Paediatric rehabilitation

A number of factors necessitate a different approach to the rehabilitation of children compared to that of adults. One such factor is brain maturity, with a child’s brain still in the process of growing and developing through an active process of learning and acquiring new skills. The occurrence of brain injury resulting from illness or injury can severely affect a child’s ability to achieve milestones as would normally be the case. Research evidence indicates that starting rehabilitation as early as possible is important in optimising recovery of brain function and reducing the level of short and long term impairment and disability. In the enriched environment created through paediatric rehabilitation, the child is stimulated to successively achieve age-appropriate skills. Dedicated and intensive inpatient rehabilitation of children also serves to provide a supportive and informative environment for parents, other family members and caregivers, who usually struggle to come to terms with the trauma that paediatric disability brings about.

Benefits of paediatric rehabilitation

The benefits of Life Rehabilitation’s programme include the following:

• Prevention of prolonged stay in an inappropriate, acute hospital environment
• Improved outcomes achieved over a shorter, focused period of time
• On-site rehabilitation service offered by a comprehensively trained, interdisciplinary team of medical, nursing and therapy professionals, who address all issues without overlap
• Child and family centered, outcomes driven rehabilitation
• Simulation of the home environment where the child has the opportunity to practice tasks with increasing confidence
• Focused and appropriate caregiver training by all team members

Case management

Case management is carried out according to the Life Rehabilitation standard process. When ready to refer a child for rehabilitation, the specialist should contact the closest Life Rehabilitation unit. The rehabilitation admissions consultant will personally visit the child within 24 hours of the referral to do a pre-admission assessment, in order to determine the potential benefits of rehabilitation and to optimise the appropriate admission with regards to timing and the child’s condition. The admissions consultant will discuss the admission and any queries regarding the rehabilitation process with the referring specialist, and the child’s family. Authorisation for short term rehabilitation will be requested from the funder, and further authorisations may be requested, if necessary, as rehabilitation progresses. Regular reports will be sent to the funder and referring specialists.

Paediatric rehabilitation programme

Life Rehabilitation’s paediatric programme is focused on providing time limited, patient centered, cost effective and outcomes based intervention early in the recovery process; thereby ensuring that all medical, physical and psycho-social needs are addressed timeously for an optimal outcome. The holistic, interdisciplinary programme includes both individual and group sessions. Individually targeted intervention is developed for each child, based on a variety of standardised and internationally recognised assessments, which cover functioning across the spectrum of functional areas. Interdisciplinary team meetings are held weekly to assess the child’s progress and, based on this, whether any adaptations should be made to the programme.

The following interventions form part of the programme:

• Neuro-developmental therapy to facilitate appropriate function
• Facilitation of speech and safe swallowing
• Cognitive therapy
• Psycho-social intervention
• Continence retraining, where needed
• Facilitation of appropriate seating systems
• Facilitation of appropriate splinting
• Implementation of play and leisure activities
• Establishment of a home programme
• Assessment of scholastic ability and recommendation for future scholastic intervention
• Facilitation of access to appropriate disability resources
• Referral to appropriate resources for continued therapeutic intervention after discharge
• Follow-up assessment to ensure maintenance of functional development

The following services are provided by the interdisciplinary team:

• Daily doctor visits
• Nursing care by skilled rehabilitation nursing professionals
• Individual physio, occupational and speech therapy as required, designed to stimulate optimal outcome
• Group therapy
• Dietary services
• Psycho-social support and intervention on therapeutic and clinical levels
• Patient and family education and support
• Education, training and support of primary caregiver by all team members, if required

Tariff

The cost effective, comprehensive tariff is inclusive of all professional services and caregiver accommodation, if required. Medication, investigations for diagnostic purposes and assistive devices (if necessary) are additional to the tariff.

Paediatric neurological injuries in South Africa

The inordinately high incidence of road traffic accidents in South Africa contributes significantly to neurological injuries in children. This, together with near-drownings, violence, accidental injuries, certain medical conditions and, to a lesser degree, birth trauma, result in many children being affected with varying types and degrees of neurological challenges.

Which children could benefit from paediatric rehabilitation?

Children (under 12 years) with acquired neurological conditions, for example traumatic brain injury, spinal cord injury or Guillan Barre syndrome.

Children with cerebral palsy, who have limited access to appropriate therapy resources. Children with degenerative conditions, such as muscular dystrophy. Life Rehabilitation’s specialised paediatric programme has been developed to help restore affected children to their fullest physical, mental, emotional, social, scholastic (and eventually vocational) potential possible. Success in this restoration results in reduced healthcare costs and burden of care in the long term, and improved quality of life.