Physical trauma, like a fall or a car crash, can cause brain injuries. These are often called traumatic brain injuries. But 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). Brain injuries from causes like these may be called acquired brain injuries.

Our team evaluates and treats children with an acquired brain injury. Treatment plans may be similar to those for children with a traumatic brain injury.

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.   

If your child has arthrogryposis, they may see a team of providers, including a rehabilitation medicine doctor, orthopedic surgeon, geneticist, dietitian, social worker, occupational therapist or physical therapist. This is based on your child’s needs. 

Our team recommends treatment to improve your child’s overall function and the range of motion of their joints. Treatments may include therapy, special equipment, splints, braces and surgery.

A stretch injury to a child’s neck and shoulder can injure the set of nerves that control the muscles of the arm (brachial plexus). This can happen during birth if the baby’s shoulder gets stuck against the parent’s pelvis. In older children and young adults, a brachial plexus injury can happen because of an accident, such as a car crash or sports injury.

We work closely with others from the Brachial Plexus and Peripheral Nerve Program to assess your child’s injury and recommend treatment, such as therapy, splinting and sometimes surgery, to improve your child’s use of their arm.

Cerebral palsy (CP) is caused by an injury to the brain. CP affects your child’s muscle tone. It may be hard for them to move their arms and legs in a coordinated way. CP 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. These may include therapy, special equipment, orthotics, orthopedic surgery, neurosurgery and medicines such as botulinum toxin (Botox) (PDF) and phenol. Seattle Children’s is the only provider in the Pacific Northwest to offer selective dorsal rhizotomy surgery to improve mobility and quality of life for children with CP.

We work closely with Seattle Children’s Cancer and Blood Disorders Center to care for children who have cancer. Brain tumors, spinal cord tumors and some 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 help with equipment needs and your child’s return to school and their community.

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. Some of these diseases affect the heart and lungs. Common neuromuscular diseases that we treat include: 

• Becker muscular dystrophy
• Charcot-Marie-Tooth disease
• Congenital muscular dystrophy
• Congenital myopathy
• Duchenne muscular dystrophy
• Facioscapulohumeral muscular dystrophy
• Limb-girdle muscular dystrophy
• Myotonic muscular dystrophy
• Peripheral neuropathy
• Spinal muscular atrophy

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, medicines and surgery. The team also recommends treatments that help prevent other health problems.

A spinal cord injury can be from a physical trauma, an infection, an immune condition (such as transverse myelitis) 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 arm and leg movement
• Helping your child move around their home and community
• Helping them perform daily activities (such as getting dressed and eating)
• Supporting their bowel and bladder needs
• Decreasing stiff muscles (spasticity)

A stroke happens when the blood supply to part of the brain is cut off 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 1 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 medicines to relax tight (spastic) muscles. We also work closely with stroke specialists from the Pediatric Vascular Neurology Program. Learn more about strokes in children.

A serious head injury can damage a child’s brain. A TBI can cause problems with walking, moving the arms and legs, talking and thinking. A mild TBI may also be called a concussion.

Our team evaluates your child to check how their brain is working. We recommend ways to help them improve their function. We also help plan for their return to school and their community.

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 daily tasks, such as children with cerebral palsy, spina bifida or a missing or short limb.

Based on your child’s needs, they may see a team of providers, including these: 

• Rehabilitation medicine doctor
• Nurse practitioner
• Rehabilitation nurse
• Occupational therapist
• Physical therapist
• Neuropsychologist
• Speech and language pathologist
• Social worker
• Therapeutic recreation specialist
• Educator
• Dietitian

The team may recommend treatments such as therapy, special equipment, splinting, orthotics, medicine and surgery. These treatments may help improve your child’s ability to walk, move and use their hands and arms.

Children with a TBI may be seen at our TBI and Concussion Clinic if they have symptoms from their injury. Often children come to this clinic after their injury was evaluated somewhere else, such as at a trauma center or by the Concussion Program. They come to the TBI and Concussion Clinic because they need more support.

Based on your child’s needs, they may see a team of providers, including these: 

• Rehabilitation medicine doctor
• Nurse practitioner
• Neuropsychologist
• Rehabilitation psychologist

The team evaluates your child and recommends ways to manage problems and help them return to school.

Selective dorsal rhizotomy is a surgery done on the lower spinal cord to permanently reduce tight, stiff muscles (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 2 to 3 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 clinic appointments for therapy at least 3 to 4 times each week. Read more about selective dorsal rhizotomy and other surgical options for cerebral palsy and spasticity.

Baclofen is a medicine that relaxes muscles. It can reduce spasticity throughout your child’s body. A pump filled with baclofen is placed under the skin in your child’s belly. The pump delivers baclofen 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 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 rehabilitation medicine doctor and physical therapist watch 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.

Seattle Children’s surgeons who specialize in bones, muscles and joints provide a full range of orthopedic surgeries to improve children’s function and comfort. For example, based on your child’s needs, we might recommend surgery to release stiff joints (contractures), better align bones and joints or treat scoliosis.

Our Rehabilitation Medicine doctors work closely with our orthopedic surgeons, therapists and other experts, such as in our Arthrogryposis Clinic, Ortho Rehab Clinic, Hand and Upper Extremity Program, Spine Program and Brachial Plexus and Peripheral Nerve Program.

If your child needs orthopedic surgery, your team will plan and provide inpatient or clinic-based rehabilitation to help your child recover.

Children with cerebral palsy who have several stiff joints (contractures) or deformed bones in their hips, knees, ankles or feet might benefit from having surgery to address all of these concerns at once. This approach is called single-event multilevel surgery (SEMLS).

SEMLS requires the advanced skills, teamwork and careful coordination you will find at Seattle Children’s.

Our Orthopedics and Rehabilitation Medicine teams work together closely to develop a detailed SEMLS plan that is right for your child. We map out every aspect of your child’s surgery, as well as the intensive therapy your child will need after surgery, to get the best results. Read more about cerebral palsy treatment and the Ortho Rehab Clinic.