Impact of early rehabilitation on the outcome of a chronic disease in children

Abstract

Djecu rođenu s neurorizicima i djecu koja se ne razvijaju po očekivanim psihosocijalnim i neuromotornim obrascima treba uključiti u ranu intervenciju i rehabilitaciju. Nakon otpusta iz rodilišta djece s neurorizicima, neonatolog upoznaje roditelje s mogućnostima rane intervencije i rehabilitacije u mjestu stanovanja ili najbližem rehabilitacijskom centru. U Republici Hrvatskoj ne postoje standardizirani instrumenti i protokoli probira za odstupanja u psihosocijalnom i neuromotornom razvoju djece, što uvelike otežava rad pedijatrima u primarnoj zdravstvenoj zaštiti. Pedijatrijskim praćenjem psihosocijalnoga i neuromotornoga razvoja djece trebalo bi otkriti djecu koja se ne razvijaju po očekivanim obrascima. Djecu s neujednačenim neuromotornim i psihosocijalnim razvojem treba uključiti u ranu intervenciju i rehabilitaciju. U Udruzi za pomoć osobama s mentalnom retardacijom Đakovo (Udruga) koristimo razvojne probire prema Münchener Funktionelle Entwicklungsdiagnostik (MFED) i Guide for Monitoring Child Development (GMCD). Oba probira provode se do kraja treće godine života djeteta. Udruga provodi razvojnu neuromotornu rehabilitaciju po Vojti i Bobathu. Za ranu intervenciju i psihosocijalnu rehabilitaciju postoje educirani timovi. Timovi za psihosocijalnu rehabilitaciju i ranu intervenciju rade s djecom i njihovim roditeljima u kući i individualno u prostorima Udruge. Uz pomoć razvojnih probira MFED-a i GMCD-a te razgovorom s roditeljima kontrolira se napredak djece u neuromotornom i psihosocijalnom razvoju.Children born with neurorisks and children who do not develop according to the expected psychosocial and neuromotor patterns should be included in an early intervention and rehabilitation scheme. As soon as babies at neurological risk are discharged from a maternity hospital, a neonatologist informs the parents about the possibilities of early intervention and rehabilitation in their place of living or the nearest rehabilitation center. In the Republic of Croatia there are no standard instruments or screening protocols for deviations in the psychosocial and neuromotor development of children, which greatly affects and complicates the work of pediatricians in primary health care. Monitoring the psychosocial and neuromotor development of children, pediatricians should detect children who show deviations from the expected patterns. Children who show inconsistent and uneven neuromotor and psychosocial development should be included in early intervention and rehabilitation. In the Association for Assistance to Mentally Disabled in Đakovo (hereinafter referred to as the “Association”) the following developmental diagnostic procedures are used: the Münchener Funktionelle Entwicklungsdiagnostik (MFED) and the Guide for Monitoring Child Development (GMCD). Both diagnostic procedures are being carried out until the child turns three. The Association offers and provides developmental neuromotor rehabilitation using the Bobath and the Vojta method. There are trained teams that are responsible for early intervention and providing psychosocial rehabilitation. Those teams work with children and their parents at their homes and individually at the premises of the Association. Correspondingly, by using the developmental diagnostic procedures MFED and GMCD, and by communicating with parents, the children’s progress in their neuromotor and psychosocial development is being successfully monitored