Pediatric Therapy Services: Two Examples of a Discipline That Knows No Bounds

Specialized pediatric therapy services are constantly evolving to expand and complement the treatment mix for young people striving to overcome chronic medical challenges.

The rehabilitation specialists with Cleveland Clinic Children’s Therapy Services recently introduced two innovative therapy services that they believe are worthy of greater awareness and consideration for appropriate pediatric patients. The fact that both happen to involve auditory interventions speaks to how refined and specialized the proliferation of new offerings has made the discipline of pediatric therapy services in recent years.

Interactive Metronome

Interactive Metronome® is a research-based training program designed to help children and adults overcome limitations in attention, memory and coordination.

This computer-based intervention directs patients to perform 13 different repetitive hand and foot movements to a rhythmic beat. Audible tones provide immediate feedback on how well each movement is in sync with the rhythm. These efforts to keep the beat train the brain to plan, sequence and process more effectively. The aim is to improve timing, attention and coordination in children with impairments in:

• Cognitive abilities
• Speech and language
• Social-behavioral skills
• Motor skills
• Sensory processing and integration

Treatment typically requires at least 12 to 15 one-hour sessions with an occupational therapist over several weeks.

Therapeutic listening

Therapeutic listening is an evidence-based auditory intervention to support individuals who face challenges with sensory processing dysfunction, listening, attention and communication.

The approach uses music and rhythmic sound patterns to stimulate brain regions used in listening and processing sensory information. These techniques are combined with movement and core-strengthening exercises to help patients improve:

• Focus and attention
• Praxis, motor planning and fine motor skills (including handwriting)
• Response to sounds and verbal directions
• Eating and sleeping patterns
• Social skills and communication
• Mood and energy regulation
• Sensory defensive behaviors
• Anxiety

Music and sounds are customized to each child’s individual needs with input from parents/guardians. Treatment is administered by occupational therapists over a period from eight weeks to several months.

Other services of note

Beyond these spotlighted offerings, the more than 125 therapists (occupational, physical, speech-language and recreational) who make up Cleveland Clinic Children’s Therapy Services offer dozens of other interventions to patients from infancy through age 21.

The services are provided at six locations across Northeast Ohio for patients with serious injuries, developmental delays, learning difficulties, challenges with ADLs, and other chronic or acute conditions that affect development. A team of specialists evaluates each patient and custom-designs treatment to help increase the child’s functional abilities and independence.

Among the therapists’ other notable service offerings:

• Constraint-induced movement therapy, which involves three five-day weeks of intensive outpatient occupational therapy for upper extremity rehab in children with neuromotor impairments
• Torticollis therapy, in which parents of infants are trained by physical therapists in how to do tailored positioning, rotating and reaching exercises with their child at home
• Concussion evaluation and treatment, which comprehensively addresses cognitive and executive function to devise a treatment plan and target individual deficits
• Lymphedema treatment, which features complete decongestive therapy, age-appropriate home programs and patient/caregive education for children with primary or secondary lymphedema
• Universal Exercise Unit (“Spider Cage”), a system of pulleys and straps (see photo at top of post) used to improve strength, range of motion and flexibility in children with neurological disorders and developmental delays

A fuller range of interventions offered by Cleveland Clinic Children’s Therapy Services is detailed at clevelandclinicchildrens.org/therapyservices.