Dear Norileen,
I am an O.T.  from Canada working with young adults with Cerebral Palsy. I
cannot advise you on what progress you can expect in terms of physical
improvement and I will leave that to colleagues who are working with
children with C.P.. I can however tell you that some of the young adults I
work with are non-verbal, Ng-tube fed and have no functional physical
abilities and yet live a very meaningful enjoyable life, often living in an
independent living setting with 24 hour attendant care services. Will the
youngster you are presently working with be one of those? It is certainly
too early to tell. So, if your health care system will allow it, do keep
working with  this child on quality of life issues. For instance is there a
reliable way for him to communicate his needs, his desires, his feelings. Is
there any degree of  mobility  "by choice "?Are there at this present time
moments of his life that are devoted to sheer enjoyment?  I am not familiar
with the opportunities available to your young adults but I suspect that it
holds true in the Phillipines as well as in Canada that the ability to make
choices, assume some level of responsibility, take some risks is a more
important factor to having a life worth living than actual physical
abilities. So basically, I am saying that your concern for your youngster's
quality of life is very heartening and well worth pursuing.
Keep on reaching out to therapists all over the world to hear more ideas to
support you in your work
Ginette Grewal
 -----Original Message-----
From:   Norileen Joco Rosales [mailto:[EMAIL PROTECTED] 
Sent:   Monday, February 24, 2003 6:05 PM
To:     [EMAIL PROTECTED]
Subject:        Cerebral Palsy Prognosis

I am a therapist from the Philippines and currently working with a 3 yr old
CP spastic Quadriplegia. I am worrying about his development because I have
been treating him for 1 1/2 years already and still find very little
improvement regarding his motor develoment. I used NDT for the first 6
months incorporated with facilitatory techniques for his hypotonic lower
extremities and very spastic upper extremities. From the sixth month up to
present I am using therapeutic electrical stimulation to relax his muscles
and develop strength. During every treatment I incorporate play to
facilitate his communication and still uses NDT once in a while. I have also
used icing/ cold stimulaiton as well as use techniques of sensory
integration. I am very open to every treatment technique so that I would
achieve my goal for him. He has frequent seizures, breathing problem (barrel
chested) hip subluxation, has an NGT for almost 2 years, has very limited
voluntary movements, his ATNR and primit!
ive
 reflexes persists, and still does not developed equilibrium reactions and
righting reactions while placed in sitting position and demonstrated very
little improvement with all the techniques and modalities I used and now I
noticed he has structural scoliosis. I'd like to know if i CAN STILL EXPECT
SOME IMPROVEMENTS IN THE NEXT COUPLE OF MONTHS.What do you think will be his
prognosis? What do you think would be the most effective treatment for him?
Please give me some practical suggestions regarding the best therapeutic
technique I can do. As a therapist I aim to provide my patients the best
treatment possible to make their little lives wothwhile and I always try to
find the best solution for every problem. PLEASE HELP ME!!!!

Norileen J. Rosales, OTRP
Private Practice 
--

On Sun, 23 Feb 2003 08:24:44  
 Elizabeth H. Thiers wrote:
>Where are you located Rick?   I know several sources in our area and since
>many are federally funded you may find a correlate in your area.  For young
>children who are blind with physical impairments there is CITE and the
local
>Lion's club center.  For others there is the Florida Division of the blind.
>Orientation and Mobility is a specialty area of vision teachers and
requires
>advanced training.  However, at least the resources in our area are great
>about sharing their wealth of information.  I know when I started working
>with some deaf/ blind clients they gave me oodles of information.
>Also, you may already know this already but, get a good idea of difference
>between blind and visually impaired.  You want to know what type of sight
>the person may or may not have.
>
>Elizabeth H. Thiers, OTR/L
>Florida Elks Children's Therapy Services
>[EMAIL PROTECTED]
>
>
>  -----Original Message-----
>  From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED] Behalf Of
>[EMAIL PROTECTED]
>  Sent: Saturday, February 22, 2003 1:10 PM
>  To: [EMAIL PROTECTED]
>  Subject: ADLs and blindness
>
>
>  Rickot-
>  The independent people I know with blindness have everything in their
>house very organized.  They always keep things in the same spot.  If they
>know braille, they use a labeler to label everything with braille writing.
>A professor I had really used his ears for everything!  He could walk
>through a city and know when to  cross the street by just listening to the
>sounds of the cars.  I have never worked with training the blind myself,
>this is just what I have seen with the blind people I know.  There are
blind
>rehab centers around which are residential programs for training the blind.
>That is all the help I can offer.
>


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