved his awareness and communication skills. My email address is tlcpeach@msn.com. Abel’s birthday is 11/26/93. His nickname is Bubba. His Dad’s name is Abel, also.  His brother, Adam, is 8 years old, healthy, born 11/08/94 (11 months apart!)

Abigail: Parent: Heidi (Updated 02/03) 

She was full-term, but went into fetal distress during the birth and was born via C-section. She had great Apgars–9 and 10, so initially we didn’t know she had any problems.  She had poor muscle tone (“floppy”), but not enough to alarm us our or pediatrician.  My parents started questioning her development by the time she was 5 months and by the time she was 9 months, she was still not crawling or able to get into sitting on her own.  To make a long story short–she was evaluated and went to PT from 13-23 months; at 18 months re-evaluated and ST & OT were added.  At nearly 21 months we took her to a developmental pediatrician who has yet to find the root cause of her global delays.  By this time she could get into sitting, pull herself on her belly for short distances and “bunny-hop” across the room; still hypotonic & non-verbal.  The dev. ped. told us she’d probably eventually get the motor skills and may or may not develop cognitively but there was nothing we could do except wait to see how she develops–he recommended continuing traditional therapy, which was PT & ST 2x’s per month and OT once every 1-3 months.  My husband & I questioned how this infrequent intervention was going to get her to where she needed to be.  We started the IAHP aspirant program in July (she was 23 months); we did that for 6 months and in January we started a program with the Family Hope Center.

Amir: Parents: Fezia & Asger (Updated 03/03) 

Hello, my name is Fezia and my little boy Amir is a Near Drown. He fell into our neighbor’s fish pond when he was 18 months old. Amir turned 6 last month. We do the Brain Net Sensory stimulation programme, have done 350 HBOT, see an Oestopath, do ST, PT and go swimming regularly. Amir also does Hippotheraphy once a week (probably the highlight of his week) Amir has a Gastrostomy button, however he eats nearly 90 % by mouth and is learning to drink water from a cup. Whilst he has gained some strength in his trunk and has full head control, he is still unable to sit. He does attempt to wriggle around when he is on the floor (which is all of the time unless he is doing therapy). We hope to start a cycling program with him and his bike is being ordered from Australia. We live in Kuala Lumpur, Malaysia. Amir’s website http://www.amirs-page.cc/. Amir’s birthday is February 4, 1997.
Alissa: Parents: Matt & Leslie (Updated 2/03)

My name is Matt Palaszynski.  My wife is Leslie.  We live in Milwaukee, WI.  Our daughter Alissa was born 11/01/00 with a Hypoxic Ischemic Encepholopy due to my wife having an Amniotic Fluid Embolism.  Leslie almost lost her life because of this rare delivery complication, but luckily she managed to pull through and eventually recover completely. Alissa is now 27 months old and is sitting-up independently, belly crawling, starting to creep on all fours.  Her injury was mainly in the Basil Ganglia (Bilateral Putamen) and has symptoms of mainly of
hypotonia, difficulty swallowing, mixed tone.  We are very happy with Alissa’s slow but steady progress.  Our goal is for Alissa to be 100% independent and as free from the symptoms of her original injury as possible.  We are confident that with continued diligence in addressing her development needs, she will achieve this goal.  Our email address is: donations@brightfoundation.org

Allison: Parents: Michelle & Tony (Updated 2/04)

I would like to introduce our little angel to everyone.  Her name is Allison and has been diagnosed with severe cerebral palsy.  We had a home birth which turned out to be our worst nightmare.  Allison came out without breathing on her own and was not resuscitated until the fire dept came to our house.  We were all transported by ambulance to the hospital only to find out that she was intubated improperly.  To make a long story short the neurologist gave  us no hope so we took her off her breathing device.  By the grace of God Allison started to breathe on her own and she was doing well.  We fought with the board of directors to bring her home two weeks later due to the fact that she was not on any meds.  Boy what a challenge that was in front of twelve woman who thought we weren’t capable of taking care of her.  Allison is now two and a half years old and is so wonderful to be around.  We all know the challenges are daily, but somehow her smile changes all that everyday.  Allison is a quad/spastic/mixed tone and relies on equipment to help her with everything.  She is such a trooper and loves her little one year old sister.  Allison has been with Easter Seals since she was five months old.  Her therapists, (OT, PT, Swimming, Speech, Child Dev. and Music) have been very helpful in making sure Allison has gotten a lot of equipment to help her with daily activities.   She will be starting preschool in May and I am very nervous as to what the Lord is going to give Allison in terms of fairness of what is needed for her to maintain and not lose what we have had in the past.  The whole idea the school districts has of “educating” the children with disabilities is quite maddening.  We live in California and heard about the bright foundation through a friend.  I am looking forward to reading and helping out those who are having the challenges that we too face everyday of our lives.
Looking forward to meeting you all. Our email address is drpotter@earthlink.net.

Andrew: Parents: Laura & Loren (Updated 9/03)

My name is Laura and I’m mommy to Aaron who is 4 1/2 and to Andrew who will be 3 in October. Andrew suffered a brain injury (HIE) at birth which has resulted in spastic-quad cerebral palsy. We have been very fortunate in that he has been quite healthy. We’ve had no major illnesses, have been able to avoid the g-tube and have had no seizure activity for more than 2 years. However, his left hip has displaced enough that the Ortho is wanting to do an osteotomy in December, on both hips. Andrew is limited as far as his gross and fine motor skills go. He can roll from tummy to back, but not back to tummy. Socially Andrew seems more on track. He is very aware of his surroundings, recognizes faces and voices, and absolutely loves the
Teletubbies. We get both PT and OT through the school district as well as privately. I have been very disappointed w/ the therapists from the schools. Well, guess that’s the short version of us.
Andy: Parents: Kristi & Bruce (Updated 2/04)

Our first child, Andy was born on February 4, 2000. He had a shoulder dystocia and was stuck for 7 minutes. Once he was out, he was without oxygen for 15 minutes. His apgar scores were 0, 0, 0, 4 at 15 minutes. A g-tube was placed at 4 weeks of age and he was able to come home from the hospital at 4 ½ weeks old. At 11 weeks old, he had a VP Shunt placed because he developed Hydrocephalus due to a Subdural Hemotoma at birth. A few days later, he had to have a revision because it was infected. Once he was finally out of the hospital at 4 months old he started receiving PT once a week. As he got older I started asking for more therapy. While he was in the Infant Program he received PT, OT, Speech, Music, and Water Therapy per week. His g-tube was removed at 16 months of age.

As of today, Andy is in preschool. He is receiving Speech, OT, PT and OT for Sensory Integration. His diagnosis is Mild-Moderate Mixed Tone CP, possibly Athotoid (depending on who you talk to), Major Sensory Integration issues & Hydrocephalus. He is Non-Verbal. He knows and uses about 50 signs and we are working with a communication device. He is sitting independently, cruising the furniture a bit, walks short distances with a Kaye Walker,  loves to climb on things, he has a strong personality that can get him into trouble.

We are very pleased with his progress and hope he will continue to gain strength the older he gets.  Our email address is mcconnell@frontiernet.net.

Anton: Parent: Maryrose Rubenacker (Updated 2/03)

My name is Maryrose Rubenacker and I’m the mom to a 3 1/2 yr. old named Anton. Anton born on July 12, 1999, suffered a severe hypoxic event-length unknown due to an unidentified prolapsed cord. An emergy- c ensued followed by full resuscitation, bagging, intubating and apgars of 0,1,3,4, which lead to a fairly grave prognosis for that night, and not a bright one for his future.

He spent a month in NICU, was intubated for only 2 days, but was pretty much in a Phenobarb coma for the whole time there. My little guy today is a very astute (at least I think so) but, a quiet, passive individual, suffering from severe gross and fine motor skills and without a true specified cp label. Even beyond that, he seems to be one of the chosen few who got a double whammy with the severity of his gastrointestinal system.- horrific episodes of gas and bile reflux (pain, pain, pain), which impacts his breathing and a FTT diagnosis ,as well. However, he is seizure free, has minor vision issues and no hearing issues.

I label him as primarily a hypotonic quad, with mixed tone extremities depending on the function he’s placed in, and a newly emerging thing he’s got going on with his arms that appears to be athetosis-like. To date, he has not had issues with spasticity that prohibit his function, but that may be because he functions little (stiffness appears when he’s in a state of activity only, or upset with me). He cannot sit fully on his own, has a ongoing love affair with ATNR, rolls inconsistently but does attempt to creep, though very little. His head control is almost weather dependent.

He has received consistent and intense therapy from the time he brought home. He currently sees 3 speech therapists, one for rib-cage mobility, one for aumentative comm, one for oral motor- and 3 PTS. one practicing integrative manual therapy (for structure only-not function), one feldenkrais therapist and one NDT pt. He does not receive OT (tried it, but can’t find one that doesn’t just shake a toy at him). He’s also done water therapy, has dabbled in Doman like patterning and slide but nothing more extensive. My email address is: mrrubenacker@ameritech.net..

The Bennett Family (Updated 02//03)

We are Colleen and Craig Bennett.  We live in central Texas with our three sons, CJ (8), Will (5) and Joe (2).   I am currently pregnant with our 4th son.  He was diagnosed as having had a fetal/in-utero stroke sometime between 14 and 24 weeks gestation.  We know that approximately ½ of his right cerebellum and part of his vermis was damaged/destroyed by the stroke.  We do not know what caused the stroke, nor do we know what to expect as far as his health and development will be after he is born.

We are interested in learning from and sharing with families of children who are dealing with issues similar to what we have been told to expect…possible problems with feeding, speech, hemiplasia, muscle tone, coordination and strength. Thank you for accepting us into your group.   The Bennett Family

Cameron: Parents: Sue & Dan (Updated 08/03)

My name is Sue, my husband is Dan and son Cameron.  We live in San Carlos, CA (25 miles south of San
Francisco)  My son has HIE, due to a chocking accident back in October.  CJ was just a year old (10 days past his first birthday.) CJ was diagnosed with severe encephalopathy, but just two weeks ago had his first EEG post the hospital stay. He now has moderate-severe encephalopathy.

Today, he can roll over mainly from front to back and back to side. The interesting thing about CJs injury and timing is that he remembers things, like crawling.  Though he does not have the strength or muscle coordination to crawl he sure tries and can actually get his OT to practice with him when it is not on the days regiment.  He can also walk support by someone, but does not have the fine motor skills to manage a walker.  We have ordered him a Lecky pronestander, which the demo he uses every week at his development class and he loves it.  He is starting to sit on his own, but his low tone in his waist makes it hard.  He has high tone in his arms and legs. He has CVI, but with the help of Blind Babies Foundation, has made a lot of strides. From having no recognition to today being able to see things in mirrors and smile. He also begun looking at people when they talk and really trying to control his environment instead of just participate.  Still unsure of if he can tell if a person is a person, but he does distinguish between family, friends and care givers. It is pretty cool to have your little one smile at seeing you come home from work. It is really bad now, because he likes to watch TV.  We have to turn it off during PT and visual therapy.

CJ’s hearing has not been effected that we can tell.  It seemed to be the first thing that really came back.  He was able to move his head to sound, but not to vision for the longest time.  He does have a vocabulary, but has not mastered by any means pronunciation.  He does verbalize some vowels, m, n and g.  He continues to add new
sounds to his arsenal as he gains more control of his tongue.  He has a speech therapist and through eating and a few exercises we are working on gaining back control and looking at some adaptive technologies as well.

Dominic: Parents: Helene and Gerry

We have 2 children: Dominic (9 1/2) and Chloe (12 years old) who is and has been her brother’s best therapist to date.

Dominic was born 10th Dec. 1993 with emergency C-section due to my uterus rupturing during delivery. I recovered perfectly but Dominic didn’t. He suffered birth asphyxia and was put on life support for the first 24 hrs of his life. He came home after 10 days and we were told that we might spend the rest of our lives finding out if he’d been affected by the ordeal.

His development was normal for the first 5 months, he could even roll over! But then, it just stopped. He never learned to crawl, creep or sit. He was diagnosed with CP quadriplegic at age 1. Later he was also diagnosed as athetoid.

Being in Malaysia, the support provided and expertise available were minimal. He had P.T. 3 times a week and it wasn’t doing much. I quit my job and started an intensive home program for him when he was 3 1/2. The program was based on the Glenn Doman approach. We did this program for 3 1/2 years and hated every minute of it! I also did a home schooling program for him as there was not enough hours in the day to go to school and do exercises. He did progress though and started walking independently at age 5.

We then moved on to Brain-Net’s sensory stimulation program and have seen good results. We are still on the program at a much reduced pace (1 hr/day). We have also been doing Speech Therapy every week for the past 5 years, HBOT (over 400 dives), horse ridding and swimming (he can now swim independently). We just started primary reflex therapy (too early to say if it will help) and a brand new “Theratogs” is on the way!!

Dominic started school part-time 2 years ago, in year 2 in a mainstream environment. He is now fulltime in school, in year 4, and doing well. He has no one-to-one support but needs help going up and down the stairs and changing for P.E. Handwriting is his biggest challenge in school and we’re getting an extra large keys keyboard for him. Our email address is: zemog@index.com.jo.

Dustin:Parent: Christiana (Update 09/03)

My name is Christiana and I have three children.  My middle son, Dustin is 11-yrs old (Born on      8-16-1989). At age 7, he sustained a head injury from a baseball bat while practicing.  His injury effected his executive functions and triggered a severe psychiatric reaction that landed him in a psychiatric hospital with hallucinations and other thought disorder problems for 4-months when he was 8-yrs old.  Over that next year he regressed completely academically.  He lost the ability to read or write and his language and processing skills are effected.
This past year we started some intense remedial learning using multi-sensory reading and we got him between an upper 1st grade, lower 2nd grade level reading and a 3rd grade level math.  We are using assistive technology for writing but we are having troubles teaching him the keyboard.  So here we are going into 6th grade and I think we are on the right track and I’m sure our issues aren’t nearly as severe as many on this list but we continue to look for ways to help him learn.  He takes Aricept which has helped his cognitive and processing speed. So that is us, my other two children are 14 and 5.

Elizabeth: Parent: Kimberly (Updated 2/03)

I’m Kimberly. My daughter, Elizabeth, is 4 ½. She was born on May 9, 1998 at 31 weeks, intubated, PDA surgically repaired, IVH. She developed infantile spasms at 8 mos. Now has a dx of Spastic Quad CP. We’ve been with NACD for about 2 1/2 years. She is also in Conductive Ed, NDT, Speech, Vojta, Feldenkrais, Horses, Swimming, Massage and Vision Therapy. I take her to an Osteopath for treatment whenever I get the chance. She is on an anticonvulsant, but has been seizure free for over a year now. My email address is: kimberly@invento.com.mx

Eric: Parent: Andrea (Updated 2/03)

I'm Andrea, mom to Eric who is 9 1/2 years old. Eric was born on June 15, 1993. He suffered brain damage at 5 weeks of age due to a hyponatremia episode. He was deprived of oxygen for a short period of time so that explains a portion of the damage, the remaining damage is attributed to the damage caused directly from the hyponatremia episoid itself - led to a status tonic seizure and problems intubating him. He has Cerebral Palsy (PVL) mostly low tone but tight heel cords/ankles, CVI - no progress here!, mental retardation (seems to understand simple things but still no way for him to communicate), seizures (controlled pretty well with depakote) with abnormal EEG pattern but no organized seizures present on it. He does eat orally, and is hypersensitive to sound.

I am very interested in the NACD program…especially to get some ideas to help in regard to CVI. I am discouraged by everything I read about CVI that we are too late for him to develop visual connections at this point. His vision has essentially been static at nothing for years… on a rare occasion he will show a spark of notice at a Christmas light or something. Vision therapy has been stumped and essentially backed out except for “consult” to explain
the condition. All we ever really received was “opportunities to see” which he never was interested in.

What does NACD include in their program for such severe CVI?
Anyone have any success in insurance or other assistance with NACD
expenses? Have you all had your initial evaluations/programs in Utah?
Look forward to more discussions/information!

Erin: Parents: Sharon & Danny Soto (Updated 08/03)

Erin was born March 1, 2001, a healthy baby, a developing typically until she got a virus at 6.5 months.  She was diagnosed with herpes encephalitis due to direct contact with a cold sore.  She was hospitalized for 4 months, during that time she had metabolic studies, immunologic studies, MRI, Cat Scans, EEG’s and every other test/study that could be conducted.  She also had a brain biopsy and a nissan and gtube inserted.  Her primarily diagnosis is herpes encephalitis which led to cortical vision impairment, infantile spasms and she is globally delayed.

Erin is now 2.5 years and has made slow progress, which we are grateful for and hope that it continues.  She receives PT, OT, Speech, Vision weekly through our county, PT 2 times a month through our insurance, Maryland School for the Blind comes out 2 times a month, cranial sacral therapy once a week and acupuncture once a week, and we took her to a Neurodevelopment Specialist, Sargent Goodchild at Active Healing, and have a home therapy program that we are trying our best to do.

Erin can sit unsupported, get into a crawl position, but can not push to extended arms, she rolls all around and weight bares nicely on her legs.  She has the most beautiful smile which lights up my world.

Erin: Parents: Jennifer & Andy (Updates 10/03)

My name is Jennifer, my husband is Andy and my daughter is Erin.  She is four now (just turned in September!).  She was born with holes in her ventricular septum of her heart, but otherwise healthy.  She was developing normally until two weeks prior to her first birthday.  We had surgery to repair the holes in her heart and she coded the day after surgery.  The resuscitation took 40 minutes and during that time her brain suffered the anoxic/hypoxic injury.  We have just done traditional therapy, some patterning but I don’t always have the help to do it consistently.  She has made some progress—she can roll from supine to prone, either side.  She can hold her head up for 15 seconds or so.  She consistently and appropriately can activate a switch, either hand or leg.  She is g-tube fed w/fundo, cortically visually impaired, and has seizures we are trying to control.  She also has a little brother, Drew, that will be two in January. I am eager to share my experiences with all of you and learn from you as well.

Gerard: Parent: Ilse & Francis (Updated 03/03) 

My name is Ilse Montocchio, and I am the mother of Gerard, featured on the Bright website under case studies at
http://brightfoundation.tripod.com/main/id10_3.html

In a nutshell, he is now 7 years old, was born with a serious heart defect and subsequently suffered hypoxic brain injury. We have been doing an intensive program from IAHP for 2 years and 9 months.

His progress since I wrote the article for the BRIGHT website: his hearing has improved a lot, he can read, he can sit in the W-sitting position, rigidity (spasticity) had improved a lot (his left hip is luxated, but his left leg can now be pulled manually into the correct position in the hip socket); and best of all, he started creeping on hands and knees in September 2002. Gerard’s birth date: 10 October 1995.

Jessica: Parent: Karen  Hopkins (Updated 2/03)

My daughter, Jessica, was born at 37 1/2 weeks with perinatal asphyxia – the cord was wrapped around her body 3 times.  She was born by (planned) C-section and had to be revived, then immediately started having seizures and was put on a respirator. She was not expected to live 48 hours and now is 4 1/2!  She has severe (fluxuating) CP, CVI, Swallowing problems, g-tube fed, non-verbal, on-ambulatory but as smart as a whip and very determined.  Her injury was primarily to the basal ganglia but had a total of 5 areas of insult.    Her neurologist put her on Artane about three months ago and has very gradually increased the dose due to the possible side affects and so far she is doing great.  The reason her neurologist put her on Artane was to “smooth out” her movements.   Because she goes from low tone to high tone she tends to shoot past her target but with the Artane her accuracy has greatly improved.   Her swallowing has improved but we tend to think that is because one of the side affects of the Artane is to dry up her secretions. Her improvements have been very subtle and slow but since we have noticed improvement with no bad side affects, we are still going to continue the gradual increase.  Anyone that has input from experience would be greatly appreciated. My email address is: karebear5160@aol.com.

Jon-Jon: Parent: Sherry (Updated 2/03)

My name is Sherry. Jonathon was born on June 22, 1998 and has severe HIE and CP among Ftt, trached, g-tubed tonic/clonic seizures, brain shrinkage and overlap, scoliosis, CVI plus more. He is 4.5 yrs old and now 15 pounds and 15ozs 24.5 inches long same H.C. since birth at 32.3 c.m. I hope to get to know more parents out there. My email address is: jonjonsma@aol.com

Joshua:Parent: Wendy (Updated 6/03)

My name is Wendy Spivey. My husband and I are the proud parents of Joshua, age 14, Jonathan, 14, and Julian, 15.

 

Joshua was born on January 8, 1989. He was the second twin. It was an awful night. I went into labor at 28 weeks and was fully dilated by the time we reached the hospital. There was no stopping these guys.

 

Jonathan was born by natural delivery. Unfortunately, I had a placenta abruptio, and the placenta blocked Joshua inside. 25 minutes later, he was born by an emergency c-section.

 

During the C-section, my heart and breathing stopped. I had to be intubated, and didn’t wake up until the next day in intensive care. The twins had to be transported to an NICU about 1 and 1/2 hours away. Jonathan was placed in an oxy-hood and Joshua had to be intubated. Jonathan weighed 3 and 1/2 pounds. Joshua weighed 3 pounds.

 

We were later told that the sudden burst of oxygen from the intubation had caused Joshua to have an Interventricular hemmorage (IVH grade 3). CT scans showed Joshua to have less than half of his brain tissue and extremely large ventricles, which created hydrocephalus.

 

At age 4 mos., Joshua had a shunt put in.

At age 18 mos., he had a failure and had it replaced.

At age 3 years, he had another failure and had it replaced again.

(Since that time…his shunt has been fine.)

 

At age 6 months, we had a neurosurgeon tell us we should put him in an institution. We didn’t believe a thing the Doctor said and made up our minds to help Joshua be the best he could be. We started a journey forward and have never looked back with any regrets.

 

Joshua has had PT and OT since he was 6 months old. He had the shunts as previously mentioned. He had a Selective Dorsal Rhyzotomy at age 2. He then learned to crawl. Before that he had only pulled himself around in combat fashion.

 

He started to preschool in the Public School system at age 3 in a physically impaired class. By the time he got to Kindergarten, I had him in a full inclusion classroom with a full time personal assistant, getting all his PT and OT at school…Usually twice weekly at 45 minutes each.

 

Joshua is extremely verbal and it seems as though he always has been. He began talking at an early age. His Cerebral Palsy manifests itself in the form of physical mobility. He has spastic diplegia. His upper body is in pretty good shape. He propels himself independently in his wheelchair. He is very auditory. His visual perception is lacking. He has great difficulty reading. In fact, he’s in 8th grade and reads on a grade equivalent of about 1.5. His listening comprehension and ability to formulate answers is on grade level.

 

I have fought the system many times….Joshua is presently receiving 5 hours per week of PT and 2 hours per week of OT. This is a battle that will continue. The school is presently making us go through re-evaluations, IEP meetings with their lawyer, etc. etc.

 

Joshua has had BOTOX, attended Euromed twice (Now he’s learning to walk with crutches), and HBOT, briefly. I would be happy to discuss these ventures with anyone who is interested.

 

Justin: Parents: Amy & Rob (Updated 2/04)

 

Justin was born on 8/20/02 with the cord wrapped around his neck 3 times. He was not breathing when he was born and required resuscitation.  His APGAR scores were 1,3,6,7 and the neonatologist initially felt that the hypoxic
ischemic insult he suffered was mild and that he would be fine.  The neonatologist became less confident about Justin’s prognosis when, after removing his vent at 1 week, Justin was given a bottle and would not take it.  Justin was in the hospital for a month and most of the time was spent trying to get him to orally feed.  During that time he was diagnosed with acid reflux.  We brought him home with an ng-tube and immediately started working on the reflux and feeding issues.  The reflux got so bad that he had a Nissen Fundoplication at 7 months.  This worked out excellent and allowed him to switch from ng-tube to g-tube also.  Justin had an MRI at 4 months that showed mild damage to the basal ganglia.  As a result of his injury, Justin’s motor skills are extremely delayed.  As of now (2/6/04) he cannot sit and when put in a sitting position often stiffens up to get out of that position.  He does not use his arms or hands purposefully.  He has had no seizures to date.  Justin’s head control has improved a great deal over the last couple of months and is pretty good at this point.  Justin has PT, OT, and ST at home.  He is also in a program at a nearby therapy facility and has recently started aqua-therapy.  He also gets dad’s therapy program on
the weekends.  Throughout all of this Justin has turned out to be a sweet little boy with a wonderful disposition.  He, along with his big sister Alexandra, bring a great deal of joy to our lives. Our email address is amyrichards@charter.net.

 

 

Kaitlyn: Parents: Jessica & Charlie (Updated 09/03)

Hi my name is Jessica and my daughter’s name is Kaitlyn. Kaitlyn is 9 months old. She has HIE, CVI, Spastic Quad CP, Microcephaly, Failure to Thrive, and Global Developmental Delays. Her injury was caused by perinatal asphyxia due to doctor error. Kaitlyn as of now has Physical Therapy and Occupational Therapy through the medical model. She sees an OT, PT, Visual Therapist, and Early Education Teacher through the school district. She has a wide variety of doctors…a neurologist, physiatrist, ophthalmologist, orthopedic surgeon, gastroenterologist…I think that covers it. When she started therapy, we worked mostly on getting her to respond because for the first few months of her life she didn’t do much but sleep. Now most of her Physical Therapy is range of motion. I like her therapist and the work she does. She recommended getting Kaitlyn a stroller/seating system which is helping. It is the Kimba. Kaitlyn recently began work with her OT and that is more working with her Vestibular system. I haven’t had any problems thus far regarding the therapies they are doing. I ask lots of questions and research a lot. My email address is: jess_of_the_lake@hotmail.com.

Kitty: Parent: Jane (Updated 2/03)

My name is Jane and I have a 14 month old daughter called Kitty who was born on November 2, 2001. We live in the UK.

Kitty has athetoid CP, with the emphasis being mainly on feeding difficulties, exacerbated by reflux. Kitty has a g-tube/gastrostomy, depending on what side of the Atlantic you are! Kitty can sit up with a little support round her hips and can stand when her hands are help (for a short time). We have been fortunate in that Kitty has not suffered seizures and her cognitive abilities are well on track.

I have been reading some past posts on this site and a couple of children (particularly Andy and Alissa) sound very similar indeed to Kitty. Kitty has the daytime snoring – her family nickname is ‘snuffles’ – but this is caused by pooling her secretions, we have
been told. Kitty also had a normal MRI – or rather ‘no abnormalities seen’ – but I have been led to believe that this is often the case in tiny babies when the problem is in the basal ganglia. Kitty’s apgars were 7 and 9 and her cord pH was 7.28. I am pretty convinced that the problem occurred in the last week or two of my pregnancy when she went from being a very responsive fetus to suddenly not. I then swelled up and showed mild signs of pre-eclampsia (though not enough to do anything about apparently). I went into induced labor following rupturing of my membranes and there was a lot of meconuim in my waters and, during the 23-hour labor, Kitty suffered from ‘decelerations with slow recovery’, but again nothing was done. She had not engaged at all when I was induced, was facing the wrong way round and was finally delivered after two hours of pushing with the ‘help’ of two ventouse suctions, one on the back of her head and one on her shoulder. As she had not engaged properly, she was still curled up and so came out back of the head and shoulders first. And her cord was wrapped round her neck. So … put it all together and it is not really surprising really that she has the problems that she has.

Kitty was born with a ‘chest infection’, but has since not had an aspiration pneumonia. Following a swallow-study six months ago when Kitty screamed throughout (and aspirated without even passing go!) we
were told not to give her any more oral feeds. Kitty had been doing fairly well with oral feeding up to that point, but to our great regret, we took the advice of the professionals. A big lesson learnt
there.

Kitty has had tremendous oral aversion which she is just starting to get over now (with the help of an electric toothbrush of all things!). That was due to inserting NG tubes sometimes up to 5 times a day as
she would strain, pull or vomit them out. We also had to carry out a LOT of oro-pharyngeal suction for the first three months of her life. At this stage she will tolerate a dummy/pacifier in her mouth for short periods of time – sometimes I even tape it in (don’t worry I keep a close watch!) – and that helps a lot.

Anyway, treatment wise, we have looked at all sorts for Kitty and have finally settled on Conductive Education (she has a place in a school starting next week) and g-therapy which just seems to make sense to us as giving her brain that ‘helping hand’ that it needs.

I have lots of tips and suggestions to share and will post as they come to me!

I would love to exchange experiences with parents of similar children, in my experience FAR, FAR more valuable that anything any of the medics have come up with for us. My email address is: baker_jane@yahoo.co.uk.

Laura: Parent: Val (Updated 03/03)

Laura's date of birth is 7/24/84. She was diagnosis cerebral palsy spastic quadriplegia. Gestation 29 weeks. Weight at birth 1.7 kilos. Apgar score 6. Laura suffered from Respiratory Distress Syndrome. She was tube fed for the first 5 weeks. Preference in using left side of her body. She has had no surgeries. Previous therapies tried Conductive Education between ages of 4 years until 12 years when Laura started G-Therapy. 75 sessions of HBOT therapy. The Hart walker from ages 9 until 12 years. Physiotherapy and rigid and flexible splints. Currently 6 years on G-Therapy using a Kaye-walker. Difficult periods have been tiredness due we feel to changes in her metabolism and changes in both gross and fine motor control. At certain times of change we can experience extra high tone due Laura says to a change happening. Later this has been followed by an influx of new feelings. Laura tells me that she can feel it stretching something when this has happened. We have experienced also occasional aches.  Other than this, no bad effects. Laura seemed to go back to basics when she started on G-Therapy.  She needed to crawl for 4 years. Previously this had been completely impossible; she had always fallen to the right, not even being able to hold the position. We feel that her spasticity is gradually decreasing.  We are noticing much more flexibility in the right foot. We feel also that the crawling has helped decrease spasticity. Laura has also experienced many comfortable cracks in her joints all over her body since taking G-Therapy, this may also be helping. Her page on the G-Therapy site with recent photos is:www.g-therapy.org/cslaura.htm

Laura’s Email

I started G-therapy in January 1997 at the age of 12, I am now 18. I have Cerebral Palsy spastic quadriplegia. I have tried several other therapies, including Conductive Education, splints, orthotic walkers and oxygen therapy, among others. G-therapy was the first alternative treatment I’ve tried. It all started when I noticed a difference in my right hand very soon after taking the medicine. My fine motor control kept improving. I also found that when I got off the chair I didn’t feel stiff, panic and fall backwards like I did normally. As my limbs began to lose the stiffness they began to crack and afterwards they felt more comfortable. Later I started to get up on my hands and knees several times, and crawl slowly. I felt I needed to do this because it made my whole body feel less tight, particularly my hips, and strengthen my body throughout. It took me a long time before my body was ready to go on and do more walking.

Before G-therapy I couldn’t put my right heel flat, generally now it goes down with ease and makes Kaye walking a lot easier. Recently I can feel my knees getting looser and my hamstrings have ached and I can feel them stretching. This process has been vital for my whole body as the stiffness in me gradually decreases. Although my physical changes have been slow, because I was nearly a teenager when I started G-therapy, I have been consistently aware of changes in my body. I have had no adverse effects from G-therapy whatsoever.

Though I attended mainstream school I was withdrawn from secondary school due to the fact I was spending a lot of time in a wheelchair and physically I deteriorated. I was educated at home so I could concentrate more on my physical side. Math was the one subject I couldn’t understand, which is common in cerebral palsy, after G-therapy it was far easier for me to comprehend. I feel it is important to work on my improvements physically, while I’m quite young. I would like to return to my education in the future.

Laurel: Parents: Rochelle & Bob (Updated 2/04)

My name’s Rochelle Garwood, and my husband Bob and I have a little girl named Laurel who was born 11/11/00. Laurel suffered a hypoxic incident around the time of her birth (nobody is exactly sure when) and is categorized as having mild to moderate hypoxic ischemic encephalopathy. Secondary to that, she has spastic quad CP, cortical vision impairment, has had infantile spasms (about 2 years seizure-free at this point), and is fed by g-tube. Laurel still doesn’t quite sit independently, crawl, or talk, but she keeps edging incrementally closer to those things and she seems to understand a great deal. We have done craniosacral therapy, NACD (National Association for Child Development), and Feldenkrais with her as well as the standard PT, OT, and ST and are always interested in learning more about other treatment options. My email address is: rochelle@rochelle.org.

LeAnne: Parents: Jessica & Mak (Updated 03/03)

:LeAnne was born on September 8, 1999 with  Lissencephaly Type I Incomplete ; macrocephaly as well. My email address is icebox@pacific.net.sg.

Leiby-Henyu (Updated 03/03)

Hi! My name is Henyu, I'm new in this group, Have been a member of the CB list for quite some time and enjoyed it. My son, Leiby is 7 ½, DS. He’s been on program on and off for 6 years. We were on the intensive at IAHP for 2 years. He reads fluently in 3 languages. He is highly intelligent {like most kids on program}, and very bright.
Right now we are doing a program of creeping, masking, running and braciation, of course an academic program. Right now my biggest concern is establishing complete dominance. He is right dominant in everything
but his eyes, He has about 150/20 vision in his rt. eye, and about 60/20 in his left. Do I go right or left??? The laterality problem is causing many behavior problems that he didn’t have. Good luck to all parents and children.

Lloyd: Parents: Steve & Wendy (Updated 2/03)

“Croeso y Cymru” Means "Welcome to North Wales", which is where Lloyd and his mum & dad Steve & Wendy live. Lloyd was born 2001:4:30. At 2/3 months dad noticed that his head circumference was falling behind the charts, though his height and weight were growing fine. Now 20 months, he is healthy and feeds well, but definitely delayed. Sits, rolls, maybe about to crawl, takes weight on legs but can’t balance unless hands held. Does not
show interest in toys, but holds his bottle; mainly with left hand.

MRI showed no brain malformation; just small. HC now 44cm. Brainstem hearing and vision tests OK. CVI – ??. Does not talk or make many noises, but alert and responsive. No seizures as normally understood, but some momentary head drops which may be atonic or “reverse myclonic”. Tends to constipation, but not to the extent of being a big problem.  All in all, he’s a nice little fellow. We get PT/OT/ST as part of the UK National Health Service. Not tried any alternatives yet except for homeopathy to humor a good friend who is a homeopathic doctor. I can
see no scope for pills with nothing in them to do Lloyd any harm – nor can she convince me they can do any good.

We are thinking of trying Conductive Education in Spring. Our email address is: stephen_l_phillips@talk21.com

Mia & Diamond:Parent: Lynn (Update 09/03)

My name is Lynn and I am the parent of two daughters with CP, ages 6 and 10.  We adopted them in 2000.  The oldest child went into cardiac arrest due to dehydration at about 3 months and the younger child vomited and aspirated on a bottle also at about 3 months.  The therapies that we practice are integrative manual therapy, HBOT and accupncture.  I am interested in hearing from someone who has done neurofeedback for CP. Mia’s birthday is on July 22nd and Diamond’s birthday is on February 19th.

My email address is  project1116@hotmail.com.
Megan: Parents: Thad & Debra (updated 11/03)

This is Megan.  She suffered a severe TBI with hypoxic injury in a motor
vehicle accident on June 26th, 2003 .  She was almost 7 months old at the
time of her injury.   She continues to progress a bit each day.  Currently
she receives daily traditional therapies (OT, PT, SLT, Dev T) in our home
through the early intervention program.  Megan has cerebral palsy(non-specific) and global developmental delays as a result of her injuries.

She was in a pentobarbital induced coma for almost three weeks and spent a
total of eight weeks in the hospital after her accident.  She has a G-tube
which we currently use for medications only, and as insurance to prevent
dehydration if she becomes ill. She suffered injury to her pituitary gland which has resulted in diabetes insipidus, or "water diabetes", and a need for on-going monitoring of other pituitary functions such as thyroid and growth hormones.  Megan has also had simple partial seizures diagnosed via EEG, so is on anti-convulsive meds.  Megan has recently gotten her smile back and has started to giggle and laugh on occasion.  She is hypertonic in her left arm and hypotonic in her trunk, but her tone continues to improve.

She is trying to crawl but has difficulty because of the high tone in her left arm.  She has recently started to babble and make increasing attempts to talk and communicate.  For the first two months after her injury she suffered from severe CVI which appears to have improved greatly as has her cognitive function.  She responds appropriately to her name and to familiar voices, faces, and a limited number of vocabulary words.  She has a very strong gag reflex and we continue to work with her to improve her tolerance of varied solid food textures.

Megan lives at home in Indianapolis, Indiana with her dad and I, Thad and Debra. My email address is  DSarkine@reillyind.com

Rene: Parents: Lisa & Paul (Updated 2/03)

I am Lisa Davenport, wife to Paul and mother of three children: Paul, 4 years, Jenna 7 months, and Rene, 6 years.  We are from Apex, North Carolina.  My daughter, Rene Davenport was diagnosed at 15 months old with central hypotonia, bilateral esotropia, and developmental delay.  At that time, an MRI of the brain showed that she had absence of the posterior portion of the corpus callosum, as well as Periventricular Leucomalacia*.  At 6 years of age, she has severe speech delay, hyperactivity, and below average motor coordination. Our email address is:   lisa-davenport@nc.rr.com

*Brain injury near the ventricles of the brain http://www.pediatrics.wisc.edu/childrenshosp/parents_of_preemies/pvl.html

Samuel: Parents: Raynou & Steve Terry (Updated 03/03)

Samuel is my eldest son out of two sons. He has Cerebral Palsy. We live in U.K. Sam was born 10 weeks early following premature rupture of membrane and loss of amniotic fluid some weeks earlier. He was oxygen dependant for 6 months. His birthday is 12/14/96.

Sara: Parents: Amy & Jim (Updated 2/03)

My name is Amy Young and my husband is Jim.  We are the parents of Sara who was born on June 8, 1999 (and Ryan).  Sara had a hypoxic injury during delivery and is diagnosed as dystonic quad CP (moderate to severe on scale).  Sara is 3.5 and began pre-school this year.  Her physical limitations have not allowed her walk independently (she uses a gait trainer for short distance) or speak.  She is G-tube fed and has some gastric issues as well.  She can not sit up but has begun rolling (when she feels like it).  Her happy, outgoing personality shines and she is very creative in expressing her needs (everyone says her eyes say it all and they do!).  She has had the traditional PT, OT, ST, Aug. Communication and has made minimal gains physically but major gains cognitively.  Even with her ‘decreased’ communication she scores at or above developmental on all pysh and cognitive tests.  Hippo-therapy has been wonderful for her and I can see the difference in head control and trunk support in the short 6 months she has been participating.  We go to Ability Camp in Feb for HBOT and Conductive Ed.  We feel we are realistic in our expected outcomes….Our email address is ayoung@lowell.k12.ma.us

Sarah: Parent: Brandie (Updated 09/03)

My name is Brandie Carboni mother of 9 month old Sarah born on December 28, 2002. No one knows exactly what went wrong with her. Her heart beat when up when it was suppose to and down when it was suppose to. I had a great labor no complaints. No one knew that there was anything wrong with Sarah until they cut the cord and she did not breath on her own. Around 11:00 that night she began to have seizures, they made the call to air lift her to Omaha NE. About 3 hours from where I delivered. We did not know if she would live or die. There we found out that she had suffered a brain injury. We also found out that she had lost her suck, swallow, and gag reflex. It was a long and hard time for us. This was our first child we were suppose to have the perfect child but something went wrong and no one knows what. We did find out that Sarah had tied her cord in a true tight knot and then wrapped it around her neck. Many doctors have told us that we better be thankful that she is still alive because many of the babies die. Sarah spent a month at  children’s. When we left we felt like the doctors were thinking  I hope you take your vegetable home and enjoy her because she will never do anything. She was home for 6 days and but back in the hospital for a common cold she was there for 6 days and then got to come home again it took her about 2 weeks to recoup from this. She has been home ever since. Sarah has therapy 5 days a week OT, PT ,Speech. But like I say she has therapy 24 hours a day and 7 days a week it is better to teach them the right way now instead of having to break a bad habit and teaching them how to do it the right way. Besides Sarah thinks it is just playing with her. :-) She is the love of our life and I will always be behind her and she will be all that she can be and wants to be. She has proven her doctors wrong many of times and she will continues to do so. Our email address is BBourgoyne@alltel.net.

Sebastian: Parents: Louis & Anna Selo (Updated 2/03)

Let me introduce myself. I live in London, England and have a severely disabled 11 year old son, Sebastian who was born November 27, 1991.

Unfortunately, like many disabled children Sebastian’s story is long and complex. So I will try to be precise.

Sebastian, who has a healthy twin sister, was born with an extremely rare brain tumor called a hypothalamic hamartoma. As a result Sebastian has suffered from seizures since the day he was born. Starting with gelastic (laughing) seizures, they have evolved into generalized tonic/clonic seizures.

He also suffers from severe learning and behavioral difficulties and his chances of leading any form of independent life are non-existent.

If that was not enough in 1996 Sebastian suffered a stroke, as a result of an aborted operation to remove part of the tumor. This has left him paralyzed on his left side and with optic nerve damage.

In 2001 we took Sebastian to Australia and had the tumor completely removed by a neurosurgeon who specializes in successfully remove this type of tumor. We heard about this surgery through a wonderful Internet support group (HHUGS) for children with this tumor.

Although Sebastian’s well being and cognitive skills have improved since this operation, he continues to suffer from seizures (on average 5 a week, lasting up to 30 minutes).

I have been very interested in and grateful for the excellent work Matt has been doing by identifying all the medical resources and research on brain injury. I believe in the power of Internet collaboration in moving forward the frontiers of medical knowledge and have already experienced it in a big way with the HHUGS group.

On a personal level I am interested in any leads that can help Sebastian with:

- reducing/abating his seizure activity
- enhancing/”switching-on” his learning abilities
- reducing/reversing his left sided paralysis.

I appreciate that this is a very tall and almost impossible order, but any help, no matter how small, will be truly appreciated.

Over 11 long and difficult years my wife, Anna and myself have tried many therapies/treatments, both conventional and alternative, that have and have not helped Sebastian to varying degrees. We are more than happy to share our experiences and insights. Our email is louis@selo.fsnet.co.uk

Timmy: Parent: Julia (Updated 2/03)

My name is Julia Lang.  I have four children.  Chris 19, Gemma 16, Rachel 10 and Timmy 7 /8months. Date of birth: 27 May 1995. Timmy has cerebral palsy spastic quadriplegia. We live in the UK in a small town near Oxford.

Cure not Care!

“Cure not Care”, “Cure Warriors”, “Cure Tribe”

These are just a few of the phrases coined by the Spinal Cord Injury community to express their dedication to the idea that a cure is very possible.

Charles Carson, was founder of the Spinal Cord Society – the first cure advocacy group dating to the late 1970s, and trademarked the slogan “cure not care”.

Sam Maddox writes these words: “Chuck, who died a year ago, believed that science and medicine could fix SCI with a focused effort. He used to suggest cure research would happen more quickly if scientists were given epidural nerve blocks to induce paralysis – to sharpen the sense of urgency. He also used to wonder whether progress was impeded by the rehab and caring industries, whose bottom line would suffer if people started dumping their wheelchairs. Carson used to host an annual SCS convention. Scientists meet the consumers. Even in the most incomprehensible neuro-babble, there is hope. As Carson often said, “A lot more people have died from no hope than from false hope.”

“The biggest difference now as opposed to 30 years ago: the warriors are much better informed. And they all seem to know each other, thanks to a networked world. There is more hope now, or at least there are more clinical trials. Better biology and more shoulders to the wheel. But today there’s still just as much impatience, passion, and anger as there was in Chuck’s day.”

Sam’s and Chuck’s words are so true.   BRIGHT’s members are most defiantly “Cure Warriors”.     Check the Treatments and Research Category frequently to see what is on the horizon as a possible cure to help recovery after Brain Injury.

Care not Cure

Care not Cure