Paediatric Services Adult Services Paediatric Services Assistive Technology Services Teaching and Research What are the Paediatric Services The SCCR Paediatric Service consists of 2 specialized, interdisciplinary teams: Autism Team Neuromotor Team Both teams provide on site (at SCCR), outpatient and outreach (off site) services. The Neuromotor Team provides inpatient care which is at the discretion of the Physiatrist. Services are offered in both official languages (English and French) and are accessible to children from birth to adolescence. Autism Rehabilitation Services Neuromotor Rehabilitation Services Neuromotor Speciality Clinics Neuromotor Specialty Services What is the Autism Team? We are an interdisciplinary team of professionals who work together to support children and youth with a diagnosis of autism spectrum disorder and their families. Our team takes a family centred approach in our process, valuing individual needs and differences to optimize quality of life. Each plan is unique to the individual and their family. Our goal is to help children and youth be their best and most independent selves. We work together with families and community clinicians involved in the child’s care team to find helpful and practical solutions. Who We Are Our team is comprised of many different professionals with representation from: Behavior Analyst Clinical Dietetics Education Occupational Therapy Social Work Speech-Language Therapy Developmental Paediatrics This interdisciplinary team model is essential in providing our clients with the best care possible Who We Help We work with clients from across New Brunswick and offer services in French and English. We also use language interpretation services to work in any language preferred by our clients. We can accept referrals for home-based support once the child has entered school until the child’s 18th birthday. The focus for youth aged 14 to 18 is on transitioning to adult support and services. Services We Offer Our team mandate is to offer tertiary services. Therefore, we are available to consult with families and other professional who work with the child at the community level. We can also help with resource connection. It is important to note that our team does not provide direct therapy services. How To Get A Referral All referrals for home-based support should be signed by a pediatrician, psychiatrist, neurologist, or physiatrist. After a referral is accepted by our team, the child’s name will be placed on our waitlist and the parent or guardian will be notified. There are then two mandatory steps to be completed before the first appointment can be booked. Parents and guardians must complete & return our parent questionnaire document which can be provided to them by either email or mail. We then ask that they also watch our Parent Education, a series of presentations and videos, and return the worksheet provided. Once these steps are completed, our team’s therapists will be assigned based on the goals identified. The first appointment will focus on the parent or guardian’s top priorities. Next steps will be determined based on individual need, with consideration for location of visits, goals for intervention and when the next contact should happen. Our team is also available to provide support to school district teams. This request must come directly from a school district representative involved in the student’s team. The required referral form can be found within the Department of Education and Early Childhood Development’s education portal. Referrals for school support initiated by medical professionals cannot be accepted. Form: Rehabilitation Services Request (Paediatric Team – Neuromotor and Autism) What To Expect When You Visit During the visit, designated members of the team work together, focusing on the goals identified by the family. The result is a verbal summary to caregivers, followed by a written report describing our impressions and recommendations. We may also provide treatment or training materials such as pictures and/or handouts. We encourage caregivers and local professionals to attend appointments at the Stan Cassidy Centre in order to optimize treatment planning and to facilitate communication between all of the people involved in the child’s daily life. Video and teleconferencing options are also employed to enhance communication. Contact Us Attn: Autism Team Stan Cassidy Centre for Rehabilitation 800 Priestman Street Fredericton, New Brunswick, E3B 0C7 Tel.: 506-452-5225 Fax: 506-452-5727 Email: mylene.roy@horizonnb.ca Who We Are The Paediatric Neuromotor team is made up of professionals in the fields of: Physiatry (physicians with a specialty in physical medicine and rehabilitation) Occupational Therapy Physiotherapy Speech-Language Pathology Dietetics Social Work Psychology Nursing Recreation Augmentative Communication & Education The team is led by a manager and supported by rehabilitation assistants, an administrative assistant and scheduling coordinator. The Paediatric Neuromotor Team also includes the child’s family, caregivers, school, and local clinicians. The goal of the team is to help children maximize their potential. We work together to find effective and practical solutions to meet the child’s needs. Who We Serve The Paediatric Neuromotor Team accepts referrals for children with neurological diagnoses (i.e., Cerebral Palsy, Neuromuscular Disease, Genetic Syndromes, Spinal Cord Injuries, Brain Injuries, etc.) Referrals can be initiated by therapists, school, parents, and other individuals, but must be signed by a physician or nurse practitioner. All referrals must be accompanied by medical and therapeutic documentation. Photo caption: Neuromotor Team occupational therapist observes her patient making pizza with his father in the Paediatric kitchen. What We Do We have a provincial mandate and as such serve the entire province of New Brunswick. Service to our clients is provided in their language of choice. We do not carry a caseload of our own. Rather, we provide assistance to caregivers, local teams and teachers who are working with our clients on a regular basis. Our team can help by providing assessments, consultation and/or training. We support children’s rehabilitation programs by providing consultation, evaluating specialized equipment, providing short periods of intensive therapy or by visiting children in their own school or home. Children may be seen on an inpatient, outpatient or outreach basis. They could be seen by a single service or by an interdisciplinary team. We are family centred and we strive to provide services that meet the needs of our clients. Once we accept a referral, we look at the clients overall needs and set up an initial appointment that is of beneficial length and includes the appropriate team members. Services are prioritized based on urgency of need. We also reach out to families prior to the visit to discuss their goals, concerns and to plan for the visit. With permission we also reach out to local professionals involved. Single Service Appointments Our single service appointments could include Occupational Therapy, Speech-Language Pathology, Physiotherapy, Dietetics, Psychology, Recreation, Augmentative Communication, Education & Social Work Occupational Therapy Works with you and your child to promote participation, access and safety during daily activities, leisure pursuits, and in becoming a member of their community as a student, volunteer, friend, worker and / or family member. Speech-Language Pathology Works with clients to identify solutions for communication, swallowing and learning issues within the context of each client’s condition. We promote independence by teaching and maintaining new skills and finding adaptive strategies like an augmentative communication system. Physiotherapy Our physiotherapy team provides assessments to identify your child’s physical impairments or disabilities. Promotes independence through the development of appropriate functional skills, adaptive strategies and education to family and caregivers. Dietetics Our team’s dietitian works with clients, their families and caregivers to learn how food and nutrition can support health and improve quality of life. They assess height, weight and what your child eats in a day. Psychology Our psychologist provides services such as neuropsychological and psychodiagnostics assessments to children with a wide range of complex neuromotor impairments. These may include identifying cognitive changes overtime. The psychologist can also help with behavior and emotional concerns in relation to the child’s medical condition, for instance by providing consultation/intervention services for disruptive behavior, acute/chronic pain management, anxiety about medical procedures, or treatment adherence, while also offering recommendations that will help in the home, school, and community settings and for future planning. Social Work Our Social Workers provide consultation, education, counselling and support while also connecting families to resources and services. They assess and identify client and family needs, including socio-economic concerns, family coping and social support systems. They liaise with community partners, provide advocacy support and help families navigate systems of services and transitions in care. Our Social Workers are able to meet with parents and caregivers to discuss matters that are important to the family. Recreation Our team’s Recreation Therapist with clients and their families to learn about and explore options to optimize their quality of life. Whether it be playing a musical instrument, being physically active, going to the beach, or playing video games- the Recreation Therapist is there to support each client to explore his/her interests and access to recreation and leisure. Augmentative Communication Our Speech-Language pathologists work with you and your child, your local team, other clinicians on our team to identify strategies and devices for your child to be able to communicate besides talking. This might replace or supplement speech. There are no-tech, low tech and high-tech options and it is important to find the right one(s) for your child. Technology Access Our Occupational Therapist works with you, your child, and other clinicians to find ways your child can use technology to play, learn, communicate, and participate. From using a simple switch to electronic eye tracking, we identify the best solution for every child to be successful and have opportunities that may not be possible without technology. Every child has unique interests and needs and these will change as your child develops new skills or possibly encounters new challenges. We will be there along the way to optimize your child’s opportunities and quality of life. Education Liaison Our team’s Education Liaison works to facilitate a dynamically collaborative relationship between the SCCR and school/district teams. The goal is to support the SCCR team to ensure the child or youth has the best possible experience at school from a rehabilitation perspective. This can be achieved by participating in SCCR visits, assisting the team in sharing recommendations to the school or district and participating in outreach visits. The education liaison can also meet with parents and caregivers to share school related processes if they have questions or concerns. Team Service Appointments Our team service appointments include team evaluations, rechecks and intensives. These visits could range anywhere from half a day to two weeks. Before a team visit, we consult with caregivers and professionals. During the visit, designated members of the team work together, focusing on the goals of the child and family and on the areas most needing assistance. The result is a verbal summary to caregivers, followed by a written report describing our impressions and recommendations. We may also provide treatment or training materials in the form of pictures or handouts. We encourage caregivers and local professionals to attend appointments at the Stan Cassidy Centre in order to optimize treatment planning and facilitate communication between all of the people involved in a child’s daily life. Video and teleconferencing options are also available to enhance communication. Photo caption: This young Paediatric Neuromotor patient (centre) sits with his interdisciplinary team during his last appointment at SCCR. What To Expect Before a visit, we consult with caregivers and professionals. During the visit, designated members of the team work together, focusing on those areas most needing assistance. The result is a verbal summary to caregivers, followed by a written report describing our impressions and recommendations. We may also provide treatment or training materials such as pictures, handouts, or a videotape of therapy sessions. We encourage caregivers and local professionals to attend appointments as the Stan Cassidy Center in order to optimize treatment planning and facilitate communication between all of the people involved in a child’s daily life. Video and teleconferencing options are also employed to enhance communication. Contact Us For more information on our services, how to refer, the status of your referral, or your appointment, please contact our resource-scheduling coordinator at 506-447-4078. Attn.: Paediatric Neuromotor Team 800 Priestman Street Fredericton, New Brunswick E3B 0C7 Tel. 506-447-4078 Fax: 506-443-2600 The Neuromotor Speciality Clinics include the following: Feeding Consultation Services Neuromuscular Disease Clinic Orthotics Clinic Tone Management Clinic Orthopaedic Clinic Feeding Consultation Service The Feeding Consultation Service consists of speech language pathology, dietetics and occupational therapy. Therapists are involved in assessment and consultation, based on the needs of the child, family, and local team. Who we help: Children with neurological conditions paired with any of the following concerns: A child who is at risk of choking and requires further assessment. A child who is tube fed and the family/local team are interested in exploring the transition to oral feeds. A child who is at risk nutritionally due to problematic feeding (accepts less than 20 foods). Local therapists who are looking for consultation. Neuromuscular Disease Clinic The Neuromuscular Disease Clinic provides services and support to children and their families affected by a variety of neuromuscular disorders. We use a holistic and family-centred approach to care. Our goal is to help children and adolescents maximize their potential. We work together as a team to find effective and practical solutions to meet your child’s needs. Orthotics Clinic Orthotic leg braces are made with plastic materials or carbon fibers, which fit around part of the lower leg and foot. Orthoses can be custom made by a certified orthotist or ordered prefabricated. At the Orthotics Clinic, a team of health care professionals, such as the physiotherapist, physiatrist and Orthotist will assess the child’s orthotics needs. A management plan will be developed together with the family and caregivers. Orthotics Clinics are provided on-site and in certain outreach locations around the province. What are orthoses used for? Orthoses can be used to help a child who is already walking to walk better by improving the movement, position and support of the ankle and foot and lower extremities. For example, children who walk on their toes may come down on their heels when wearing orthoses. As well, children who drag their feet when they walk may be able to pick up their feet when wearing orthoses. They can also be used to improve the position of the feet for someone who is sitting or standing. Tone Management Clinic Children with a neuromotor diagnosis may have symptoms such as increased or decreased muscle tone, decreased muscle strength or movement coordination issues that eventually contribute to muscle length and/or joint motion issues. This in turn may impact a child’s mobility. In Tone Management Clinic, motion analysis technology is used to help assess mobility issues. This includes Video Observational Gait Analysis and upper extremity video assessments such as the Assisting Hand Assessment for children with hemiplegia. Physiotherapists, occupational therapists and physiatrists provide a coordinated approach to a comprehensive assessment and treatment plan to address the child’s mobility issues and the family’s concerns. The clinic may include treatment procedures such as Botox Injections, Serial Casting, Taping, and Splinting. Consultation with local physiotherapists or occupational therapists regarding therapeutic programs is an important part of Tone Management Clinic. From this clinic, the child may be referred to Orthopaedic clinic for further consultation regarding muscle and joint contracture management. Children with elevated muscle tone, meeting the criteria, may be referred to a specialist such as a neurosurgeon who can assess for other interventions such as Selective Dorsal Rhizotomy or Intrathecal Baclofen pump. Orthopaedic Clinic The Orthopaedic Clinic is an interdisciplinary clinic held on-site at SCCR, in partnership with the orthopaedic program at the IWK Health Centre. Children are assessed by SCCR clinicians, physiatry and by a visiting Orthopaedic Surgeon from the IWK for musculoskeletal monitoring and management. Musculoskeletal issues can affect a child’s mobility, positioning, and comfort. Clinics are run multiple times throughout the year at the SCCR. Children may be referred to the Orthopaedic Clinic by SCCR physiatry. Hip surveillance, which monitors hip health for children with Cerebral Palsy, is provided by our Centre and Xray reviews and examinations are often done as part of the Orthopaedic clinic. Single event multi-level surgery (SEMLS), which addresses orthopaedic issues at multiple joint levels in one surgical event, may be discussed through this clinic, as well as other single level orthopaedic procedures. Specialty Services Adapted Swim Clinic Adapted Bike Program Augmentative and Alternative Communication Adapted Video Gaming Surgical Planning Program Serial Casting and Splinting Adapted Swim Clinic The SCCR Adapted Swimming Program consists of an aquatic therapist/recreation therapist, occupational therapists, physiotherapists, and rehabilitation assistants. It is offered several times per year in locations throughout New Brunswick. The ultimate goal is to get children safely in the water, to be able to swim for fun and for therapy. The water is magical when it is hard to move your body on land, and this program is fully funded to make swimming an option for all abilities. Adapted Bike Program The SCCR Adapted Bike Program began in 2012 and consists of physiotherapists, occupational therapists, rehabilitation assistants and equipment vendors. Bike clinics are offered once or twice a year on-site, as well as individual assessments as needed. Each child is evaluated for an adapted tricycle/bicycle that specifically fits their needs. The program is fully funded allowing biking as an option for children with all abilities. Augmentative and Alternative Communication Our speech-language pathologists work with you, your child, and your local team to identify strategies and devices to enhance your child’s communication. This might supplement or replace speech. There are no-tech, low tech, and high-tech options. It is important to have an assessment to find out the right options for your child. Adapted Video Gaming The Game Changers Team consists of a team of an occupational therapy, recreation therapy and rehabilitation engineering. Video gaming is an equalizer to allow our clients the ability to run, jump and play with customized controllers and set-ups. The clinic provides a variety of options and set ups to meet the physical needs and game interests of the client. Surgical Planning Program If a child is referred for orthopaedic or neurosurgery from our Centre, the surgical procedures often occur out of province, typically in Nova Scotia at the IWK or sometimes in the province of Quebec. The surgical planning program at SCCR is designed to help ease the complexity and stress of having surgery out-of-province and can help families navigate issues such as post-operative equipment, bracing, home access and school re-entry as well as provide social supports and help with coping. Serial Casting and Splinting Serial casting is the use of a series of progressive casts to increase muscle length using low load prolonged stretch to shortened muscle tissues. Serial casting is most commonly used for the ankle and foot and application of the casts is done by physiotherapy and a rehab assistant. For example, a child with tight calf muscles may benefit from serial casting. In this case a below knee walking cast is placed on the ankle-foot for approximately 5 days. The cast, often made of semi-rigid fiberglass, is then removed at home prior to the child’s return to the Centre for the next cast. Typically, a set of 3 casts is booked. Lengthening muscles may also have the benefit of lowering high muscle tone in the area as well. Splinting, using thermoplastic and neoprene, can help maintain or increase soft-tissue length in the upper extremities or lower extremities. Many splints are used night-time for this purpose. Day-time splints may also help with functional activities. A child may be referred to an occupational therapist or physiotherapist for splinting at our Centre.