Conditions We Treat
We serve the complex needs of children who are in the hospital and in the outpatient setting. Some of the conditions we treat include:
- Cerebral palsy
Cerebral palsy is caused by an injury to the brain. CP affects your child’s muscle tone. It may make it hard for them to move their arms and legs in a coordinated way. It can lead to other health issues, such as vision, hearing, speech and learning problems. Our team recommends treatment to improve your child’s overall function and general health. Treatments may include therapy, special equipment, orthotics, surgery and medications to relax tight (spastic) muscles. Read more about cerebral palsy and spasticity and selective dorsal rhizotomy.
- Traumatic brain injury and concussion
A serious head injury can damage a child’s brain. A TBI can cause problems with walking, moving arms and legs, talking and thinking. Our team evaluates your child to check how well their brain is working. We recommend ways to help them get back as much function as they can. We also help plan for their return to school and their community. A mild TBI may also be called a concussion.
- Acquired brain injury
Some children have brain injuries that are not from trauma. Infections and problems with the immune system can lead to brain injuries. Examples include meningitis, encephalitis and acute disseminated encephalomyelitis (ADEM). Our team evaluates and treats your child. Our treatment recommendations may be similar to those for children with TBI.
- Spinal cord injury
A spinal cord injury can be from a trauma, an infection or a tumor. The spinal cord controls movement of the arms and legs and the muscles that help with breathing and using the bathroom. The effects depend on what part of the spinal cord is injured. Our team assesses your child, and we recommend ways to treat their condition and improve what they can do. We focus on improving your child’s strength, flexibility and ability to move their arms and legs; helping them perform daily activities (such as getting dressed and eating); managing their bowel and bladder; and decreasing stiff muscles (spasticity).
- Guillian-Barré syndrome
In Guillain-Barré syndrome, the body’s immune system attacks the nerves. This causes muscle weakness and tingling. Weakness may make it hard for your child to move their arms and legs, which may make it hard for them to sit, walk, play or eat. In rare cases, weakness can make it hard for a child to breathe or swallow. Most children recover. Children rarely have lasting weakness. Our team evaluates your child, and we recommend ways to help improve their strength and function. Read more.
- Function problems related to cancer
We work closely with Seattle Children's Cancer and Blood Disorders Center to care for children who have cancer. Brain and spinal cord tumors and some types of cancer treatments can cause problems with walking, doing daily activities (such as dressing), talking and thinking. We focus on helping your child improve their movement, strength, flexibility and communication, and on managing stiff muscles. We also consult on equipment needs and help with your child’s return to school and their community. Read more about cancers, such as brain tumors and spinal tumors.
A stroke occurs when the blood supply to part of the brain is cut off by a clot or when a blood vessel in the brain bursts and causes bleeding in the brain. In both cases, brain cells don’t get the oxygen and nutrients they need to survive. Strokes can cause loss of muscle use on one side of the body (paralysis), as well as problems with speech, memory, learning and thinking. Our team recommends treatment to improve your child’s overall function and general health. Treatments may include therapy, special equipment, orthotics, surgery and medications to relax tight (spastic) muscles. We also work closely with stroke specialists from Neurology. Read more.
- Neuromuscular diseases
Neuromuscular diseases are caused by problems with the muscles or nerves. These diseases cause muscle weakness that may make it hard for children to walk, run and use their hands and arms.
Common neuromuscular diseases that we treat include Duchenne muscular dystrophy, limb-girdle muscular dystrophy, fascioscapular muscular dystrophy, myopathy, spinal muscular atrophy, myotonic dystrophy and peripheral neuropathy. Some neuromuscular diseases are serious and get worse quickly. Some cause fewer problems and may be stable over time or get worse slowly. Some affect the heart and lungs.
Our team recommends treatments to improve your child’s muscle strength and function. The goal is to help your child do things for themselves. Treatments may include therapy, special equipment, orthotics, surgery and medications. The team also recommends treatments that help prevent other health problems. Read more.
Children with arthrogryposis are born with several joints that have limited flexibility (contractures) and muscle weakness. This affects your child’s ability to move. It most often affects shoulders, elbows, wrists, hands, hips, knees and feet. Our team recommends treatment to improve your child’s overall function and the range of motion of their joints. Treatments may include therapy, splints, braces and surgery. Read more.
Lymphedema occurs when thick, protein-rich fluid called lymph builds up because of a problem with the lymph vessels or nodes. This causes swelling, usually in your child’s arm or leg. Children may be born with a condition that can cause lymphedema, such as a problem with how their lymph system formed. Or lymphedema may develop later because part of the lymph system is removed or damaged. It can be treated with complete decongestive therapy. Read more.
Services We Offer: Inpatient Services
Some children have an illness or injury that requires intensive therapy to help them dress, walk, talk, eat or take part in school or their community. If this is true for your child, we may have your child stay at the hospital in our inpatient rehabilitation unit.
- Inpatient rehabilitation
Inpatient care is common for children with conditions such as moderate-to-severe brain injury, spinal cord injury, encephalitis or Guillain-Barré syndrome, or after surgery or other treatment that affects function.
In the hospital, your child is cared for by our team of specialists. We work with other healthcare providers in the hospital to make sure that all of your child’s needs are being met. Our entire focus is on what your child needs to get back to home.
We recommend a treatment plan and review it with you and your child. Your child has therapy each day, typically in the morning and afternoon. Our team works closely with you and your child to adjust your child’s treatment goals as they improve.
Each day, your child’s team comes to the bedside to talk with you about your child’s plan. This is a time to review your child’s progress, discuss medical concerns and get answers to your questions. We also have weekly family meetings with the entire team to review your child’s progress.
Services We Offer: Outpatient Clinics
Rehabilitation Medicine offers several outpatient clinics. In some clinics, your child may see more than one provider during a visit so we can address your child’s different needs.
- Rehabilitation Clinic
In our general clinic, we see children with a range of problems that affect function. Some need follow-up after their inpatient rehabilitation stay, such as children with brain injury, spinal cord injury or stroke. Others were born with a condition that makes it hard for them to do what other children do, such as children with cerebral palsy, spina bifida or a missing or short limb.
During their visits, your child may see a rehabilitation doctor, rehabilitation nurse, occupational or physical therapist, speech and language pathologist, social worker, therapeutic recreation specialist, educator and dietitian. This is based on your child’s needs.
The team may recommend treatments such as therapy, special equipment, splinting, orthotics and surgery. These treatments may help improve your child’s ability to walk, move, and use their hands and arms.
- Traumatic Brain Injury (TBI) Clinic
Children with a TBI may be seen at our TBI Clinic if they have symptoms from their injury. Often children come to our clinic after their injury was evaluated somewhere else, such as at a trauma center or by the Seattle Sports Concussion Program. They come to us because they need more support.
A child who has a TBI may be seen at the clinic if any one of these is true:
- They have been in the hospital for more than 24 hours.
- They have a history of a skull fracture or bleeding in their brain.
- They were injured in some way other than sports.
- They have already had rehabilitation in the hospital for their TBI.
- They are younger than 6 years old.
Your child may see a rehabilitation doctor (physiatrist), neuropsychologist, speech and language pathologist and education specialist. This is based on your child’s needs. The team evaluates your child and recommends ways to manage any problems they are having and help them to return to school.
- Tone Management Program
Spasticity means some muscles are stiff or rigid. Spasticity is caused by an illness or injury to the brain or spinal cord. Spasticity may make it difficult for a child to walk, move their arms or speak. Your child may be seen by a team of providers, including these:
- Rehabilitation doctor
- Neurodevelopmental doctor
- Orthopedic surgeon
- Physical therapist
- Occupational therapist
This is based on your child’s needs. After careful testing, our team recommends a plan of care. We work with you to create a plan that is right for your child.
The team may recommend treatments such as casting, injections of medicines that reduce the spasticity, therapy, orthotics or surgery. Surgery may include orthopedic procedures, an intrathecal baclofen pump or a selective dorsal rhizotomy. These treatments may help improve your child’s ability to walk, move and use their hands and arms. The treatments may also make it easier for you to take care of your child.
- Neuromuscular Clinic
If your child has a neuromuscular disease, they may see a rehabilitation doctor, neurologist, cardiologist, pulmonologist, endocrinologist, nurse, occupational or physical therapist, dietitian and social worker. This is based on your child’s needs. The team recommends ways to improve your child’s overall medical status and function. Treatments may include therapy, special equipment, orthotics, surgery and medications. The Neuromuscular Clinic is supported in part by the Muscular Dystrophy Association.
- Arthrogryposis Clinic
If your child has arthrogryposis, they may see a rehabilitation doctor, orthopedic surgeon, geneticist, dietitian, social worker, educator, therapeutic recreation specialist and occupational or physical therapist. This is based on your child’s needs. The team recommends ways to improve your child’s overall function. Treatments may include therapy, special equipment, splinting, orthotics and surgery.
We partner with our Neurosurgery and Orthopedics programs to offer surgical options to treat muscles that are tight and stiff (spasticity). After careful testing, our team of medical doctors, surgeons and rehabilitation therapists will make recommendations. We will work with you to create a plan of care that is right for your child. Options may include:
- Selective dorsal rhizotomy
Selective dorsal rhizotomy is a surgery done on the lower spinal cord to permanently reduce spasticity in the legs. Certain nerve fibers that lead to spasticity are cut.
The goal is to improve your child’s ability to move and the quality of their movement. After surgery, your child will likely need two to three weeks of inpatient rehabilitation (physical and occupational therapy). The purpose is to increase your child’s strength and muscle control with a special focus on walking.
After going home from the hospital, your child will need outpatient therapy at least three to four times each week. Read more about selective dorsal rhizotomy and other surgical options for
cerebral palsy and spasticity.
- Intrathecal baclofen pump (ITB pump)
Baclofen is a medicine that relaxes muscles. It can reduce spasticity throughout your child’s body. A pump filled with baclofen is placed in your child’s belly. The pump delivers baclofen all the time to the fluid around your child’s spinal cord. The medicine goes directly to your child’s nervous system, so your child doesn’t need as much baclofen this way as they do if they take it by mouth.
Before placing a pump, we inject a test dose of baclofen around your child’s spinal cord to be sure this medicine is right for your child. Then a physical therapist watches for several hours to see how the medicine affects your child’s body. Once we know the medicine is right for your child, we can schedule your child to get a pump. Read more about baclofen pumps and other surgical options for cerebral palsy and spasticity.
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