May is Pediatric Stroke Awareness Month

Did you know that babies have strokes too? In fact, 1 in 2800 infants will have a stroke.

CHASA (Children's Hemiplegia and Stroke Association) has created a 2012 Pediatric Stroke Awareness Montage. This video contains more than 200 children who are pediatric stroke survivors! Please watch and share with others to promote pediatric stroke awareness!



For more information about pediatric stroke, please visit the Children's Hemiplegia and Stroke Association website at www.chasa.org.

Loving the Bumble Ball, Junior!

I have a few kiddos on my caseload right now with hemiplegia that are so good at accommodating and doing things with their less affected hand, that it is a challenge to get them to use both hands!

Blocks are not exciting enough, wind-up toys can be too difficult, but the Bumble Ball, Junior is just right! Holding the ball in one hand and pulling the string with the other provides just the right amount challenge. And they love the vibration of the ball, which motivates them to pull the string over and over again, strengthening the more affected arm!

In my therapy bag...a safety pin

As promised yesterday, here is a simple way to promote the use of the more affected arm in a child with hemiplegia. I simply used a safety pin to hold the unaffected arm close to the body. (Caution! This should only be done under CLOSE supervision, as it WILL affect the child's ability to maintain balance! Also, this should only be done for short periods of time, as it does inhibit the use of the unaffected arm, thereby limiting the child's ability to complete tasks that require the use of both arms.)

With that said, it can be a great way to work on grasping items and playing with toys using the affected arm!

What are your favorite ways to promote the use of the affected arm in children with hemiplegia?

Pediatric Constraint Induced Movement Therapy

What is Pediatric Constraint Induced Movement Therapy?
Pediatric constraint induced movement therapy (also known as CIMT) is a form of therapy that encourages children with hemiplegia to use their affected arm by physically constraining the less affected arm. CIMT is offered by many children's hospitals across the country. These programs are intensive and follow a rigorous protocol.

How does CIMT work?
CIMT programs typically involve casting the child's unaffected arm anywhere from 2 hours per day to 24 hours per day for 4-8 weeks. During that time, the child also receives intensive occupational therapy, sometimes up to 6 hours per day!

What are the benefits?

• Improved use of the child's affected arm
• Improved fine motor skills
• Improved spontaneous use of the child's affected arm
• Improved bilateral coordination (using both arms together)

Is there research to support the use of CIMT?
In general, research on the use of CIMT is limited, but growing. The research that has been conducted generally reports positive outcomes.
A quick literature review of the American Journal of Occupational Therapy revealed the following studies, all of which report positive outcomes:

• Case-Smith, J., DeLuca., S. C., Stevenson, R., & Ramey, S. L. (2012). Multicenter randomized controlled trial of pediatric constraint-induced movement therapy: 6-month follow-up. American Journal of Occupational Therapy, 66, 15–23.
• Cope, S. M., Forst, H. C., Bibis, D., & Liu, X.-C. (2008). Modified constraint-induced movement therapy for a 12-month-old child with hemiplegia: A case report. American Journal of Occupational Therapy, 62, 430–437.
• Dickerson, A. E., & Brown, L. E. (2007). Pediatric constraint-induced movement therapy in a young child with minimal active arm movement. American Journal of Occupational Therapy, 61, 563–573.
• Martin, A., Burtner, P. A., Poole, J., & Phillips, J. (2008). Case report: ICF-level changes in a preschooler after constraint induced movement therapy. American Journal of Occupational Therapy, 62, 282–288.

In addition, The CanChild Centre for Childhood Disability Research has written An Update on Constraint Therapy in Children with Hemiplegia. The research in this article is a little outdated, as it has not been updated since 2006. However, it does give a good overview of CIMT, as well as a review of the research completed prior to 2006.

Where can I learn more?
The update written by the CanChild Centre referred to above, provides an excellent overview of CIMT, as well as a review of the research.

Parents, if you think your child could benefit from constraint induced movement therapy, ask your pediatrician, your child's physical or occupational therapist, or check with your local children's hospital to see if they offer a program.

Therapists, Cincinnati Children's Hospital has created an Evidence-Based Care Guideline for Pediatric Constraint Induced Movement Therapy. To download the guidelines, visit their website by clicking here. Scroll to the bottom of the page and click on Constraint-Induced Movement Therapy under the Occupational Therapy and Physical Therapy section.


Check back tomorrow to learn about technique that I use to promote the use of a child's affected arm.

Friday Features

~New blog alert! Check out A Stroke of OT to follow Bea, an occupational therapist, on her journey of raising her son, who had a stroke on the day of his birth. 

~Next Monday, January 23, 2012 is National Handwriting Day. Check out the Handwriting Without Tears website for ideas on how to incorporate National Handwriting Day into your classroom. In addition, Handwriting Without Tears is hosting a contest to win a free license to their interactive Digital Teaching Tools. What are you doing to celebrate National Handwriting Day?

~February 25, 2012 will be OT Global Day of Service. This is a day for occupational therapy practitioners and students to participate in volunteer activities. For more information and ideas on how you can participate, check out the Promoting Occupational Therapy website. Slack Incorporated will be making a donation to UNICEF. This donation is tied to participation, so be sure to register your day of service.

~Thank you to Lindsey Biel, OTR (from Raising a Sensory Smart Child) for bringing this amazing young woman to my attention. Anastasia Somoza is a 27 year from New York, who just happens to have cerebral palsy. She received a scholarship to pursue a masters degree in human rights at the London School of Economics. Due to her cerebral palsy, she is not able to live alone and needs funding for an aide to assist her in London while she pursues her studies. To learn more or to donate to her cause, click here. 

~The National Fragile X Foundation unveiled their new website this week. This is a great resource for families and anyone who works with someone with Fragile X. Be sure to check it out!