Therapy for Spastic Blind Child?

Hi, I am treating a spastic Double hemiplegic child with birth history of prematurity (7 months) who also has associated congenital blindness (probably due to retinopathy of prematurity). Presently the child is 1yr 2 mths old, though still does not right the head when held in upright position. She occasionally lifts head when in prone on forearm while reaching up with one hand but does not sustain it.

I had been trying to use NDT .... but am STUCK UP :( .... as don't understand how to encourage/ motivate the child to right her head without important visual feedback. As the parents of the child are very desperate .... I implore you to please help me with any suggestions. Thanking u in anticipation.

because he is not use his eye so you cannot motivate him to look up for a toy< insted you can use other toys that has a sound and you try to move the sounded toy up, so the child will try to move head up to follow the sound
(Always use toys according to the child limitation and child prepheras)
Hessa

Quote:

---

Originally Posted by Hessa

because he is not use his eye so you cannot motivate him to look up for a toy< insted you can use other toys that has a sound and you try to move the sounded toy up, so the child will try to move head up to follow the sound
(Always use toys according to the child limitation and child prepheras)
Hessa

---

Hi Hessa,
Thanks a lot for the reply . I agree and have put it to practice.
the problem now I face is that.... the child lifts her head only when there is some sound to reach for overhead . I mean she does not hold it when the stilmulus is removed... leaving her head to drop again. could u give some suggestion which help her to understand how to right her head with trunk in upright positions and sustain is in absence of stimulus (like sound). I would also like to add that the child has predominent extensor tone .

Don't let your child see that you can't handle the situation because of his blindness thus be more active in activities with your child to cheer up. I know it is a year so to this thread but I've been touch with your love, care and understanding with your child. The children therapist could give your child assistance towards the acceptance and to have a meaningful life ahead.

hi dmpedneuro as u want sustains of head try some object that child likes to suck as it may be some babyfood than put child in prone and stroke arnd lips she will move head up to catch up also maintains head in effort to catch object.give it in mouth for movt. than again remove it.this is from my personal experience.hope it helps u to get head control...

Along with toys with sound, tactile stimulation can be added by making the child to touch different textures, shapes, toys with sound or stuffed toys. Toys making sounds with touch e.g piano, recorders can be used to encourage child to use his hands in different directions. Supine on wedge, to catch or touch the toy in midline, would facilitate the child to pull his head and upper trunk off the wedge and to improve head and neck control. This position would help children with extensor tone where prone position could make adverse effect. Standing in standing frame to start with the session would help to get arousal and effect of approximation/ compression to improve tone in case where child is less motivated and low tone. Blind child may not have good body awareness, massage may be helpful to improve that and thus improving the function of parts of body. Make the child to touch your face during speech time while child is facing you sitting in a lap. These children could also get benefit with different vestibular stimulation e.g prone on ball, hammock, tilting boards, or tilting them in different directions on towel to improve head and neck and trunk control.

I think you will find Lily Nielsen's ideas on working with blind chidlren very helpful.

If you google "lilyworks" you will find more information on the active learning approach she has developed. She creates stable and accessibel environemtns that make it possible for a child to interact with the environment in a meaningful way - and once the child gets the idea that they can actually influence what happens around them they motivate themselves.

Her ideas fit in very well with task based physiotherapy approaches to intervention. I think it is important to understand that no amount of passive sensory stimulation will get a child to actively exert itself - only intention and the desire to achieve something does that. So active learning is the only way to go.

Pam