General Principles
The treatment of a child with CP requires a multidisciplinary approach. Once the diagnosis is made, the infant or child should be evaluated by a comprehensive rehabilitation team.
The members of this team will vary, depending upon site and availability. Potential team members may include a physiatrist, developmental pediatrician, orthopedist, neurologist, physical therapist, occupational therapist, speech and language pathologist, therapeutic recreation specialist, orthotist, psychologist, social worker, and a nutritionist. The team should work with the child's caregivers to develop short- and long-term goals that address neuromuscular concerns such as maintaining range of motion and tone control, as well as functional goals related to self-care skills, mobility, and communication. Goals related to increased societal participation should also be included. Goals should be routinely reassessed to ensure that they continue to be valid as the child grows older, and the child should be encouraged to take an active role in goal setting when appropriate.Once the goals are determined, the family and the team must determine the most appropriate therapeutic approach. Although there are many treatment options to choose from, little scientific evidence exists on which to base one's treatment decisions. The heterogeneity of CP, in addition to the lack of controls and disease-specific outcome measures, all contribute to this lack of evidence. In general, treatment should always start with the least invasive means with consideration of the cost-effectiveness of treatment options.
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