The patient was a full-term baby. The doctors identified through ultrasound that the child had an…

The patient was a full-term baby. The doctors identified through ultrasound that the child had an unusually large head and were expecting problems. At birth, they had placed the child in the neonatal intensive care unit (NICU) and obtained CT scans of his head. It had been identified that he did not have closure of his lateral and third ventricles. Their prognosis had been that the child would die within days after birth. They had encouraged the family to take him home and spend as much time with him as they had before his death. One author of this chapter was called in to help colleagues
View complete question The patient was a full-term baby. The doctors identified through ultrasound that the child had an unusually large head and were expecting problems. At birth, they had placed the child in the neonatal intensive care unit (NICU) and obtained CT scans of his head. It had been identified that he did not have closure of his lateral and third ventricles. Their prognosis had been that the child would die within days after birth. They had encouraged the family to take him home and spend as much time with him as they had before his death. One author of this chapter was called in to help colleagues establish realistic expectations and treatment protocols for this child. The child was 18 months of age at the time of this therapists first visit. The childs motor development was very delayed owing to the large size of his head (hydrocephaly). He was also nonverbal, and the doctors had concluded that he had an extremely low level of intelligence. He had loving parents who played with him, fed him, bathed him, and interacted with him all day. They felt he had more ability than the pediatrician had stated. This video case study illustrates a situation in which there is a mismatch between the medical diagnosis/medical imaging results and what the client presents in terms of function and movement. This case will engage and guide the therapist in a clinical decision-making process of analyzing the clients movement and functional capabilities and relating those to the integrity of the specific areas of the nervous system that are responsible for the movement or behavior. It is recommended that the reader first look at and analyze the motor function of this child at 18 months and then 6 months later, looking specifically for increased motor function and potential. During the interim, the child did receive weekly therapy, but most of the practice was done at home with the parents interacting with the child. Analyze the movement from a motor learning and neuroplasticity perspective as you determine the potential for motor control. Then look at the MRI images that lead the doctors to diagnosis the medical problem and the prognosis of death. Then ask yourself what could be happening to cause such a mismatch between a movement and a medical diagnosis? Note: The continuation of the case, including the video clips and imaging results, can be found on the companion website.

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