Review article

(Re)habilitation guidelines for children with neurodevelopmental disorders

Valentina MATIJEVIĆ ; Odjel za dječju rehabilitaciju, Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, KBC Sestre milosrdnice, Zagreb
Jelena MARUNICA KARŠAJ ; Odjel za dječju rehabilitaciju, Klinika za reumatologiju, fizikalnu medicinu i rehabilitaciju, KBC Sestre milosrdnice, Zagreb

Abstract

The central interest of (re)habilitation guidelines for children with neurodevelopmental disorders is to identify children at neurorisk. Children at neurorisk are not always children with neurodevelopmental disorders. Those children make 10 to 15% of newborns. About 50% of children at neurorisk might develop potential disorder with lasting consequences. (Re)habilitation guidelines for children with neurodevelopmental disorders are based on the following: children’s physiatrist is the head of the (re)habilitation program; he or she performs early screening of newborns with symptoms of neurorisk in the maternity ward; evaluates spontaneous and active movements, provides qualitative analysis of the general movements, does assessment of muscle strength and tone, performs palpation and testing passive mobility, reflexes; performs diagnostics by Vojta principle; evaluates using other diagnostic tests. Only a children’s physiatrist indicates specific kinesiotherapeutic procedure for stimulation; makes a decision on the implementation of ambulatory and stationary treatment; if necessary, a defectologist, speech therapist, psychologist and other specialists are included in the team. Due to the absence of subspecialisation in children’s (re)habilitation, the casuistry of the area should be address by a physiatrist who has experience in this area for at least 5 years or certificate in Bobath concept or Vojta principle course. It is necessary to maintain appropriate nomenclature for certain neuromotoric disorders related to the varying pathology disease and age when it occurs. Neurodevelopmental disorder should be identified at baseline and at each follow-up examination to evaluate whether it is a 1) very mild, 2) mild, 3) moderate or 4) severe disorder, and according to the findings apply adequate stimulation. Therefore, we suggest that the DTS checklist admit two new leading diagnosis: neurodevelopmental disorder and child at neurorisk, which would be the indication for inpatient treatment, and accounted equally as existing dystonia syndrome and paraparesis. The clinical presentation of neurodevelopmental disorders can change slowly or rapidly, because of its dependenence upon maturation, neuroplasticity and applied therapeutic procedures. To sum up, we received a positive answer from HZJZ for the launch of the National register of children at neurorisk, through which children would be monitored in a professional and organized manner, which would not exclude the possibility that its coordinator might be a children’s physiatrist.

Keywords

children’s physiatrist; neurodevelopmental disorder; children at neurorisk; children’s (re)habilitation; register

Hrčak ID:

163313

URI

https://hrcak.srce.hr/163313

Publication date:

14.3.2016.

Article data in other languages: croatian

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