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Damiano, D. M. (2006). Activity, activity, activity: Rethinking our physical therapy approach to cerebral palsy. Physical Therapy, 86, 1534-1540.
March 2007
In This Issue
Reviews from The Zero to Three 21st National Training Institute .......... 2
REACH Telehealth Activities... .................... 3
REACH Telehealth Seminar Series ............... 3
Keys to Caregiving Classes .......................... 3
Editorial Staff Mary ZarembaJulie Bachechi
Design & LayoutJoette Baity
Early Childhood and Specialized
Personnel Development Division
UNM Center for Development
& Disability (CDD)
2300 Menaul NEAlbuquerque, NM 87107
Cerebral Palsy and Activity-Based Intervention —Article Review
by Sandy Heimerl
A growing body of scientific evidence suggests that activity-based strategies are one of the keys to maximizing potential for persons with Cerebral Palsy (CP). I attended the III STEP conference in July 2005 in which a theoretical basis for rethinking the physical therapy in-tervention paradigm for individuals with CP was presented. The concepts were reviewed in an article by Da-miano (2006).
Intervention strategies for persons with cerebral palsy need to shift from traditional approaches to an activities-based approach. Increased motor activity has been shown to lead to better physical and mental health and improved cognitive performance. More recently, this activity has shown to promote neural and func-tional recovery in individuals with central nervous system insult.
Three major potential outcomes were discussed from an activity-based approach to intervention.
Activity prevents secondary musculo-skeletal impairments and maximizes physical functioning. A logical corol-lary to this is that not moving enough or moving incorrectly can produce negative physical or physiological con-sequences to the muscles, bones, and the cardio respiratory system. These secondary changes contribute to a vi-cious cycle; whereby a disability leads to deconditioning, that in turn, worsens the level of disability. Muscles need to be stretched to their limits in CP on a regular basis to maintain length,
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University of New Mexico / CDD / University Center for Excellence in Developmental Disabilities Education, Research, and Service
Volume 10, Issue 1
and they need to be loaded adequately and frequently to maintain strength (force-gener-ating capacity).
Activity is important for a child’s overall development. In children with severe mo-tor impairment, studies have found that increased mobility leads to independence, social interaction, and even facilitation of socio-psychological development. It does not limit future self-mobility; it may
even stimulate it. This newer approach has led to increasing use of mobil-ity devices or motorized wheelchairs for children. Children are less likely to develop a passive “help me” attitude.
Activity supports the development, mainte-nance, and perhaps restoration of neural structures and pathways. The early move-ment of children with CP is different and distinguishable from those who do not have CP. If these movements persist and are reinforced, this sets the stage for neural ad-aptations that may restrict future movement options and negatively affect motor progno-sis; making it difficult to reverse once they are well established. The rationale for early intervention is for establishing and reinforc-ing movement patterns early in development before the potential for change is lost.
There is a need to optimize limited therapy time by eliminating approaches or treatment compo-nents that have only marginal positive effects. More ways for children to incorporate activity into their lifestyles need to be identified. Howev-er, children with greater physical challenges may need more intense conditioning or strengthening, exercise equipment or computerized devices.
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Updates
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Child Parent Psychotherapy with Culturally Diverse Families
by Regina Huffman
Initially, I had not picked this particular session “Child Parent Psychotherapy with Culturally Diverse Families” presented by Chandra Ghosh Ippen, PhD, and Patricia Van Horn, JD, PhD, of the Child Trauma Research Project, University of California, San Francsico — it was chosen for me! While I thought the session would be interesting, it turned to be quite remarkable. It was remarkable because it was presented in a way that was clear and easy to under-
stand. The presenters utilized a unique approach that featured a story that was written and illustrated by one of the pre-senters with her husband. The circumstances in the story were those that any of us working with infants, toddlers and their families would certainly find familiar.
The story included a little boy about three or four years of
age, his mom and dad and baby sister, who was about one year old. An unspecified traumatic event occurred within the family. For the children, this event manifested into an ominous, big, green monster lurking around them. Both children saw the monster and they were sure that their parents did as well. They couldn’t understand why their parents didn’t talk about the monster or make it go away.
This is how children experience trauma. They may not know what it really is, what to call it or how it materialized in their lives. The unacknowledged “monster” creates fear and stress that can be devastating to the health and well be-ing of each family member.
This example used in the workshop emphasized the impor-tance of guiding children not only in their typical, everyday experiences, but in the scary, threatening events as well. A dangerous assumption exists that young children, especially infants and toddlers are not impacted by traumatic events in the way older children and adults are because they don’t re-ally understand them. In fact, we know that if these events are not addressed, they are internalized by the young child who’s world becomes terrorized by the “big, green, monster.”
We are challenged in how to best intervene around these issues with children in ways that are developmentally ap-propriate. I believe that New Mexico is becoming more informed regarding the mental health needs of young children. In our agency, we are keenly aware of how mental health issues affect the well being of children and their families. To ensure that social and emotional needs of young children are addressed, we have clinical psycholo-gists on staff to provide consultation and direct services to families. It is important that traumatic events in a young child’s life go unrecognized, hidden or ignored.
The Dance of Partnership: Why Do My Feet Hurt? by Karla Cristine Sanchez
During the 2006 Zero to Three Conference, I had the op-portunity to hear Janice Fialka, MSW, ACSW, the author of “The Dance of Partnership: Why Do My Feet Hurt?” She discussed the process of the working relationship of the family and those professionals who work in relationship with them. One point that stood out the most in Janice’s presentation was when she talked about the family’s denial and the purpose denial serves in their lives. She helped to put it in perspective by describing denial as a place for families to go when things become overwhelming. This place still allows the family to have hope and dreams for their child when they feel there may be none left. The de-nial serves as a safe haven for the family.
As a practitioner, it helped me real-ize that telling the family, they must move forward so that they can begin to help their child is only robbing them of the feelings they need to ex-perience fully and to work through. It’s robbing them of the dreams they have for their child. Janice’s perspec-tive helped me to see that my role is not to deny them the process of denial, but to support them through it. So that eventually, according to their readiness, they can rekindle their hopes and dreams for their child and move forward in their lives.Regina Huffman as a FIT provider is the Coordinator of the DSI-ELFS program in Gallup. Karla Cristine Sanchez is a Service Coordinator and Developmental Specialist with NAPPR in Albuquerque.
Reviews from The Zero to Three 21st National Training Institute (NTI)Sharing a Vision for Babies and Families
Albuquerque, December 1-3, 2006
Keys to Caregiving ClassesWhen: May 9, 16, and 21, 2007—9:00 am to 3:30 pmWhere: Parents Reaching Out, Albuquerque OfficePresenter: Doreen A. Sansom, Family Infant Toddler Program
After attending these classes, participants continually say, “I will never look at a baby in the same way.”
Keys to Caregiving is a video training program for profession-als working with parents and newborns in a variety of settings, including homes, hospitals, child care, community outreach programs, physical and occupational therapy sessions, and clin-ics. Based on the research of positive parent/child interactions as a predictor of later social-emotional, cognitive and language development, the materials emphasize the competencies and capabilities of infants, the effect on caregiver-child interaction, and ways to effectively impart this knowledge to parents.
Registration is limited to 20 participants. Information has been sent out on the FIT listserv.
Contact Doreen at (505) 827-2162 or [email protected]
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REACH Telehealth Activitiesby Deb Hall, MD
REACH (Rural Early Access to Children’s Health), the Telehealth program at the Center for Development & Disability (CDD), has continued to grow. We think about REACH as being the technologic arm of the CDD. We have a designated a telehealth room, where we can conduct both clinical and training encounters. In communities, we utilize our own technology if we can, or partner with pri-mary care sites that have high quality equipment. We have two programs: clinical and training.
The clinical program, funded by the Department of Health through the NM Telehealth Commission, allows us to provide clinical services (Speech-Language Therapy, Behavioral Health-Psychology, Physical Therapy, and Developmental Pediatrics) via televideo as a resource when specialists are not available in local communities. We do both direct clinical service with the family and the Devel-opmental Specialist/Service Coordinator present, and case consultation with early intervention staff to confer about children and families they see. We are currently working with about nine communities that have access to broadband
(high-quality TV-like) technology. These include: Grants, Farm-ington, Raton, Carlsbad, Deming, Lordsburg, Silver City, and Las Cruces. In the first three months of the program, we provided about 42 clinical services.
The training programs will begin this month. Pertinent to early inter-vention, this series is offered for a fee to sites.
The training schedule is included here. CEUs will be of-fered. If you are interested in knowing more about how we might be able to link our communities together, please call or email Sandy Heimerl (272-0096, [email protected]) or Deb Hall, MD (272-3782, [email protected]). We would love to talk to you! Our website is: http://cdd.unm.edu/ec/REACH/
For more information about telepractice, the American Speech-Language-Hearing Association (ASHA) has an article with a video about telepractice on their website:http://www.asha.org/about/leadership-projects/national-office/focused-initiatives/01-03-archive/telepractice.htm
Telehealth Seminar Series Topics on New Mexico Early Intervention
2007 CalendarAdministered by: REACH Telehealth Project at the
Center for Development and Disability, UNM(Rural Early Access to Children’s Health)
Dates: 3rd Friday of the month from February 2007 - July 2007
Times/Location: 90 minutes / session(Training times and locations will be determined with you, the early intervention programs registering as participants, and the availability of the local teleconferencing site.) CEU’s (OT, PT, SW, SLP) and Developmental Specialist hours towards recertification offered.
Date Topic Presenter
3/16/07 Play-Based Interventions for Young Children (Part 1)
CDD Staff
4/20/07 Play-Based Interventions for Young Children (Part 2)
CDD Staff / Examples from session participants will be discussed
5/18/07 Children with Aggressive Behaviors and Dysregulated Temperament (Part 1)
CDD Staff
6/15/07 Case Studies – Children with Aggressive Behaviors and Dysregulated Temperament (Part 2)
CDD Staff / Examples from session participants will be discussed
7/20/07 Children Prenatally Exposed to Drugs TBD
UNM’s Center for Development and Disability (CDD) is partnering with early intervention providers from around the state to bring developmental training to rural communities via teleconferencing. The Network, Rural Early Access to Chlidren’s Health (REACH) uses video-conferencing technology for distance education. For the 2007 seminar series, topics were identified based on input from our early intervention partners.
Programs must register for each date. The cost of registration is $100/program/training. For two part series, you are required to sign up for both sessions at a cost of $175/program/training. The cost of the complete training series is $450/program. CEUs are offered at no extra charge.
To Register and Reserve a Space:Registration is required so that teleconferencing sites can be reserved.
To register, Email: [email protected] If you have questions, please call Sandy Heimerl at (505) 272-0096Metro region participation may be available depending on interest in Albuquerque. Email REACH or call Sandy Heimerl.
http://cdd.unm.edu/ec/REACH/
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Early Childhood and Specialized Personnel Development DivisionCenter for Development and Disability2300 Menaul Blvd. NEAlbuquerque, NM 87107
Non-Profit OrganizationU.S. Postage PaidAlbuquerque, NM
Permit # 39
Early Childhood StaffMette Pedersen, Director ([email protected]) . . . . . . . . . . . . . 272-1040Alison Noble, Division Coordinator ([email protected]) . . . . . . . 272-2756
CDD Library Information Network for the Community (LINC) 1-800-827-6380 or 272-0281
Visit the Early Childhood & Specialized Personnel Development Division website at http://cdd.unm.edu/ecspd/
Early Childhood Evaluation Program Sherri Alderman, MD ([email protected]) . . . . 272-0273Audrey Autrey ([email protected]) . . . . . . . . . . . . . 272-0712Julie Bachechi ([email protected]). . . . . . . . . . . . 272-0284Nancy Brandon ([email protected]) . . . . . . . . . . 272-0258Frank Faustine ([email protected]). . . . . . . . . . . . 272-1916Karin Fulford ([email protected]) . . . . . . . . . . . . . 272-9846Maria Lawrence ([email protected]) . . . . . . . . 272-2943Judy Ledman, MD ([email protected]) . . . . . . . . . 272-5894Brian Lopez ([email protected]) . . . . . . . . . . . . . . 272-2586Marcia Moriarta ([email protected]) . . . . . . . . . 272-5679Trish Peebles ([email protected]) . . . . . . . . . . . . . 272-0543Patricia Rodriguez ([email protected]) . . . . . . 272-0108Lucy Salazar ([email protected]) . . . . . . . . . . . . . . 272-4135 Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-0386
Early Childhood Network Joette Baity ([email protected]) . . . . . . . . . . . . . . . . . . 272-3011Debra Billings ([email protected]) . . . . . . . . . . . . . 272-0289Harrie Freedman ([email protected]) . . . . . . . . . 272-0325Sheila McKisson ([email protected]) . . . . . . . . . . 272-0098Bird Podzemny ([email protected]) . . . . . . . . . . 272-6511Mary Zaremba ([email protected]) . . . . . . . . . . . . 272-1042Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-0277
Preschool Network Janet Alvarado ([email protected]) . . . . . . . . . . . . 524-1115Sophie Bertrand ([email protected]). . . . . . . . . . . 272-1506Holly Harrison ([email protected]). . . . . . . . . . . . 272-0403Betty Lansdowne ([email protected]) . . . . . . . . 272-8192Leslie Sandoval ([email protected]) . . . . . . . . . . . . 272-9924Kathleen Trumbull ([email protected]). . . . . . . . . . . . . . 644-7362Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-0384FOCUS
Main Phone Number . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-3459Harrie Freedman ([email protected]) . . . . . . . . 272-3469Karol Kelly ([email protected]) . . . . . . . . . . . . . . . . . 272-3459All Other Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-3459 Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-3461
REACHPat Demny ([email protected]) . . . . . . . . . . . . . . . . 272-3844Deborah Hall, MD ([email protected]) . . . . . . . . . . . 272-3782Sandy Heimerl ([email protected]). . . . . . . . . . . . . 272-0403Fax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272-0386
SERVICE COORDINATION modules are required for all new service coordinators working in early intervention programs.
It is highly recommended that these modules be taken in order,
if at all possible.
Please make reservationsfor all workshops.
March 15 Developing the DREAM: The IFSP ProcessAlbuquerque Debra Billings – [email protected]
March 20Visual Impairment & Early Intervention, Day 2ClovisJulie Pino – (505) 268-9506NM School for the Blind & Visually Impaired
March 20 Service Coordination: Eligibility to IFSPAlbuquerqueSherri Davidman – [email protected]
March 21 Service Coordination: Eligibility to IFSPAlbuquerqueSherri Davidman – [email protected]
March 28PE MOSAA (Presumptive Eligibility; Medicaid on Site Application Assistance)Albuquerque Kathryn Karnowsky – [email protected]
March 2007April 13Service Coordination: Family-Centered Ser. Coordination EspanolaAnna Marie Garcia – [email protected]
April 17Service Coordination: TransitionAlbuquerqueSherri Davidman – [email protected]
April 19Family Visiting: Relationship-Based Early InterventionRoswellDebra Billings – [email protected]
April 26Service Coordination: Eligibility to IFSPEspanolaAnna Marie Garcia – [email protected]
April 26Service Coordination: Eligibility to IFSPEspanolaAnna Marie Garcia – [email protected]
April 2007
May 10It’s Only Natural!Gallup Mary Zaremba – [email protected]
May 16Orientation to Part CAlbuquerqueSherri Davidman – [email protected]
May 25Orientation to Part CRoswell Suzanne Pope – [email protected]
May 2007
Please Post!
Early Intervention Workshops
