Pediatric Rehabilitation

Pediatric Rehabilitation at Mayo Clinic's campus in Rochester, Minnesota, offers the latest evaluation and treatment techniques to improve function and quality of life for children, from our own region as well as from all over the world. Our experts see children from birth through age 18, in a warm, holistic and collaborative environment.

The Pediatric Rehabilitation team diagnoses and treats a wide range of conditions from the most common to the very rare. Using a team approach, Mayo's pediatric rehabilitation experts partner with pediatric specialists at Mayo Clinic Children's Center, such as Mayo's Child Life Program, general and developmental pediatrics, pediatric neurology, neuropsychology, neurosurgery, oncology, orthopedics, rheumatology, social work, and many others. You and your child are at the center of our comprehensive team.

Pediatric Rehabilitation programs

• Inpatient program
• Outpatient program

Mayo Clinic's Pediatric Rehabilitation programs serve infants, children and teenagers, from birth through age 18. Pediatric rehabilitation services are provided at Mayo Eugenio Litta Children's Hospital, the inpatient rehabilitation unit at the Generose Building, and the outpatient area in the Mayo Building.

Mayo's Pediatric Rehabilitation team facilitates ongoing care in your home community as needed, partnering with primary care doctors, schools and other community organizations to help maximize your child's recovery, wellness, independence and quality of life.

Quality commitment

Our rehabilitation programs share Mayo Clinic's longstanding primary value that "the needs of the patient come first."

Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals, or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Most Pediatric Rehabilitation appointments can be made directly. However, a physician referral is required for consideration of admission to our pediatric rehabilitation inpatient program or for an appointment in our pediatric rehabilitation outpatient program.

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Mayo Clinic Pediatric Rehabilitation offers the following tests, procedures, and treatments as appropriate for each child based on medical need.

Mayo Clinic Pediatric Rehabilitation doctors and therapists are equipped to treat a range of brain, spine and musculoskeletal disorders, including but not limited to:

Mayo Clinic has one of the largest and most experienced practices in the United States, with campuses in Arizona, Florida and Minnesota. Staff skilled in dozens of specialties work together to ensure quality care and successful recovery.

Find doctors and medical staff:

Pediatric Rehabilitation's outpatient specialty practice works with you and your child to set functional goals. Goals are individualized and established in partnership with you. Our overall goal is to help your child have the best quality of life possible and achieve optimal functional ability.

We work to improve specific problems such as spasticity, weakness and pain. Because we treat so many different types of injuries, illnesses and disabilities, goals look very different from person to person. Here are some examples:

• One baby and her mom might work with an occupational therapist to improve oral eating skills. Another might work with a physical therapist to improve neck range of motion.
• A toddler with cerebral palsy may get botulinum toxin injections and a prescription for braces from the Pediatric Rehabilitation doctor while the physical therapist works on the skill of walking and the occupational therapist works on self-dressing.
• A school-age child with a lower extremity fracture who's had a cast removed by orthopedics might receive additional therapy to start standing on the foot again and learn to walk correctly, with or without crutches.
• A middle schooler with a concussion might receive recommendations about how to successfully manage symptoms and return to school and sport.
• A teenager with chronic pain might receive recommendations for medication and therapy to improve symptoms.

Treatment team

Mayo Clinic Pediatric Rehabilitation uses a team approach to care, which includes the experts below and others, depending on your child's needs.

• Pediatric physical medicine and rehabilitation doctors (physiatrists) provide evaluation, testing, diagnosis and treatment planning. They also provide prescriptions for medications, equipment and therapy. A physiatrist is a physician trained in physical medicine and rehabilitation (PM&R). Pediatric physiatrists have additional training and knowledge about children and teenagers with disabilities. With expertise in the brain, spinal cord, nerves, muscles and bones, the physiatrist treats injuries and illnesses to reduce pain and restore function.
• Occupational therapists (OTs) evaluate and treat children and teens who have problems that limit the ability to perform functional activities in their daily lives, such as dressing, bathing and participating in school. OTs develop a personalized treatment plan to improve cognitive, physical, sensory and motor skills and to enhance self-esteem and a sense of achievement. OTs focus on skills such as fine motor, sensory motor, feeding and swallowing, and vision to maximize the abilities to be as independent as possible at home, at school and in the community.
• Physical therapists (PTs) evaluate and treat children and teens who have medical problems or other conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques that promote the ability to move, reduce pain, restore function and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness and wellness programs for healthier and more active lifestyles.

Mayo Clinic's Pediatric Rehabilitation Inpatient Unit on the Minnesota campus provides coordinated, child- and family-focused, inpatient rehabilitation care to children and teenagers from birth through age 18 with serious injury or illness resulting in disability.

Our inpatient program provides a vital link in the continuum of recovery care between the intensive care or acute care hospital and transition to home. The program's goal is to help children and teens optimize recovery, maximize quality of life, and live as independently as possible within their families, schools and communities.

Accreditation

Mayo Clinic Pediatric Inpatient Rehabilitation Program is accredited as a Pediatric Specialty Program by the Commission on Accreditation of Rehabilitation Facilities (CARF) International. This means that Mayo Clinic Pediatric Rehabilitation applies CARF International's comprehensive set of standards for quality to our practice, and we're committed to continuous quality improvement.

Facilities and equipment

Mayo's Pediatric Rehabilitation Inpatient Unit is based in Mayo Clinic Hospital, Saint Marys Campus, in Rochester, Minnesota. The rehabilitation unit is on the same campus as the pediatric ICU and general pediatric care floors. That means immediate access to Mayo's pediatric and surgical specialty expertise is available.

Dedicated pediatric single rooms offer a sleeping option for parents who choose to stay overnight with their children. Pediatric gyms offer toys and equipment appropriate for all ages and sizes to facilitate recovery and functional improvement.

State-of-the-art rehabilitation equipment includes robotic trainers for arm and leg function, body weight-supported gait trainers, functional electrical stimulation (FES), including FES bike, Ovation balance training system, SmartDrive mobility device and many other options.

Admission as an inpatient

Pediatric patients enter the Pediatric Rehabilitation Inpatient Unit in one of these ways:

• Following referral to Pediatric Rehabilitation by a pediatric or surgical service at Mayo Eugenio Litta Children's Hospital
• As a direct admission from a separate institution after evaluation by a Mayo Clinic admissions coordinator
• Admission from outpatient status if it is determined that an inpatient stay to meet the rehabilitation needs of your child is medically necessary

Before admission to our Pediatric Rehabilitation Inpatient Unit, experts evaluate your child's medical status and ability to participate in intensive therapy program sessions. Then they discuss rehabilitation goals with you and your child. The focus is to improve function. Your child must be medically stable and able to participate in about three hours of therapy a day while still requiring physician oversight and nursing care.

We care for children and teenagers with many different diagnoses, but brain and spinal cord dysfunction due to trauma, cancer or illness are the most common causes for admission to the Pediatric Inpatient Rehabilitation Program.

Treatment team

Mayo's Pediatric Rehabilitation team includes — first and foremost — your child and family. Based on your child's needs, experts may include a pediatric physiatrist, physical therapist, occupational therapist, speech and language pathologist, care coordinator, recreational therapist, rehabilitation nurse, neuropsychologist, social worker, dietitian, orthotist, prosthetist, respiratory therapist, music therapist, and child life specialist.

We work directly with many other pediatric specialists, when needed, such as neurosurgeons, orthopedic surgeons, pediatricians, oncologists, neurologists, cardiologists, cardiovascular surgeons, transplant surgeons and others to provide coordinated care.

Specialty consultations, diagnostic tests and emergency services all occur in a timely, seamless manner since the rehabilitation unit is part of the Mayo Clinic Hospital, Saint Marys Campus, which includes the children's hospital.

Plan of care

A goal-directed therapeutic plan of care is established for your child, based on individual needs, and may include any of these elements.

• Medical management.
• Techniques to improve self-care skills, mobility, bowel and bladder function, swallowing, speech and language skills, cognitive skills, and sensorimotor and perceptual skills based on age, developmental stage, cultural background and psychosocial considerations.
• Additional services such as assistive technology, augmentative and alternative communication, environmental modification, peer visitation, or pet therapy may be provided.
• At any time during your child's stay, consultation with any of Mayo Clinic Children's Center pediatric medical and surgical specialists may be arranged as needed.
• Team members regularly monitor progress, update plans of care and communicate with each other as well as with your child and family.

Planning for progression in rehabilitation

Planning for care along the continuum of recovery from illness or injury begins at the first contact with our program. As part of your child's care, our experts:

• Continuously update the plan through regular interaction among program team members, your child, your family, and your child's school.
• Emphasize the educational needs of your child.
• Provide you and your child with recommendations — before dismissal from the inpatient setting — on next steps. These may include outpatient therapies, home exercise programs, and follow-up consultations with therapists and physicians.

Outcomes

Mayo Clinic Pediatric Rehabilitation is known for outstanding expert care of children and teens, as shown by outcomes data:

• The average length of stay for our pediatric patients is a couple of weeks and is shorter than the national average for similar pediatric rehabilitation units.
• The functional improvement our patients experience exceeds national norms. This means that, on average, our patients get better faster than at other similar facilities.
• After treatment in our inpatient unit, the majority of our patients are discharged to home, though some choose to stay at the nearby Ronald McDonald house for ongoing outpatient therapy before going to their home communities.
• All responders to our patient and family satisfaction surveys indicate that they would recommend Mayo Clinic Pediatric Rehabilitation to a friend or family member with a similar problem.

Mayo Clinic's Rehabilitation Medicine Research Center draws on the strong clinical practice, research and education skills in rehabilitation medicine and surgery. In the Children's Research Center at Mayo Clinic, doctors and scientists from a wide range of fields work together to improve health care for newborns, children and teenagers. The center aims to ensure today's children — whether healthy or ill — become tomorrow's healthy adults.

For example, the long-term goal of one research team is to understand the effects of spasticity and spasticity treatment on muscle properties to improve quality of life for children with cerebral palsy and other diagnoses associated with spasticity. Focus areas include:

• Spasticity treatment. The team is working to measure the effects of botulinum neurotoxin and selective dorsal rhizotomy on passive muscle stiffness in children with cerebral palsy. The team is using novel ultrasound technology in order to provide evidence-based treatment recommendations.
• Effects of spasticity on the developing central nervous system. Using an animal model of congenital hypertonia, we are investigating the development and maturation of spinal motor neurons and motor units, which are critical to physical function and muscle control. The long-term goal is to identify optimal timing for regenerative rehabilitation interventions along with new targets for these interventions.
• Measurement tools for cerebral palsy. We are working with the National Institute of Neurological Disorders and Stroke (NINDS) and a group of clinical researchers to update and maintain a source of measures and methods for collecting data in clinical research involving children with cerebral palsy. This resource is called Cerebral Palsy Common Data Elements (CP CDEs).

Another group of studies is looking at exercise and activity levels in children of all abilities.

• Education and exercise. One study investigates compliance with physical activity recommendations based on how information is delivered so that we can improve our service to patients with autonomic dysfunction and postural orthostatic tachycardia syndrome (POTS).
• Physical activity in children with cerebral palsy (CP). The study aims to investigate knowledge and understanding, daily behavior, physical competency, motivation and confidence surrounding physical activity in children with CP. The secondary aim is to compare responses from the Promoting Lifestyle & Activity in Youth (PLAY) questionnaire between typically developing children and children with CP.

Other lines of active research include:

• Plagiocephaly. We are using a population-based approach to quantify the incidence of nonsynostotic positional plagiocephaly and brachycephaly as well as investigate the association with disorders that affect development.
• Diversity and inclusion. A therapy team is focusing on patients who speak Arabic to determine their needs and preferences in order to optimize rehabilitative care.
• Traumatic brain injury (TBI) and mental health. A foundational study using the Southeast Minnesota Birth Cohort will determine risk of psychiatric diagnosis after childhood TBI.
• Training and certification related to pediatric rehabilitation. Various studies seek to understand the professional certification process for physical medicine and rehabilitation doctors as well as subspecialists including pediatric rehabilitation medicine.

Publications

See a list of publications by Mayo Clinic doctors about physical medicine and rehabilitation on PubMed, a service of the National Library of Medicine.

For more information, see the Physical Medicine And Rehabilitation Research pages. Or visit the Rehabilitation Medicine Research Center.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people.

In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Learn more about appointments at Mayo Clinic.

Please contact your insurance company to verify medical coverage and to obtain any needed authorization prior to your visit. Often, your insurer's customer service number is printed on the back of your insurance card.