The way pediatric neurorehabilitation is provided to children with cerebral palsy is problematic in light of current knowledge of neuroplasticity. The maximum intensity of therapy is given in the middle years, completely MISSING the two peaks of optimum brain growth!
There are two peaks of brain neuroplasticity in growing children: Birth to 4-6 years and 4-6 years during puberty. In the early years, many children who are missing developmental milestones are either not given an accurate diagnosis or told to “wait and see” how things develop. Often, the catchall diagnosis of Developmental Delay is given to buy time.
A child who falls off a bike and has a head injury starts therapy early. An adult with a stroke starts therapy while still in the hospital bed. Some children with CP have no antecedent warning signs until they start missing milestones, but why not immediately refer them to an expert for diagnosis once a delay is detected?
The situation is even worse for high-risk babies who were born prematurely or with complications at term birth. Most, if not all of these babies have had one or more scans and the doctors KNOW that there is brain damage. And yet, even with known damage, the only treatment plan for most is “wait and see and hope for the best”. In many areas, it is standard practice to delay the diagnosis of CP until 2 to 4 years and it may take even more time before the child is referred to a specialized treatment program. The delay for diagnosis and appropriate treatment is a real and widespread problem.
If you have not seen it, read the responses to Cynthia Frisina’s May 12th post on this topic at the Reaching For The Stars Facebook page. www.facebook.com/reachingforthestarscerebralpalsy
The problem in the teenager and young adult is equally worrisome. There is a second burst of neuroplastic change as the child goes through puberty. It too is wasted, but there is a different reason. By this time, everyone agrees that the child has CP, but now it is apparently “too late to change”. This is WRONG and NOT supported by neuroscience research. Human brains are capable of change throughout life. The outdated philosophy of some neurorehabilitation specialists and therapists effectively limits the usefulness of the second burst of brain growth and neuroplastic change in puberty. As the brain matures, more function is possible, but re-training is needed.
More research into methods to maximize the peak periods of neuroplasticity in our children’s growing brains needs to be done. Even if you have never signed a petition on Change.Org, please consider adding your name to this one and encourage all your all your friends and family to join as well. If there is money for research, the scientists will come. We all need their help to change the outlook for all children with early neurological disorders.
To offer your support please visit…
Appropriate Dedicated Funding for Cerebral Palsy Prevention, Treatment and Cure Research