Compliance with the developmental principle as a problem of selection of approach to the therapy of children with cerebral palsy
Journal Title: Rehabilitacja Medyczna - Year 2005, Vol 9, Issue 4
Abstract
The developmental principle is the most typical and probably a superior principle in improvement of children with cerebral palsy. This principle is described as management according to the physiological sequence of development. However, the developmental principle, considered as a simple teaching of successive “milestones” during the therapy is neither a positive nor a proper solution. Literal and simplified understanding of the developmental principle cannot be valid any longer. It cannot be seen as the necessity to achieve successive “milestone” according to their occurrence during the normal development. The developmental principle should monitor the approach to children’s problems and determine the frame of the procedure on the basis of normal and pathological development. Management complying with the developmental principle should be based on cause and effect analysis of growth deficits and mechanisms of abnormal motor behaviour formation. The understanding and application of this principle changes with the advancement of knowledge. The developmental principle should be used in a flexible manner taking into account not only motor development sequence but also other aspects. During the treatment of cerebral palsied children, there are many situations when a decision must be made by considering other elements rather than those connected with posture-motor aspects, such as nursing care, orthopaedic, psychological, pedagogical, social and logopedic ones. At present, this principle could be described as the necessity to consider in the therapy process mechanisms of acquisition and accumulation of proper sensorimotor experiences by the child, which provide a chance to generate the most proper movment patterns in the central nervous system. The interpretation of the developmental principle has always required that a child should not be pushed to overpass its motor abilities. Such a view is correct but has to be shown in a different light since such management can lead to a “trap”. Taking into consideration different aspects of cerebral palsy children care, it should be thought over, if and how the developmental principle is to be kept and whether it is really indispensable. Emphasizing the complexity of a problem, the author of this study discusses some dilemmas regarding the application of the developmental principle within the aspect of the diagnosis of motor disturbances, nursing care, psychological, pedagogical, logopedic indications, orthopaedic indications and child’s daily living and therapy. The necessity of detecting both present and remote functional needs of children with cerebral palsy has also been highlighted.
Authors and Affiliations
Małgorzata Matyja, Krzysztof Czupryna, Janusz Nowotny
Keywords
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