The child or adolescent and family members
The child or adolescent patient and his or her family are the most important members of the rehabilitation team. The rehabilitation program strives to create an environment in which collaborative, empowering relationships between children, families and health care providers thrive, and thus meet the needs of the child and family.
Physiatrists (Physical Medicine and Rehabilitation physicians) are medical doctors who focus on function and quality of life. Physiatrists complete medical school and at least four additional years of residency training in this specialty. Pediatric physiatrists have additional training and demonstrated competency (subspecialty board certification) in caring for children and adolescents with musculoskeletal, neurologic and developmental problems. A pediatric physiatrist may perform a medical evaluation and order any supporting diagnostic tests, develop a treatment plan, provide any necessary prescriptions for medications or equipment, and coordinate a multispecialty team.
Rehabilitation psychologists are trained in the psychology of adjustment to disability. They have a Ph.D. and are board certified by the American Board of Professional Psychology. Rehabilitation psychologists assess how a child or adolescent patient and family are coping with the demands of rehabilitation. They help patients adjust to his or her disability and plan for the future. Frequent areas of interventional assistance include stress management, coping with loss, behavior programs and vocational/school planning. In addition, neuropsychologists may perform formal evaluations (neuropsychological testing) and provide recommendations related to learning, thinking and return to school.
The focus of pediatric rehabilitation nursing is to improve quality of life as well as to assist children and adolescents, regardless of their disability or chronic illness, to function at their maximum potential. Mayo Clinic's rehabilitation nursing staff includes registered nurses (RN), rehabilitation clinical nurse specialists (CNS), licensed practical nurses, and patient care assistants. RNs are accountable for coordinating family-oriented and age-appropriate nursing care related to:
- potential complications secondary to your child or adolescent's disability
- bowel and bladder management
- skin care issues
- surgical incision care
- independence with activities of daily living
Nursing personnel provide opportunities to practice techniques and skills learned in therapy sessions, and they assist with dismissal planning.
Physical therapists (PT) observe and analyze how a child moves and plays. During a child's inpatient admission, the PT provides age-appropriate services that help to improve mobility and functional skills, relieve pain, and limit physical disability due to injury or disease. During treatment sessions, the child or adolescent focuses on increasing muscle strength, endurance, flexibility, balance, and coordination of motor skills to achieve functional goals. Physical Therapists help set up post-discharge home exercise programs and provide equipment recommendations including orthotics, wheelchairs and gait aids.
Occupational therapists (OT) collaborate with families to help children or adolescents engage with roles in daily life, such as play, learning, and developing self care skills. The occupational therapist teaches or facilitates the skills needed to return to these roles. In occupational therapy, each child or adolescent will focus on improving self care skills, feeding or swallowing, cognition, coordination, strength, psychosocial skills and safety. The ultimate goal for children and adolescents is to engage meaningfully all aspects of daily life.
Respiratory therapists evaluate and treat children and adolescents with breathing disorders. A respiratory therapist works with families of children and adolescents requiring ventilators or other respiratory equipment to ensure their skill level and confidence in managing the equipment. The respiratory therapist also teaches patients how to maintain respiratory health and prevent respiratory complications.
An important part of recovery for children or adolescents after an illness or injury is their ability to return to play and fun activities. Recreational therapists help patients and families decide which leisure opportunities are possible and help patients participate in old favorite or new activities. Recreational therapists also help children or adolescents ease back into the community by planning outings to nearby restaurants, malls, movie theaters and other settings.
Children and adolescents may have speech, language or cognitive (thinking) deficits as a result of an injury, illness or a lifelong condition. In these situations, speech-language pathologists will evaluate speech, language and cognitive skills, and provide recommendations and treatment if appropriate. The speech-language pathologist helps the child or adolescent learn the necessary skills for communication in various environments and may also develop alternative methods of communication. For younger children, these skills are often best pursued in an environment of play.
Medical social workers counsel patients and family members, provide emotional support, and offer information about economic resources and community agencies. They also help with discharge planning, return to school, home health care referrals and arranging follow-up appointments.
Caring for the spiritual needs of children and adolescents is very important. A pediatric or general chaplain is available 24 hours a day. Their mission is to deliver spiritual or religious support and care in an age-appropriate, developmentally sensitive way to infants, children or teens and their families.
Adequate nutrition is critical to recovery from illness and injury. A registered dietitian may regularly visit patients to help them make healthy food choices and to manage special dietary needs. A pediatric menu is available. Some children can not eat by mouth and may be fed via nasogastric or gastrostomy tubes. The nutrition service helps determine caloric and fluid needs.
Child life specialist
Child life specialists use planned and spontaneous activities to help a child and family adjust to, prepare for, and benefit from hospital experiences. Child life staff help pediatric patients prepare for new experiences by teaching about medical procedures and by teaching coping skills. Child life staff supervise play and provide appropriate toys and games in play spaces and in patient rooms. Child life specialists are concerned about growth and development as well as about a child's social and emotional adjustment to health-related changes.