PHYSICAL, OCCUPATIONAL, RECREATIONAL, AND SPEECH THERAPY

Since every child's needs are different after a brain injury, your child's OT/PT/Speech, etc. will probably be different than Jacob's. They individualize the therapy to meet each child's particular needs. This is a small part of Jacob's experience with these therapies. Maybe this can at least give you some idea of what to expect with these therapies. 

Jacob received Occupational, Physical, Speech and Recreational therapies. He also had special school while on the rehab unit. They have a teacher from the Columbus school system work with the kids. 

During his stay at the Children's Hospital Rehab Unit, all therapists worked together. OT/PT started with Jacob right away. While he was still in ICU they came and evaluated him and did Range of Motion exercises daily. They continued to work together after he was transferred to the rehab unit. They did several different things with Jacob, the first of which was to just get him to the point of being able to balance himself enough to sit on the edge of the bed. They worked with him together for quite awhile. They did balancing, walking, coordination. Finally Jacob was able to walk with close supervision and a gait belt due to extreme impulsivity. He had no understanding of danger. He also had what is called a Vail Bed because of his lack of understanding of danger. It's a bed with a net all around it that zips from the outside. This was so Jacob would not dive out of the bed headfirst, which he did try several times because of the impulsivity.

The speech therapist also started with Jacob immediately. The first concern was swallowing. She went with him for swallow studies, which helped determine what was safe for him to swallow. She also worked with him on communication. Jacob could not communicate for quite a while. She would bring in things to help him. Once was a little device that had red and green buttons. Red for "NO", green for "YES".  Jacob was unable to be very cooperative at this point, (because of the agitation from the injury) so the answering device and other communication board was of little use to him. She also brought him an electric toothbrush for oral stimulation. Stephanie and Jacob worked a lot on his memory and cognition. A LOT on memory. I could write all day on the work they did for his memory problems and cognition. Jacob had 1/2 hr Speech sessions up to three times a day. Speech therapy was a very big part of his rehabilitation. There was a memory book in which he was to write all activities he had done throughout the day, tons of memory games, and constant orientation to where he was, what day it was...most of which had no meaning to him until near the end of his hospital stay.

Occupational Therapy was concerned with ADL's (Activities of Daily Living). He and Karen worked on him dressing himself, brushing his own teeth with a special suction toothbrush, brushing his own hair, etc. Eventually, after he had mastered those things, she was able to move onto working on his writing and activities involving fine motor skills. And during every therapy session she somehow always incorporated some type of cognition/memory activity. Once again the constant orientation as to where he was and what day/month/year it was.

Physical Therapy is concerned with ambulation to whatever the ability of the child and muscle strength and tone. Jacob used several different devices for ambulation. He used a wheelchair, a walker for a short time, a tricycle with a safety belt and foot straps, and a gait belt, among some others that I'm probably forgetting! Once Jacob was able to walk on his own with a gait belt, Jennifer was able to work on high-level balance issues, endurance and coordination, etc.  Kristen and Jennifer also both worked on the memory/cognition activities during each therapy session. By the end of his stay on the rehab unit, Jacob was doing a lot of walking on the treadmill to build endurance! Walking the treadmill was his least favorite thing to do!

Recreational Therapy was the most memorable for Jacob of his hospital stay! As much as he loved all his therapists, Jacob seemed to bond with Todd. Recreational therapy is concerned with social/leisure activities. He got to go on field trips to the mall and Wendy's, and play basketball on the special playground on the roof with Todd. Todd also took Jacob swimming. Dad went on that field trip! He also worked on re-teaching Jacob safety issues. They worked on Stranger Danger, Street Safety, Water Safety, etc. They also had group therapy everyday where most kids on the rehab unit were together doing a project. It may have been making clay or making pizza, but most importantly they were socially interacting. Mostly Jacob did not participate socially in the beginning, but this is a very important part of rehabilitation. Social interaction is very important. It may sound like a lot of "off time" play, but there is a lot of important therapy involved. Everything they did had a reason. Whether Todd was just sitting down playing a game of Trouble with Jacob or taking him out into the public, it was therapy. And along with all the other therapists, Todd also worked on the cognition/memory/orientation.

Rehab School started soon after he went to the unit. At first Jayne would read to Jacob and see if he was able to follow or listen. He was eventually able to move onto re-learning 1 digit addition, 1st grade reading, and simple spelling words. Jayne made Jacob a "STAR" chart everyday! He has papers she made that tell what he did in school each day he was there. One says, "Jacob listened very well today." and has a big star on it! Another says, "Jacob read 7 words today." She too, worked on the memory/cognition/orientation issues.

And we had the Rehab nurses. They are also very involved in the rehab process. Our nurse would help me with bathing Jacob in the evenings. She would stop me when I tried to do something for Jacob, instead encouraging him to do it on his own! They came and offered to sit with Jacob while I took a break. And some would just come and sit with me. There were nurses who sat with me in the wee hours of the night while I cried and wished my baby back. It meant a lot to have them there. To not feel so alone.

We also had a very special woman who helped with insurance issues. We had a wonderful psychologist who helped with our own grieving and feelings of despair. She also came in on her days off to talk with my older son about the accident. That helped him so much. We had great Rehab doctors and a very special Resident doctor, and a wonderful social worker who did all kinds of things for us. And many, many other people who all contributed to our son's well-being and recovery.

It takes some very special people to be able to do the jobs these people do. The caring, patience, and compassion is evident in everything they do, not only for the children but also for the parents and families. I can't say enough good about these people. I feel very blessed to have had each one of them work with my son. Without them he would not be where he is today.

Kim, Jacob's mom