Updates

The Blue Bird Circle Muscular Dystrophy Association clinic specializes in the diagnosis, treatment, and continuing care of neuromuscular diseases in children and is affiliated with the national Muscular Dystrophy Association.

The Cerebral Palsy Clinic at Texas Children’s Hospital provides comprehensive evaluation and treatment for children with cerebral palsy and related conditions such as developmental and learning problems, difficulties with coordination, positioning and mobility as well as seizures.

The International Program for Pediatric Deformity Correction and Limb Reconstruction at Texas Children's Hospital provides comprehensive care to infants, children and young adults with complex orthopedic disorders of the lower limbs.

Spasticity is characterized by muscle tightness or stiffness caused by an imbalance of signals from the brain or spinal cord to the muscles. Rehabilitation management for spasticity depends on the location of muscle involved, the severity of symptoms, and the goals for improving care and function. This clinic helps to address spasticity by working with the patient and family to determine the most appropriate treatment options for your child.

The Electrodiagnosis Clinic specializes in evaluation of the function of a child’s nerves and muscles. As the electrodiagnostic study is an extension of clinical findings, a Pediatric Physiatrist (PM&R physician) board certified in Electrodiagnostic Medicine will obtain a history and perform a focused physical examination before starting the testing. This is a test to evaluate how the nerves and muscles are working. There are two parts of the test: the Nerve Conduction Studies (NCS) and the Electromyography (or EMG).

The Traumatic Brain Injury Clinic provides comprehensive care to pediatric patients who have sustained a traumatic brain injury (TBI).

The Brachial Plexus Clinic is a multidisciplinary clinic that specializes in the care of infants and children with brachial plexus injuries.

The Spina Bifida Program is a multidisciplinary program that includes several specialty services: orthopedics, neurosurgery, developmental pediatrics, physical medicine and rehabilitation, and urology. Prenatal evaluations are available. Patients are followed from birth until 18 years of age. The Spina Bifida Program also offers a Teen Readiness Clinic that focuses on transition.

Texas Children’s Angelman Clinic is a multidisciplinary program that includes several specialty services: genetics, neurology, physical medicine and rehabilitation and developmental pediatrics.

Our surgeons use advanced Orthopedic and Plastic Surgery techniques such as 3D computer-guided deformity correction and lengthening, vascularized bone grafting, and microneurovascular surgery to repair and reconstruct nerve and soft-tissue in a child’s extremities.

Services


Mobility support in a fun environment

Does your child like the water? Does your child like to swim, splash and play in the tub or wading pool? Does your child have difficulty moving on land? Are your child’s arms or legs stiff, floppy or weak on land? Does he or she tire easily on land? Does he or she have pain in his joints with some movements?

If you answered yes to any of these questions, you may want to try aquatic therapy.

Aquatic therapy is a favorite therapy for many children and therapists. The water is a fun place to learn and is a natural motivator. Children become more mobile and aware of their bodies, movements and even their breathing in the water. You often hear children squeal, laugh and splash with obvious delight in the pool. The water offers them support and the possibility to actually succeed at tasks they find difficult on land.

The water has various properties that assist in making it a functional place for a child to work. The temperature can help lower or raise the overall muscle tone in the body. Gentle movements allow tight muscles to relax and make movement safe as well as fun. The pressure of the water gives the child continuous awareness of their body.

The water also offers resistance to the child’s movements, which helps children increase their muscle strength, organize their behavior and produce more coordinated movements. The natural buoyancy of the water allows them the time to respond when balance is threatened and assists in making corrections to their balance. The support of the water and the fun help encourage children to move independently. It helps them develop “kid power,” which helps increase their self-confidence as well as their strength and endurance. Additionally, the water is a great place to socialize, practice sounds and use the imagination.

The water is a great medium to address all the child’s needs from physical to social to medical. Since gravity is reduced in the water, the child now has the opportunity to take risks, learn movements, socialize, and develop self-confidence while addressing therapy goals.

Our therapists are specialized and/or certified in European techniques such as Nuero Developmental Treatment (NDT), Halliwick and Bad Ragoz. These techniques are incorporated into the treatment sessions along with other techniques such as myofascial release, strengthening and coordination activities based on your child's need.

Session information

During group sessions, younger children will focus on water safety, beginning swimming and age-appropriate water play. Older children will enjoy water aerobics, jogging and kickboxing as well as aquatic sports, such as basketball, volleyball, polo and relays.

Individual sessions will address occupational and/or physical therapy goals. Evaluations are done on the first day of a patient's session.

Location information

Texas Children's aquatic therapy individual and group sessions are held at Chancellor's Family Center, 6535 Dumfries, Houston, TX 77096. Parking is free.

Payment information

Physician referrals are required for aquatic therapy, and a pre-authorization is necessary.

Schedule an evaluation

To schedule an evaluation to determine if aquatic therapy is right for your child, contact Avis Rosenthal at 832-826-2135.

Intrathecal Baclofen (ITB) therapy is an FDA-approved treatment option for severe spasticity wherein Baclofen (a medication used to treat spasticity) is delivered directly to the fluid around the spinal cord through a surgically placed programmable pump and catheter. Once this form of treatment is considered appropriate for your child, thorough discussions will be had regarding the benefits and possible complications associated with this type of intervention. Having an ITB pump requires the patient and family to consistently attend their scheduled appointments for required pump programming maintenance and pump refills. The frequency of the ITB pump refills depends on the therapeutic dose for the individual. The pump has a battery life of approximately 4-7 years, so prior to the battery needing replaced, a surgery to remove the old ITB pump and place a new ITB pump will be scheduled.

Steps involved in consideration for an ITB pump:

  1. Clinical evaluations by:
    • Physical Medicine and Rehabilitation (PM&R) Physician
    • Neurosurgery
    • Physical Therapist
    • Designated ITB Nurse/Provider:
      1. Completion of Quality of Life Survey/questionnaire
      2. Determination of goals of ITB treatment
      3. ITB education
  2. Screening Trial: A test dose of baclofen is given via lumbar puncture or via a catheter into the spinal canal for observation and evaluation of the effect of intrathecal baclofen on the individual. The trial is usually done as a day surgery procedure. If a continuous catheter trial is needed, your child will be admitted in the hospital for about 3-5 days.
  3. Clinic visit with your PM&R doctor and Neurosurgeon to discuss decisions regarding baclofen pump system implantation and surgery date if all are in agreement to go forward with ITB pump placement.
  4. ITB pump implantation: Your child will be admitted for 3-5 days for ITB pump placement and initial pump dose adjustments prior to going home. Wheelchair adjustments, physical therapy, and ITB education will be done during this hospitalization.
  5. Subsequent follow-up in clinic will be schedule with Neurosurgery immediately after surgery and with the PM&R service for ongoing ITB pump adjustments and refills.