The first stages of life are fundamental for the development of the main motor, cognitive, linguistic, perceptual, emotional and social functions of the adult. Infantile neurological disorders are a transcendental fact for both affected children and their families. That is why children’s rehabilitation has undergone an important development in recent decades. It could be defined as “developmental rehabilitation”, which aims to reduce functional disabilities and enable children to live as autonomous an adult life as possible.
Areas of children’s rehabilitation
The effectiveness of neurorehabilitation in the infant stage depends on its early start in the period in which the nervous system is in the maturation phase, a critical period in which there is maximum vulnerability and at the same time maximum sensitivity to stimuli for learning.
Infant rehabilitation is not about punctual or isolated interventions, but a process that follows the child with a disability from birth to the beginning of adulthood, preventing, diagnosing and treating the deficits and complications that may appear in each specific stage of development with the aim of minimizing future disability.
The rehabilitation needs of children with neurological disabilities are not always the same due to the great variety of deficits and level of impairment that we can find, so different models of care should be available depending on the impairment, age, evolution, level of activity and social circumstances of the child, and should not be restricted to a single area but should cover the different areas in which the child develops. In addition to the hospital setting, child rehabilitation should cover other areas such as the school and family environment.
The hospital setting in child neurorehabilitation should offer a follow-up where the evolution of each case is monitored, prevention and diagnosis of complications is carried out and specific treatments are indicated. The children’s rehabilitation team must be multidisciplinary and work in an interdisciplinary manner to achieve a global approach.
Neurorehabilitative treatments implemented in the hospital setting will be specific treatments always with specific functional objectives such as, for example: balance and gait re-education programs with the use of the latest technologies for gait analysis and the use of electro-mechanical systems for gait re-education, assessment and global treatment of spasticity, including systemic and local pharmacological treatment through infiltrations with botulinum toxin, physiotherapy and occupational therapy, assessment of orthotics and surgical treatment; reeducation programs for activities of daily living and specialized neuropsychological treatment to enhance the cognitive, emotional and behavioral functions affected; group and sports activities to promote adaptation to the disability, integration and participation in school activities, sports and social activities.
As for the school environment, all children with motor impairments between the ages of 6 and 18 must be enrolled in regular schools with curricular adaptations and support teachers, according to the specific needs of each child, and with physiotherapy and speech therapy support. Children with multiple disabilities and severe cognitive impairment will be enrolled in special education centers where they will receive physiotherapy, occupational therapy, speech therapy and nursing care, if necessary.
The approach to disability in the infant stage is of utmost importance, as it involves permanent but changing deficits throughout the child’s development, so it must be continuously monitored at all stages with proper use and coordination of resources in different areas. This optimization of resources is achieved by monitoring the child in specialized child rehabilitation units that serve as a connection between the different areas, ensuring a multidisciplinary monitoring that covers all the needs of the child and his family and promotes the greatest possible integration and participation in the community despite the existing neurological deficits.