Combination therapy
(C-therapy)
As there is no single system of treatment available for the developmental disabilities, so there is a state of confusion in the mind of parents about all the available treatment systems. At the same time, there is a long list of therapies available for children with developmental disabilities. Every single therapy has its own varieties. These varieties are considered as different approaches. Somebody says occupational therapy is better than physiotherapy or sensory integration is better than neurodevelopmental therapy. But there is no scientific data available for the comparison. A few organizations have tried to establish the difference among all these approaches but it is halfway done. As there is no standard or specific protocol available for a disorder. A child can be helped by different approach at the same time. Most of the developmental disabilities come under the heading of multiple disabilities. As for example a child with cerebral palsy can have mental retardation or a child with mental retardation can have speech problem. So the child will require not only special education but there will be need of speech therapy, physiotherapy, occupational therapy and others. When two or more modalities are used for a specific child at the same time, the treatment protocol is called combination therapy(C-therapy).
Theoretical grounds
Theoretical grounds for the different approaches depend on an understanding of brain function. This is highly controversial and cannot yet form a basis for the selection of the best treatment system. Every professional wishes to understand 'why we do what we do" and unfortunately may accept a system because it offers a ready explanation. However, there is no all-encompassing theory that fully explains all the abnormal behavior presented by the children or the effects of various treatment procedures. Every system offers unproven neurophysiological and psychological hypotheses as well as references to physiological experiments. Neuropsychology has rarely been used as a basis of treatment. Although the professional should continue to ask himself/ herself why he/she is using a particular method, this enquiry should be focused on the observation of the behavior of a developmental disable child and any changes in behavior after treatment procedures. The reason for using a technique or modality should not rest on theoretical hypotheses of brain function at this stage of our knowledge. We need to learn a lot.
This has shown that choice of methods for an individual child depends on age, sex, personality, level of motor development, developmental level of understanding, speech, vision, hearing and perception influence selection of the modality.
As it is difficult to confine oneself to any particular system and each has made valuable contributions, a combination therapy is recommended. In using the combination therapy, it has been necessary to try to understand the rationale underlying the modalities in various system of treatment.
Different treatment approaches for the children with cerebral palsy
There is numerous system of treatment available for children with cerebral palsy and allied disorders.
All these treatment approaches have some or the other benefits to a child with developmental disabilities. It is very difficult to single out any of the treatment modality. Combination therapy uses all these therapies according to the need of a specific child. It is always kept in mind that a treatment approach should fit into the specific treatment programme of a child rather a child should be fitted in a treatment approach. Every modality has a specific inclusion and exclusion criteria so one need to follow the regimen religiously. A large number of combinations can be made according to the need of the child. As for example:
Postural developmental therapy is an essential therapy approach for the children with cerebral palsy and allied developmental disabilities. Different postures are developed in combination to get dynamicity and dissociation. The specific treatment approach is called Neuro-enhancing treatment (NET) approach/ programme.
Institute of child development specializes in the management / treatment and training of children with developmental disabilities with a unique treatment approach/ programme called Neuro-enhancing treatment (NET) approach/ programme. It is safe, effective way to organize a child's neural pathways helping to facilitate milestones development. A child at any stage makes up any skipped or poorly developed milestone. The treatment programme is based on the latest knowledge of neurophysiology, bioenergetics principle of natural health.
NET approach / programme makes a parent learn to carry out therapy with professionals support and continues contact but parents are the in charge. Parents learn what their child's problems are, how they are affecting his / her nervous system and what to expect on the pathways back to health. This programme is carried out six days a week for 4-6 hours a day depending on the severity of each child. Duration of the programme depends upon the responses of the child. Generally it is less than three years at any stage / age the child starts. At any stage the child can be made independent in life but it is essential to have an average intelligence in the child.
There is no magic about the treatment system and the result which is generally achieved due to accurate assessment and dedicated implementation of the programme. As the organization has been using combination therapy so there is no dogmatism about the concept. This approach feels strongly that a professional is not the only person with the skills. It makes the parents from passive bystanders into active participants in the treatment / management of their child. Every family member / caretaker / friend / relative has a specific role to play in the whole treatment. This programme makes a child independent in life with good communication skills and an independent form of mobility in the community. The golden rule "make a child independent in life rather making him walk only" is followed consistently.
(C-therapy)
As there is no single system of treatment available for the developmental disabilities, so there is a state of confusion in the mind of parents about all the available treatment systems. At the same time, there is a long list of therapies available for children with developmental disabilities. Every single therapy has its own varieties. These varieties are considered as different approaches. Somebody says occupational therapy is better than physiotherapy or sensory integration is better than neurodevelopmental therapy. But there is no scientific data available for the comparison. A few organizations have tried to establish the difference among all these approaches but it is halfway done. As there is no standard or specific protocol available for a disorder. A child can be helped by different approach at the same time. Most of the developmental disabilities come under the heading of multiple disabilities. As for example a child with cerebral palsy can have mental retardation or a child with mental retardation can have speech problem. So the child will require not only special education but there will be need of speech therapy, physiotherapy, occupational therapy and others. When two or more modalities are used for a specific child at the same time, the treatment protocol is called combination therapy(C-therapy).
Theoretical grounds
Theoretical grounds for the different approaches depend on an understanding of brain function. This is highly controversial and cannot yet form a basis for the selection of the best treatment system. Every professional wishes to understand 'why we do what we do" and unfortunately may accept a system because it offers a ready explanation. However, there is no all-encompassing theory that fully explains all the abnormal behavior presented by the children or the effects of various treatment procedures. Every system offers unproven neurophysiological and psychological hypotheses as well as references to physiological experiments. Neuropsychology has rarely been used as a basis of treatment. Although the professional should continue to ask himself/ herself why he/she is using a particular method, this enquiry should be focused on the observation of the behavior of a developmental disable child and any changes in behavior after treatment procedures. The reason for using a technique or modality should not rest on theoretical hypotheses of brain function at this stage of our knowledge. We need to learn a lot.
This has shown that choice of methods for an individual child depends on age, sex, personality, level of motor development, developmental level of understanding, speech, vision, hearing and perception influence selection of the modality.
As it is difficult to confine oneself to any particular system and each has made valuable contributions, a combination therapy is recommended. In using the combination therapy, it has been necessary to try to understand the rationale underlying the modalities in various system of treatment.
Different treatment approaches for the children with cerebral palsy
There is numerous system of treatment available for children with cerebral palsy and allied disorders.
- Neurodevelopmental treatment( Karl Bobath and Berta Bobath)
- Muscle education and braces(W.M. Phelps)
- Progressive pattern movements(Temple Fay)
- Synergistic movement patterns(Signe Brunstrom)
- Proprioceptive neuromuscular facilitations(Herman Kabat)
- Neuromotor development(Eirene Collis)
- Sensory stimulation(Margaret Rood)
- Vojta method (Vaclav Vojta)
- Conductive education(Andres Peto)
- Usage of postural / mobility aids
- Drugs therapy
- Nerve block therapy
- Botox therapy
- Orthopedic surgeries
- Neurosurgery / Rhizotomy
- Intrathecal Baclofen therapy
- Hydrotherapy
- Hippo therapy
- Hyperbaric oxygen therapy
- Stem cell therapy and so on
All these treatment approaches have some or the other benefits to a child with developmental disabilities. It is very difficult to single out any of the treatment modality. Combination therapy uses all these therapies according to the need of a specific child. It is always kept in mind that a treatment approach should fit into the specific treatment programme of a child rather a child should be fitted in a treatment approach. Every modality has a specific inclusion and exclusion criteria so one need to follow the regimen religiously. A large number of combinations can be made according to the need of the child. As for example:
- Use of sensory integration with NDT approach b.
- Use of Phenol nerve block with Botox therapy c.
- Use of Botox with orthopedic surgery d.
- Use of antispastic oral drugs with physiotherapy e.
- Use of Vojta approach with Neuromotor training and so on.
Postural developmental therapy is an essential therapy approach for the children with cerebral palsy and allied developmental disabilities. Different postures are developed in combination to get dynamicity and dissociation. The specific treatment approach is called Neuro-enhancing treatment (NET) approach/ programme.
Institute of child development specializes in the management / treatment and training of children with developmental disabilities with a unique treatment approach/ programme called Neuro-enhancing treatment (NET) approach/ programme. It is safe, effective way to organize a child's neural pathways helping to facilitate milestones development. A child at any stage makes up any skipped or poorly developed milestone. The treatment programme is based on the latest knowledge of neurophysiology, bioenergetics principle of natural health.
NET approach / programme makes a parent learn to carry out therapy with professionals support and continues contact but parents are the in charge. Parents learn what their child's problems are, how they are affecting his / her nervous system and what to expect on the pathways back to health. This programme is carried out six days a week for 4-6 hours a day depending on the severity of each child. Duration of the programme depends upon the responses of the child. Generally it is less than three years at any stage / age the child starts. At any stage the child can be made independent in life but it is essential to have an average intelligence in the child.
There is no magic about the treatment system and the result which is generally achieved due to accurate assessment and dedicated implementation of the programme. As the organization has been using combination therapy so there is no dogmatism about the concept. This approach feels strongly that a professional is not the only person with the skills. It makes the parents from passive bystanders into active participants in the treatment / management of their child. Every family member / caretaker / friend / relative has a specific role to play in the whole treatment. This programme makes a child independent in life with good communication skills and an independent form of mobility in the community. The golden rule "make a child independent in life rather making him walk only" is followed consistently.
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