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Therapy for a Child with Hydranencephaly

For children with Hydranencephaly, the main purposes of Physical Therapy are:

  1. to maintain or improve function of all limbs
  2. to prevent deformities and contractures
  3. and to help your child be as comfortable as possible.
  4. to help them learn to play and have fun

What Physical Therapy Looks like in a child with Hydranencephaly:

Physical Therapy (PT, or Physio) in a child with Hydranencephaly will have a number of components.

  1. preventing deformities by doing range of motion exercises (called stretches or ROM).
  2. using splints, braces, etc to maintain a good position in each of the limbs.
  3. teaching you how to position your child to prevent deformities and to maximize comfort. This is done using a wide variety of pieces of equipment.
  4. Using different methods such as hydrotherapy, Hippo Therapy (Horse back riding), massage to relax tight muscles and improve function
  5. Using medications to reduce spasticity
  6. Surgery to prevent or repair damage from the spasticity.

To do that, many different strategies can be used, including both treatment and positioning. In this section are some suggestions based on the experiences of families including treatments and equipment used.


Neuro-developmental Treatment is the form of therapy most often used for our children.

Physical therapy: NDT-trained (neuro-developmental treatment), for gross motor skills. Considered one of the mainstay therapies for cp, it is used to decrease spasticity, strengthen underlying muscles, and teach proper or functional motor patterns. A good PT will also teach the family/care-givers how to help the person with cp to help themselves.

What is Neuro-Developmental Treatment?
Neuro-Developmental Treatment (NDT) is a therapeutic approach used in working with people who have central nervous system insult that create difficulties in controlling movement. Berta and Karel Bobath of London, England, a therapist/physician team, developed the NDT approach in the 1940ís. Originally working with children with cerebral palsy and adults with stroke, they believed in treating the many complex problems with control of movement caused by central nervous system insult. Persons having minimal to severe motor difficulties can benefit from the Neuro-Developmental Treatment approach.

Theory of Neuro-Developmental Treatment
While the practice of the NDT approach is supported by research in the movement sciences and psychology, the understanding of how and why Neuro-Developmental Treatment works is constantly updated and refined. As the understanding in the sciences changes, NDT theory is modified and enhanced. There are currently four broad statements of belief in NDT theory:

        A personís ability to function is a result of their many body systems working together smoothly and efficiently. Additionally, parts of those systems such as a muscle, sensory process or respiratory pattern assist with the movements in the personís unique daily environment.

        Those who use the NDT approach base efficient movement on the study of motor control, motor development and motor learning. There are consistent ways that people learn and lose motor skills throughout their lives. This can be studied and compared to people who have movement problems that interfere with learning motor skills.

        People with central nervous system insult exhibit some predictable difficulties with their movement that results in loss of function.

        Treatment begins with an assessment of the personís functional performance. It then focuses on building the personís abilities while addressing the movement problems. The goal of NDT is to help the person achieve functional skills by addressing movement difficulties.

The Practice of Neuro-Developmental Treatment
Therapists who use the NDT approach believe that early treatment can be instrumental to success. However, the approach also works with individuals who have long-term disabilities, but have the potential to gain new functional skills. To assist people in learning functional skills, the therapist first observes the movements the person can do. They then analyze the areas in which there are movement difficulties. The therapist observes the movement, often putting his/her hands on the person to feel how the person moves, i.e., what muscles are working and how they work. By guiding the correct movement with his/her hands on the person, the therapist often finds that more functional movements can begin.

Guidance is removed as the person is able to perform the skill more independently and efficiently. Carefully planned verbal instructions or other forms of guidance may be used by the therapist to help people learn new skills.

In addition to this direct treatment, therapists who use the NDT approach believe that the person being treated is best served by a team. This could include their family, physicians, other therapists, teachers, nurses, orthotists or others.

Neuro-Developmental Treatment Association
1550 South Coast Hwy., Suite 201
Laguna Beach, CA 92651
800/869-9295 begin_of_the_skype_highlighting FREE 800/869-9295 end_of_the_skype_highlighting
Fax: 949/376-3456

Other pages in this section:
Cerebral Palsy
Orthopedic Considerations
Medical Treatments for Spasticity

Orthopedic Surgery links and resources
Orthopedic Surgery Personal Experiences
Range of Motion Therapy
Other Types of Therapy

Principals of Positioning
Positioning: Orthotics and Splints
Orthotics and Splints Experiences

Alternate Positioning

Personal Care: Practical Information
Practical Care: Transportation
Practical Care: Carrying and Lifting
Sleeping Medications



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August 16, 2001- January 12, 2005

This website is funded in loving memory of Jason S. by his mother Kammy

The information on this site is provided by families, caregivers, and professionals who are or have been caring for a child with Hydranencephaly.

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