Occupational Therapy

• Cerebral Palsy
• Cerebral Palsy Treatments
• Occupational Therapy

Occupational Therapy For Birth Injured Children

Occupational therapy for children that are diagnosed with cerebral palsy or other birth injuries is aimed at promoting rehabilitation and quality of life improvements by focusing on daily life activities with support from trained occupational therapists (OTs) and therapy assistants.

The American Occupational Therapy Association (AOTA) defines occupational therapy (OT) as a form of therapy for children to learn how to improve their abilities to perform all the daily activities they wish to do or have to do with as much independence as possible.

The ability to receive OT is one of the goals of the birth injury lawyers at Miller Weisbrod Olesky. We fight to recover the compensation that will pay for the highest levels of therapy including occupational therapy throughout the life of your children. Our experience over the last 35 plus years of representing birth injured children as proven that continued therapy throughout childhood and into adulthood provides the best chance of our young clients to reach the highest possible level of independent living.

At Miller Weisbrod Olesky, We Help You and Your Child Find Help NOW!

Staffed with a team of nurses and nurse attorneys, we begin the therapy process as soon as possible even if your child’s lawsuit has not been settled. Learn about our Miller Weisbrod Olesky nurses and our liaison program that ensures your child gets help NOW so they can begin the process of maximizing their occupational therapy results.

A child’s activities, such as self-care, work/school skills, and play are referred to as activities of daily living (ADLs). An occupational therapist carries out a comprehensive evaluation to identify issues that interfere with your child’s ability to perform these skills or tasks. The issues, which commonly occur with cerebral palsy and other birth injuries, include weak muscle tone, poor eye-hand coordination, inadequate sensory processing, and lack of visual perceptual skills.

Based on their professional evaluation, the pediatric occupational therapist will recommend an occupational therapy plan to enable your child to participate as independently and actively as possible in all types of ADLs. The occupational therapy is child-directed and may also involve the use of assistive or adaptive equipment to increase the child’s independence. The earlier an occupational therapy program starts, the more effective may be its lifelong results for a child with cerebral palsy.

Occupational Therapy Works for All Types of Cerebral Palsy Symptoms

Children with cerebral palsy often experience difficulties in performing or completing daily routine tasks benefit from occupational therapy. Some of the common symptoms where occupational therapy can be useful for children with CP include:

Ataxic Cerebral Palsy (Caused by damage to the cerebellum, which is a part of the brain that controls balance)

• Lack of balance and coordination
• Shakes and tremors
• Difficulty with movements involving precision

Spastic Cerebral Palsy (Caused by damage to the motor cortex of the brain, which controls movement)

• Tight and stiff muscles (hypertonia)
• Jerky or exaggerated movements
• Abnormal gait

Dyskinetic Cerebral Palsy (Caused by damage to the basal ganglia of the brain, which sends messages for coordination)

• Poor movement control
• Abnormal posture
• Difficulty grasping, eating, and speaking

Mixed Cerebral Palsy (Caused by a combination of damage to different motor control centers of the brain)

• Abnormal reflexes
• Poor posture
• Problems with coordination
• Shakiness or tremors
• Jerky or exaggerated movements

How does Occupational Therapy Help a Child with Cerebral Palsy?

Motor Impairment
Children with CP are affected by motor impairments in different ways, which can make it difficult for them to complete daily tasks. For instance, the child may have difficulty maintaining posture, moving around, practicing daily hygiene, and completing school work or other physical tasks because of limitations in movement.

A qualified OT can assess a child’s unique needs and create a tailored occupational therapy plan to achieve best results. Activities and exercises may vary for each child with CP, but will usually include motor learning strategies (MLS) and neuromuscular facilitation techniques to develop bilateral coordination, grip and pinch strength, arch development, separation of the sides of the hand, and finger isolation.

Cognitive Impairment
Children with CP who have cognitive impairment can benefit from occupational therapy. Setting up of daily routines with reminders can help children with this condition remember to perform daily chores, such as brushing their teeth, dressing up and completing school tasks.

The goal of the OT in these cases is to help the child perform multiple cognitive exercises so that they learn and relearn everyday skills and any potential cognitive decline is arrested. Occupational therapy can also help improve the child’s memory when targeted cognitive games and activities (example: crossword puzzles) are included in the therapy program.

Visual/Perceptual Impairment
Children with cerebral palsy may experience mild or severe visual impairment. Occupational therapy can be helpful even when the impairment is severe. The occupational therapist may make use of specific visual input cues and tools as well as verbal directions to train the child about the safe performance of essential daily activities.

Sensory Perceptual Motor (SPM) training is used to help the child’s sensory or perceptual skills connect with their motor skills. In other words, it helps the brain connect with the body so that the child can confidently and safely interact with their environment. This type of occupational therapy may include teaching the child time-related movements (moving slow vs. fast), directional movements (moving back, forward, or sideways), and spatial awareness (knowing where your body is in space in relation to other people or objects).

Types of Routine Tasks Where Occupational Therapy can Help

Occupational therapy strategies should change according to the child’s age to reflect their growing needs. For instance, a baby may play with stimulating toys to improve motor skills and cognition, while a teenager with cerebral palsy may need to learn skills to perform their school work or other advanced tasks, such as using a computer or smartphone.

Routine Tasks at Home

• Brushing teeth
• Bathing
• Personal grooming
• Dressing
• Eating
• Grasping objects
• Playing
• Writing
• Using a phone or computer
• Cooking
• Interacting with parents or caregiver
• Using assistive or adaptive devices

Routine Tasks at School

• Traveling on the school bus
• Opening doors
• Sitting at a desk or chair
• Using the bathroom
• Avoiding or resolving physical obstacles
• Holding and reading books
• Handwriting and stationery use
• Opening and closing the locker
• Interacting with teachers and peers
• Participating in extra-curricular activities and sports
• Completing homework and assignments

Routine Tasks in the Community

• Using public transportation
• Navigating public spaces
• Interacting with service personnel
• Interpersonal skills
• Shopping
• Using community-based resources

Occupational therapy not only benefits the child, but it may also have indirect benefits for the parents and family. With successful therapy, parents and other family members can achieve a great sense of satisfaction and mental peace as they witness their child improve physically, psychologically, and emotionally, and become more independent.

Skills and Training of an Occupational Therapist

Occupational therapists along with their assistants perform occupational therapy in a public or private setting. An OT generally holds a master’s degree and a state license to practice. Most states require OTs to be a graduate from an accredited school, who has completed a minimum number of fieldwork hours, and passed the National Board for Certification Examination in Occupational Therapy.

Children with cerebral palsy who require occupational therapy are generally referred to a pediatric OT by their family doctor or cerebral palsy resource center/support group. The assistant to the OT would usually have completed a two-year associate degree program. Some states also require OT assistants to obtain a license for which they must complete relevant school and fieldwork. Many children with Cerebral Palsy benefit from having occupational therapy assistants who are trained to help them succeed.

Occupational therapy can be performed in various settings, such as inpatient medical centers, outpatient offices, specialized occupational therapy centers, nursing center, and in the home with a certified OT. Pediatric OTs usually have a dedicated expertise in assessing the child’s strengths and weaknesses in order to develop a tailored occupational therapy plan to help the child achieve their goals as best as possible.

Occupational Therapy Techniques
for Children with Cerebral Palsy

An occupational therapy treatment plan for a child with cerebral palsy must be highly individualized to match with their unique physical, mental, emotional, and social abilities. Before the therapy sessions begin, the OT will perform a comprehensive evaluation. This may include assessing the child’s perceptual, fine motor and oral motor skills, and noting how the child responds to movement and touch.

The OT will also interview the parents or caregivers to learn about the child’s general strengths and weaknesses related to the performance of everyday tasks. Based on this detailed assessment, the OT will create a targeted approach to therapy as well as identify specific goals for the child to work toward. Children with cerebral palsy will usually require periodic reevaluations every six months to ensure that their occupational therapy plan can be calibrated according to their age, progress, and condition.

Occupational Therapy Exercises
for Children with Cerebral Palsy

Exercises used in occupational therapy for children with CP are designed to focus on the following skill sets:

Clasping Hands

Touch the Pointer Finger

Control Fingers Individually

Pick-Up by Pinching

Holding Crayons

Opening

Hair Brushing

Buttoning

Zipping

Fine Motor Control: It involves working on the child’s hand muscle strength, in-hand manipulations, finger isolations, arching the palm, pincer grasp and thumb opposition to increase hand dexterity. OT activities may include pushing coins into a piggy bank slot, playing with water squirt toys, and squeezing a clothespin.

Upper Body Stability: It involves stabilizing and strengthening the core (trunk), wrist, and shoulder muscles through simple OT exercises and activities. Examples include crawling on the floor, pouring water from a kettle into a cup, playing catch while in a kneeling position, and lying on the stomach while reading a book.

Bilateral Coordination: It involves training the child to control and utilize both sides of their body at the same time. Occupational therapy activities to enhance bilateral coordination may including pulling apart toy building blocks (such as Lego), pushing a rolling pin, and drumming.

Cross the Midline: It involves teaching the child to reach across the middle portion of their body with their legs and arms to the opposite side. OT activities such as throwing balls at a target to the left or right of center and making figures (such as eight) with streamers may be helpful.

Visual Motor & Perceptual Skills: Activities such as throwing and catching a ball, stringing beads, and drawing or sketching can help improve visual motor skills and hand-eye coordination. To improve perceptual skills (the ability to assess and interpret what is visible), OT activities such as matching games, playing with diverse shapes, and alphabet puzzles can help.

Adaptive & Assistive Devices

Adaptive and assistive equipment and technology continue to evolve with advanced innovations that support occupational therapy for children with cerebral palsy. Some examples of the adaptive devices and equipment that are used in occupational therapy include:

• Walkers, canes, and braces
• Specialized sports equipment
• Devices to navigate transfer from original position
• Specialized utensils for eating
• Bath chairs and toilet aids
• Toys and games that help with motor and cognitive skills
• Adaptive carpentry to meet specific needs
• Specialized school chairs and tables
• Desks that rotate
• Household equipment and aids, such as adaptive scissors
• Adaptive clothing (reachers, button hooks, zipper pulls)
• Pencil grips
• Writing & typing tools
• Communication boards
• Electronic Braille systems
• Tablets
• Accessibility-focused software and apps
• Voice-to-text technology
• Computerized systems for environment control

Sensory Integration Therapy

When a baby suffers from a birth injury to their brain, such as hypoxic-ischemic encephalopathy (HIE), resulting in cerebral palsy, it may alter the brain’s ability to process sensory perceptions. Sensory integration therapy can be helpful in rebuilding the physical and mental framework within the child’s nervous system.

This type of OT can improve a child’s ability to accurately perceive sensory inputs, comprehend the purpose behind a specific sound, movement, texture, or another stimulus, and appropriately regulate their responses. Sensory integration therapy may not only offer physical but also psychological benefits to the child.

For example, as part of the sensory integration occupational therapy, the therapist may ask the child to pick up a ball or another object. Although the child may be able to identify the ball and comprehend what it is used for, they may not be able to describe the ball because of sensory miscues. A child with cerebral palsy may have impairments in the ability to perceive the texture and weight of the ball because of excessively high or low sensitivity to touch.

Occupational therapists may use finger paints, sand, silly putty, colorful liquids, and Play-Doh, among other similar tools to perform sensory therapy to improvement on these “touch” “description” impairments. This occupational therapy should be used early during the child’s development because treating sensory deficits early will give the child the advantage of learning to adjust and compensate for their condition while the senses are still developing.

Constraint Induced Movement Therapy (CIMT)

Children with hemiplegic cerebral palsy (spasticity in one side of the body) will usually start compensating early for motor impairments by using only the active arm on the functioning side of the body. If no intervention is made, the less frequent use of the affected arm will gradually render it completely non-functional. A specialized form of occupational therapy called constraint-induced movement therapy or CIMT can help in countering this condition.

CIMT involves two primary components:

• A. The occupational therapist will restrain the unaffected arm using a sling, cast, splint, mitt, or glove. This will encourage the child to use the affected arm because it’s the only one available for use.
• B. The affected arm becomes the focus of intensive occupational therapy so that the child learns how to move and utilize it correctly.

CIMT not only promotes the physical function of the affected arm, it also helps stimulate the brain to reinforce neural pathways for associated movement. CIMT may sometimes be modified according to the child’s needs. But its primary role is to encourage the use of the affected arm for most part of the day with specialized activities under the supervision of the occupational therapist to achieve the most effective outcomes.

Research shows that CIMT for babies in the age group of three months and above is also an effective and feasible treatment when it consists of professional caregiver coaching, age-appropriate activities, and therapy performed in the child’s typical environment. Parents can also support different forms of occupational therapy by helping their child practice new skills at home according to the OT’s recommendations.

Is Your Child’s Cerebral Palsy or other Birth Injury Related Complication the Result of Medical Malpractice?

Parents whose children suffer from cerebral palsy or other birth injury related complications should receive answers as to how their child suffered this injury and whether the consequences resulting from it were preventable.

• Were there signs during the pregnancy, labor, and delivery process that birth related complications were occurring, but accurate diagnosis, correct treatment, or an emergency c-section was either delayed or not performed at all leading to a birth injury?
• Were signs of fetal distress not recognized and responded to in a timely manner?
• Did the neonatal resuscitation team not act quickly and appropriate to treat your child following a difficult birth?
• Should cooling (also called “hypothermia therapy”) have been offered to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our dedicated birth injury attorneys can help you find out if any of these things occurred during or after the birth of your baby. With an experienced birth injury lawyer from Miller Weisbrod Olesky you can recovery medical malpractice settlement that will help provide specialized medical therapy and assistive devices that can help maximize the independence of your child throughout their life. A birth injury settlement will substantially increase the quality of life and care for your child.

If your child has been diagnosed with a birth injury (including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy), and you believe this may have been caused in part by mistakes of the doctors, nurses or hospital employees, Miller Weisbrod Olesky will thoroughly investigate the circumstances of your case and hold responsible the at fault medical providers by prosecuting a medical malpractice lawsuit against them. The recoveries our clients receive helps them pay for their child’s current and future occupational therapy, and specialized treatment to help their child cope while living with a permanent disability, and to be able to pay for cutting-edge devices that increase a child’s quality of life.

Sometimes families are reluctant to contact a medical malpractice attorney. It’s also not uncommon for parents to feel overwhelmed by the responsibilities they encounter in caring for their injured child and worried that they will not be able to help out in a lawsuit involving their child’s birth injury. Let us take these worries and concerns away.

Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team…and Yours

Most national birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.

Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.

Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injuries leading to a delay or failure in developmental milestones including birth injuries that cause cerebral palsy. It’s not uncommon that a premature birth related complication can be a preventable birth injury, but it takes a detailed expert review by a birth injury lawyer of the facts and circumstances of your child’s birth to determine the birth injury was the result of medical malpractice.

At Miller Weisbrod Olesky, a team of committed lawyers, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.

If we feel medical negligence caused or contributed to your child’s injuries, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. Our birth injury attorneys have recovered millions of dollars in settlements for families of babies that have suffered a birth injury.

At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.

Contact Our National Birth Injury Lawyers