Since 1989, the interdisciplinary Pediatric NeuroRehabilitation Program at Milestones has promoted recovery from complex injury or disease that affects the central nervous system. As part of the Department of Physical Medicine and Rehabilitation, the Pediatric NeuroRehabilitation Program provides a transition from the medically focused inpatient hospitalization to the longer term phase of treatment in which children and adolescents return to more familiar routines and activities. Our program philosophy is to partner with patients and families to promote innovative and creative pathways to full participation in home, school, and community-based activities.

Patients who typically benefit from a neuro-rehabilitation program may have one of the following diagnoses:

  • Traumatic and Acquired Brain Injury
  • Spinal Cord Injury
  • Infections of the Brain such as Encephalitis
  • Stroke
  • Seizure Disorder
  • Amputation 
  • Pediatric Cancers (e.g. leukemia, brain tumor)
  • Late effects of cancer treatment (e.g. radiation, chemotherapy)
  • Other Neurological Conditions (nervous system related)

For children with complex rehabilitation needs, the coordinated work of the family and the treatment team is the most effective means of promoting recovery and adaptation to changes resulting from an injury or illness. The Pediatric NeuroRehabilitation team includes the following health care professionals:

Program Case Manager
The Case Manager will help your family plan your child’s therapy program after you leave the hospital. She assists in finalizing the treatment schedule, communicating with your physicians and identifying ways to obtain special equipment and transportation services that may be needed. The Case Manager is available to assist you as you transition to the outpatient therapy program and to facilitate your ability to navigate the University of Michigan Health care system. She is a great resource for your questions and concerns as your child progresses through the Pediatric NeuroRehabilitation Program.

Occupational Therapists (OT)
Occupational Therapists work with patients to recover loss of function (skill remediation) and to learn new skills and ways to adapt to injury or illness (compensatory strategies).  This perspective encompasses all aspects of an individual’s life, including activities of daily living such as self-care, home management, rest and sleep habits, work demands, play, leisure, and social participation.  

Physical Therapists (PT)
Physical Therapists work with patients to improve a person’s strength, balance, and coordination in order to restore mobility and independence with daily tasks. Physical therapists teach clients to manage their condition in order to achieve long term-health benefits.

Rehabilitation Psychologists / Neuropsychologists (RPN)
It is common for children to experience physical discomfort, cognitive fatigue, and emotional distress related to the challenges associated with recovering from injury or illness and efforts to return to more typical activities. RPN works with patients and families as they adjust to the experiences of rehabilitation and cope with injury or loss of functioning.

Speech-Language Pathologists (SLP)
Speech-Language Pathologists assess and treat patients who are experiencing difficulty with communication or swallowing (dysphagia). Communication skills include understanding spoken and written language (i.e.reading comprehension) as well as communicating one’s thoughts through words, writing or alternate methods. Devising strategies to improve the cognitive/memory processes that underlie communication is also a core aspect of speech-language therapy.

Teacher
The Educational Specialist is a teacher with special education certification.  She meets with families to explain the educational consequences of brain injury and provides information on educational options, including special education services. She may complete academic assessment and works with your child to determine academic strengths and weaknesses. The program teacher serves as a liaison to local school districts and will participate in IEP meetings to assist in identifying appropriate educational services as well as to advocate for your child’s successful return to school.

Recreational Therapist
The Recreational Therapist evaluates children to improve or maintain their physical, cognitive, social and emotional functioning in order to facilitate full participation in age-appropriate activities. Therapeutic Recreation may include community outings, enrichment programming (for example, participation in sponsored bowling or tree-climbing groups) and discovering ways to adapt sports activities to a child’s current abilities.

Art Therapist
Art therapy allows children to tap into their natural skills, using their imagination and creativity for enhanced coping, stress management and self-expression. Children and teens can express themselves through drawing, sculpting, photography and many other art styles and materials. Sessions are tailored to individual needs. Program Art Therapists work with patients on a one to one basis by staff referral or on family’s request.

Rehabilitation Engineering (by consultation)
Rehabilitation Engineering is committed to improving the lives of children through the use of technology and engineering accommodations that promote improved function, performance and independence. Rehabilitation engineers may complete a technology assessment that allows children to try out various assistive technology devices, programs as well as techniques to improve independence. 

Consultation with referring physicians 
Most children in the NeuroRehabilitation program are followed by a Physiatrist in the UMHS Department of Physical Medicine and Rehabilitation, although we routinely work with outside providers as well. We work closely with the referring physicians to develop and refine the plan of care, including recommendations for equipment and therapy services.

How to Refer

For more information, please contact Diane DeVoogd at ddevoogd@umich.edu

What to Expect

When a child or adolescent is referred by a physician, the referral is received by the Program Case Manager. She will contact the child’s parent or guardian to provide information on the program, scheduling, and insurance coverage. A schedule is developed and the Case Manager or one of the program therapists will be available to meet you and your child during your first visit. Therapists will review past records and will complete an evaluation. The goals identified by you and your child will be shared with all treatment team members. After the evaluation is complete, you will be invited to meet with the team during their initial staffing meeting, when evaluation results are reviewed and the treatment plan is discussed.  Team meetings occur monthly and include the family, child (as appropriate) and staff to review, discuss, and update the treatment plan.

For a picture book about what to expect when coming to the NeuroRehabilitation Program, please click here!

Treatment

One of the primary challenges of any therapy program is to assist the patient in transferring skills from the therapy room into everyday life. Our treatment plans focus on creative, functional ways to reach therapeutic goals. In addition to individual treatment sessions, your child’s treatment program may include group therapy experiences.  Groups are formed based on patient needs and have included activities such as therapeutic horseback riding, creative coping, aquatic fitness, study skills, video journalism, therapeutic yoga, photography, and adaptive sports. 

Advanced Rehabilitation Technology

In the Pediatric NeuroRehabilitation Program, we utilize evidence-based practice guidelines with state-of-the-art technology to promote recovery. Many of our children and adolescents use technologically-driven devices in clinical therapies, including the Lokomat®, Bioness H200 ®,Walk Aide®, RTI Bike t®, and a variety of augmentative communication devices, including eye-gaze devices. We also consult with Rehabilitation Engineering to ensure that a patient receives the most appropriate and current access to rehabilitation technology.

Parent Family Advisory Committee (PFAC)

The Pediatric NeuroRehabilitation Program is housed at Milestones, and several of our families have served on the Milestones Parent Family Advisory Committee (PFAC). The PFAC is comprised of family members, former patients, faculty, and staff who meet monthly to identify and implement strategies to better meet patient and family needs in our therapy programs. 

Several initiative of the Milestones PFAC have focused on more accessible information and resources for patients and families who are navigating the rehabilitation experience. One such resource appears here:

Glossary

Often times you will hear team members use words that may not be familiar to you. To help make your time with us more meaningful, please click here for a complete list. If you have any questions, please be sure to ask a team member.

Recovery from a complex injury or illness is a journey of challenge, courage, and profound achievement. The faculty and staff of the Pediatric NeuroRehabilitation Program are honored to share this journey with our children, adolescents, and their families.