Pediatric Neurodevelopmental Treatment and Physical Therapy

When developing a treatment plan for neurological disorders, there are many facets of treatment that are utilized to address the different challenges a patient may face. Cerebral palsy and stroke patients commonly face issues in relation to movement disorders or dysfunctions.  Neurodevelopmental treatment (NDT) has become a common treatment to help address this by working with pediatric patients to improve their movement patterns, posture, and overall mobility.

What is NDT?

Neurodevelopmental treatment (NDT) is used by therapists in a wide array of specialties such as physical, occupational, and speech therapies. This hands-on treatment approach aims to build up function for those that have difficulties with neurological tasks that stem from conditions such as cerebral palsy, head injuries, and stroke. The basis of treatment is to address motor-based difficulties by using guided movements to help correlate that particular movement with receptors to bridge a pattern that becomes hard-wired in the brain.  This method relies on the brain’s inherent plasticity to create neural pathways that can make repeated actions or behaviors second nature. In addition to just a pure focus on movement, NDT also takes a holistic approach by incorporating the use of movement to better the patient’s quality of life and increase their overall ability to translate movements into functions they will use on a daily basis.

History

The NDT treatment method was created in 1948 by Berta and Karel Bobath. For this reason, NDT Is often also referred to as the Bobath Method. Berta, a physical therapist, and Karel, a psychologist, and neurophysiologist, had first worked with children who were diagnosed with Cerebral Palsy (CP). During this time, the standard treatments to treat CP in children often included more passive approaches such as stretching, as well as more invasive treatments such as the use of braces and even surgery. The Bobath method, however, felt that much of the problem stemmed from a lack of control in posture and difficulty with movements.  They suggested that patients could be reeducated if the condition was caught early and addressed in a way where the patient learns movements that work best for them despite whatever physical challenges they struggle with. The aim was not necessarily to make the movements universally natural, but to provide a safe and effective arsenal of movement patterns that allow for compensations that work for the individual patient.

How NDT Works

NDT is considered a problem-solving technique in that each case is considered unique and the therapist will tailor the treatment method to the individual needs of the patient. They do this by first performing a full assessment to pinpoint areas that need guidance, and they usually focus on posture and basic movements before moving into more advanced techniques that aim at improving spasticity. NDT-trained therapists are able to guide the patient by understanding the issues that they face, and then come up with treatment plans that will address the individual neuro-motor challenges of the patient.  This helps them work towards their peak functional capabilities and live as independently as possible.

The therapist will often work in collaboration with the patient’s family as well as other therapists and doctors to help create an optimal plan that addresses all aspects of the patient’s needs even beyond what is worked on in sessions. In fact, much like the work of occupational therapy, NDT does not focus just on the singular problem of movement but looks at how increased movement capabilities allow for the patient to further participate in life and tackle unique problems they may face that are not always universal issues. It is for this reason that NDT is considered a problem-solving approach because the movements taught may not always be the standard way a movement should be done. Instead, they are taught in a way that the movement can be completed by the patient with what limitations they have in addition to taking into account the individual struggles they must overcome in daily living.

What Can Be Expected of NDT Sessions?

NDT sessions can often look a lot like a typical physical therapy session in which the therapist is working on guided movements and assistance in various exercises. Since it is common for those with brain injuries to deal with diminished or limited patterns of movement, NDT focuses greatly on repetition so that the patient feels the experience of the movement and eventually is able to perform it as a natural function. The more the patients are performing these actions, the less strenuous they become, and their collection of movements will increase. Since therapists put a lot of focus on posture, core exercises are common, as well as stability guidance and working on individualized movements the patient will need for their personal movement skill set.

Why NDT is Especially Beneficial for Children

NDT can be helpful for patients of all ages that have been diagnosed with neurological disorders, but it can be especially helpful when working with children. This is because NDT treatments tend to be most successful with early intervention where the patient has yet to hardwire their patterns of movements fully. Once these movements have been set, new learning can be a bit less flexible and in turn more difficult to pick up and incorporate into the patient’s standard set of movements. This is not to say that there are no significant benefits for adults, but since children’s brains are still developing and can be more malleable, it does provide children a leg up in this type of treatment.

Another overall benefit for NDT in children is that the barrier of accessibility is lower than some other treatment methods that work with neurological disorders. NDT provides a wider benefit from many other forms of treatments for neurological disorders because it can provide benefits, regardless of severity. Many other treatment methods such as motor relearning and other more traditional treatments have proved to be the most useful for high functioning cases.

The NDT Approach with Solace

The physical, occupational, and speech therapists at Solace have been clinically trained in a variety of different approaches to treatment including NDT. At Solace, the goal for all of our patients is to provide quality, home-based treatment and guidance to the child that allows them to reach their full capabilities and live their best lives. The NDT approach not only provides results but the overall philosophy is harmonious to the core values of Solace in which each individual patient should have their needs addressed in a way that best works for them. This is why we believe in home-based learning because it has the patient thrive in a surrounding that provides them the most comfort and gives our therapists access into the child’s daily life to better incorporate treatment for their lifestyle. If you think that home-based Neurodevelopmental therapy may be helpful for your child, feel free to get in touch to request a referral.