F-Words Paper – The ‘F-words’ in childhood disability: I swear this is how we should think

Rosenbaum-Gorter-F-words-paper-CCHD-2011

Therapy – it should be all about the F Words?!

This is a great article encouraging therapists and parents to think about the future of children with disabilities – in a positive way – right from the start. Addressing function, family, fitness, fun and friends to constantly remind us of what is important in the development of all children.

It made me reflect about my role as a Physio and how successful I am in my aims – which are; to reduce the impact each child’s impairment has on their ability to join in with their friends and family, have fun, be successful at something and be fit and able to face their future. And, to support families and carers so they have the skills and knowledge to bring the best out of the children they are caring for.

Are all my programmes and session plans focused around what the child wants to do? Am I always successful in my goal to make sure my therapy input enriches the lives of children and their families?

I have seen many therapy programmes (some of mine included) with aims like “to maintain length of hamstring muscle”; “to improve posture and balance in sitting” and I am now more than every asking, so what?

Parent’s feedback to me frequently that they feel guilty for not doing therapy with their child more often – not spending more time, out of their quality family time, to do their therapy programme – this can’t be the message we are meaning to send out.

It makes me question where we are going wrong, we should be making the lives of families less stressful, enabling their child and therefore making parents worry less about the future.

Let’s think about the F- words from the article, I think as therapists we can strive to deliver an approach that has these words at the heart of it and as families we can check that we make decisions and advocate for our children with the now and their future in mind.

Function – Children’s lives should be rich with experience. They need opportunities to practice skills, be suitably challenged, make mistakes and learn from them. We need to ensure their environment is suitably adapted, that they have adequate support so that they can be more independent, more involved. We need to promote activity and with that comes function.

Family – Empowering families so they can make informed decisions. I was once asked to help a Mum sort through all the advice and therapy programmes she had been given for her 5 year old child (with Cerebral Palsy) as she couldn’t see how she could follow it all. Well, she had 5 different Physio programmes; 3 feeding programmes, speech advice about using signs, key words and switches, 4 Occupational Therapy programmes; play therapists ideas; school homework and then various different pieces of equipment she had been given over the years with advice about how long to use it for. She didn’t know if the most recently dated therapy programme replaced the others or if she should be doing it all – and to be honest it wasn’t clear to me either (for a few the newer programmes seemed to add things into a home programme but didn’t necessarily replace an older programme). There was nothing in all the information she told me, or that I saw written, that pulled it all together – nothing that linked the therapy aims to her goals for her child!

Fitness – Children need to be able to access recreational opportunities to become and stay physically active, some kids may love doing a strengthening programme with an adult – for a while – but most will want to get stronger so they can… wheel faster in there chair; kick their legs more in the swimming pool; run faster in their walker/ running bike; knock more skittles down…

Fun – What is fun for one child may not be for other so first things first; find out what your child wants to do. Most activities can be adapted to allow all children to pursue their interests. They may not do it the way others do it, or the way we may want them to do it, but if they are participating and having fun then they are achieving!

Friends – Social development is an essential aspect of personhood. In this article Rosenbaum and Gorte ask us to consider, “what can be done to encourage, empower and enhance children’s opportunities to develop and nurture meaningful peer connections”.

Future – “the future is what child ‘development’ is all about” – isn’t it just! We need to choose a therapy approach that is centred on the strengths of each individual child and their family. Think positively about the future and what each child can do; about how we can support them to have Fun, make Friends, and be Fit and Functioning to the best of their ability.

Continue reading “F-Words Paper – The ‘F-words’ in childhood disability: I swear this is how we should think”

Hello and Welcome to my blog

Who am I?

I’m Ellie – Mum of two wonderful boys, married to a childminder, and a Children’s Physiotherapist.

I started working in Paediatrics in 2008 and specialise in the assessment, management and treatment of children and young people -from 0-25 – with developmental delay and complex multiple needs that affects their function.  I have experience working with children with a variety of conditions, and their carers, including children with neurological, orthopaedic and developmental problems.

I have a special interest and knowledge in the provision of early intervention for; preemies (having had both my boys early – at 34 then 30 weeks gestation) and children with Cerebral Palsy.

I am Bobath Trained and adopt a holistic approach to management of children with Cerebral Palsy and other developmental disabilities. I am also trained in Sensory Integration Techniques to combine with NDT therapy. I work very closely with Speech and Language and Occupational Therapists where ever possible, as I strongly believe a great part of my role as a Physiotherapist is to reduce the impact a child’s disability has on their ability to function, participate, communicate and achieve.

I have worked in the NHS for 9 years, until recently, working with the Children’s Therapy Team in Newham. In July last year I left my NHS post (for lots of reasons, but mainly because I love treating children, and that is what I am good at, and I get to do loads more of it working independently). So I am now going it alone – working in East London, supporting children and families, and doing it my way – which I am loving.

However, I believe that really children and families shouldn’t have to pay to be reassured about their child’s development or to support their child with a disability. But I do still have a family to support so can’t work for free, so…

I thought I would write a blog – I can offer advice and answers to some of the questions I most commonly get asked. I can signpost families to guidelines that could support you to fight for what your child needs and offer tips to help negotiate your way through NHS services and treatment approaches that are out their.

I hope my posts are helpful and informative and interesting. If you want to chat to me and ask a specific question please add comments as there will probably be others out there with the same queries. If you want to chat privately my email and phone number are on the contact me page.

Enjoy my blog and please – I’m new to this so be gentle with me whilst i get to grips with blogging. Give your feedback freely so I can make my pages as useful as possible.

One more thing – To other Paeds Physio’s out there – please feel free to comment and agree/disagree with anything I post, I love a healthy debate.

Nearly done… To parents and carers – one of the wonderful things about Paediatric Physiotherapy is that there are nearly as many approaches to treat children as their are variations in children themselves. No child is the same so no one approach will work the same for every child. So there will always be differing opinions  about approaches. The way I look at it is; as long as we are working with families and children; talking about what works and what doesn’t; sharing good practice; and always striving to learn more & improve our skills your children are in safe hands.