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Said Fayed Rabah
Said Fayed Rabah

Said is 3-years-old child who suffers from Spastic Quadriplegia Cerebral Palsy. He was the first baby born to his parents after four years of marriage. The pregnancy was normal, but a complication of labor and delivery caused a lack of oxygen to the brain and resulted in said's spastic quadriplegia. It is a severe type of cerebral palsy in which all four limbs and the trunk are affected along with mental retardation and other problems such as speech difficulty.

PSCF team worked with the child and his family to identify the child’s needs and create an individualized treatment plan to help him reach his maximum potential. Treatment comprised both physiotherapy and occupational therapy. Therapy enhances motor skills (such as sitting and walking), improves muscle strength and helps prevent contractures (shortening of muscles that limits joint movement). The physiotherapy plan was aimed at easing spasticity and reducing abnormal movement. So far, the Physiotherapist implemented 18 sessions through which Said could improve head control in both, prone and supine positions and became able to sit for 15 to 20 minutes without his parents' assistance. Moreover, he could maintain full range of motion with no remarkable deformities. As well, his muscle power became good and he succeeded in doing weight-bearing in upper limbs, which is the first step towards creeping. Treatment will continue until the child reaches good creeping and crawling with improvements in the ability to sit, stand and walk using walker or positioning devices. It is worth noting here that Said's father does not accept his son's disability and so, he is ready to do him any surgery to make him walk and stands independently. Although this procedure may permanently reduce spasticity and improve the ability to sit, stands and walk, exaggerated care is not appreciated especially that surgical technique - usually done when a child is between 2 and 7 - is recommend by doctors only for children with severe leg spasticity who have not responded well to other treatments.

The Occupational Therapist worked with Said on skills required for daily living, including feeding and self expression in special cases. Because Said has speech problems, the occupational therapist referred him to a speech therapist who thought him how to express his need to urinate or defecate; he can call his mother. In addition, after twelve OT sessions conducted so far, Said can now eat a sandwich by himself, he plays with his hands and he draws unorganized lines and circles with a pencil.

According to the therapists' recommendations, Said may benefit from mechanical aids such as walkers, positioning devices to allow correct standing; however, since CP is a life-long condition that is not correctable, management includes focusing on preventing or minimizing deformities and maximizing the child's capabilities at home and in the community. Positive reinforcement will encourage the child to strengthen his self-esteem and promote as much independence as possible.

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