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Module 6

TRAINER GUIDE

Rehabilitation Techniques, Training and Health Care Systems


Editor Miguel Santos Authors Mintaze Kerem Gunel Akmer Mutlu zgn Kaya Kara Aye Livaneliolu

TURKEY

This project has been funded with support from the European Commission. This publication [communication] reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information contained therein.

TABLE OF CONTENTS
Training Module for Teachers and Parents Rehabilitation Techniques, Training And Health Care Systems
This training module was produced in the scope of CP-PACK project and in accordance with the Need Analysis Report derived from the results of the focus group interviews and questionnaires among parents and teachers of children with cerebral palsy. This module will give knowledge about the important issues within rehabilitation techniques, training and health care systems and will provide practical suggestions to be applied in daily life by parents and teachers of children with cerebral palsy (CP).
Subject of training module Target group(s) Goal(s) Rehabilitation techniques, training and health care systems Parents and teachers of children with CP 03-18 years of age. This module aimed to give knowledge about the important issues within rehabilitation techniques, training and health care systems and will provide practical suggestions to be applied in daily life by parents and teachers of children with cerebral palsy (CP) at 03-18 years of age. In the end of the training module the trainees will be expected to: Comprehend actual state of art and newest theories on rehabilitation techniques, training and health care systems; Know appropriate establishments, systems and methods of training and rehabilitation children, according to specific country conditions; Implement rehabilitation techniques at home, in school and in social life according to the childs needs and impairments; Motivate the child with CP during the process of care, treatment, therapy, education and participation in social life Content Time Needed 1. Basic concepts of rehabilitation approaches Accompanying conditions (oral motor, low vision, speech and communication problems, cognitive, sensorial problems and so on) Intensity, repetition, activity and active participation of the child 5 hrs Individual problem solving Physiotherapy - when, why, how? Occupational therapy - when, why, how? Medical and surgical treatment for muscle tone

Learning Outcome(s)

Contents (General and/or Detailed)

2. Training Approaches Training approaches for cognitive, perceptual, speech, oral motor problems of children. Increase of physical fitness and endurance (Strengthening programmes, neurodevelopmental therapy, treadmill training, lokomat, suit therapy, etc.) 2 hrs Goal directed therapy Home based/school based training program Handling and positioning the child for a specific task, or position (e.g. in a chair/ wheelchair). Virtual reality 3. Lifelong therapy Motivation in lifelong therapy ICFs activity and social participation according to age. Leisure and sport activities Finding relevant sports for the children/ 2,5 hrs which sport relevant for which child. The adaptation of children with CP to parents, teachers, peers, siblings (acceptance, inclusion, social participation, sharing) Integrating children to team sports HEALTH CARE SYSTEM Training of how to cope with health care system: State of art 2,5 hrs Management of onset Multidisciplinary team for rehabilitation and their roles for the healthcare system Evaluation of Trainees Time Needed 13 hrs: module content +1 hr: evaluation, assessment / Total: 14 hrs Lecture by expert, interactive approach (practice illustrationsvideo, PowerPoint presentations, question-answer, case study, etc.), discussions, dramatizations. Discussion groups Relevant legislation in education policy may be put on the projects website to allow an individual learning. 1 hrs

Methodology

Assessment and evaluation plan (trainer/trainee and module)

Evaluation through questionnaires, checklists and self-assessment at the end of the training course. Application of pre-test and post-test questionnaires such as Likert or ordinal scales shall be used in order to address the following parameters: Measurement of awareness before and aftertraining Measurements of knowledge before and aftertraining Measurement of satisfaction about the modules Taking the parental comments for our next step Handouts of papers and PowerPoint presentations, prepared scenarios for the case studies and problem based learning, website links, references. A meeting room/conference room during the lectures/presentations, as well as appropriate spaces for group work, case studies, workshops, drama, etc. Also, a projector connected to a pc, a screen, and a flip chart and internet access. Where needed there must be extra PC with internet access, video and audio-visual equipment, board and/or special equipment/assistive devices. Trainers should be physiotherapists/ occupational therapists.

Supporting training material needed

Educational Environment

Qualities of Trainer(s)

Chapter 1
Basic Concepts of Rehabilitation Approaches
Duration: 5 hrs

Learning Outcomes
1. In the end of the session, parents and teacher will:Learn and increase their awareness about the accompanying conditions of children with CP during the interaction with the child.Acquire knowledge about the concept of intensity and repetition of rehabilitation approaches as well as the importance of the active participation of the child in that rehabilitation and its contribution to the development of the child..Learn and increase their awareness about individual problems of the each child and the importance of receiving professional support. Learn and increase their awareness about who a physiotherapist is, the content and extent of physiotherapy and the referal of the child to physiotherapy Learn and increase their awareness of who an occupational therapist is, the content and extent of occupational therapy and the referal of the child to occupational therapy. 2. Learn and increase their knowledge about the recent medical and surgical interventions for muscle tone of children with CP.

Methodology
Interactive education (brainstorming, questions & answers, lecture, demonstrations by a maquette, for further information, look at the Training Booklet)

Supplementary Training Materials


Projector,Laptop, Dvd-player, Screen, Boards, Some paper and pens A maquette baby and some occupational and physiotherapy therapy materials such as chairs, pillows, etc.

Feedback on the Chapter


What are the accompanying problems that may occur in children with CP? Which accompanying problems do you think that your child/student have? What did we learn about intensity and repetition of rehabilitation approaches? 5

What do we mean by active participation of the child? How can individual problem solving contribute to us? Who is a physiotherapist? Physiotherapy when? Physiotherapy why? Physiotherapy how? Who is an occupational therapist? Occupational therapy when? Occupational therapy why? Occupational therapy how? When do you think surgery is needed for children with CP? When do you think that is necessary to apply botulinum toxin for children with CP?

Suggested Reading
Children with Cerebral Palsy: A Parents Guide , Elaine Geralis -Editor), 1998, 2nd Edition. Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers, Author-Archie Hinchcliffe, 2007. http://www.cerebralpalsysource.com/Treatment_and_Therapy/ http://cerebralpalsy.org/about-cerebral-palsy/therapies/ http://www.treatmentofcerebralpalsy.com

Chapter 2
Duration: 2 hrs

Training Approaches

Learning Outcomes
1. In the end of the session, parents and teacher will:Learn and increase their awareness about training approaches for accompanying conditions such as cognitive, perceptual, speech, oral motor problems of children with CP 2. Learn and increase their knowledge about the basic and supportive therapy technique approaches for supporting the neuromotor development of the child. 3. Learn concepts of appropriate positioning during daily life in school, at home, etc. and creating the behavioral changes related to positioning.

Methodology
Interactive education (questions & answers, lecture, demonstration) for further information, look at the Training Booklet

Supplementary Training Materials


Projector, Laptop, Dvd-player, Screen, Boards, Some paper and pens

Feedback on the Chapter


What oral-motor problems may occur in your child? How can we understand that your child needs speech therapy? Which therapy techniques does your child take or need? Which positioning and handling methods can you use for your child in school and at home? What is handling?

Suggested Reading
Children with Cerebral Palsy: A Parents Guide , Elaine Geralis -Editor), 1998, 2nd Edition. Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers, Author-Archie Hinchcliffe, 2007. http://www.cerebralpalsysource.com/Treatment_and_Therapy/ http://cerebralpalsy.org/about-cerebral-palsy/therapies/ http://www.treatmentofcerebralpalsy.com 7

Chapter 3
Lifelong Therapy
Duration: 2,5 hrs

Learning Outcomes
In the end of the session, parents and teachers will learn and increase their awareness about lifelong living with CP.

Methodology
Interactive education (questions & answers, lecture, demonstration) for further information, look at the Training Booklet

Supplementary Training Materials


Projector, Laptop, Dvd-player, Screen, Boards, Some paper and pens

Feedback on the Chapter


What is the relationship between lifelong therapy and CP?

Suggested Reading
Children with Cerebral Palsy: A Parents Guide , Elaine Geralis -Editor), 1998, 2nd Edition. Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers, Author-Archie Hinchcliffe, 2007. http://www.cerebralpalsysource.com/Treatment_and_Therapy/ http://cerebralpalsy.org/about-cerebral-palsy/therapies/ http://www.treatmentofcerebralpalsy.com

Chapter 4
Health Care System
Duration: 2,5 hrs

Learning Outcomes
In the end of the session parents and teachers will learn and increase their awareness about the facilities and supports of the health care system for their children and for themselves as well as the health professional team and their roles in rehabilitation.

Methodology
Interactive education (questions & answers, lecture, demonstration) for further information, look at the Training Booklet

Supplementary Training Materials


Projector, Laptop, Dvd-player, Screen, Boards, Some paper and pens

Feedback on the Chapter


Which health professionals are required in following up your child? Who are the members of the rehabilitation team?

Suggested Reading
Children with Cerebral Palsy: A Parents Guide, Elaine Geralis -Editor), 1998, 2nd Edition. Children With Cerebral Palsy: A Manual for Therapists, Parents and Community Workers, Author-Archie Hinchcliffe, 2007. http://www.cerebralpalsysource.com/Treatment_and_Therapy/ http://cerebralpalsy.org/about-cerebral-palsy/therapies/ http://www.treatmentofcerebralpalsy.com

References
http://www.cerebralpalsysource.com/Treatment_and_Therapy/ http://cerebralpalsy.org/about-cerebral-palsy/therapies/ http://www.treatmentofcerebralpalsy.com Kerem Gunel M. (2009) The view on pediatric rehabilitation with the title of cerebral palsy from the perspective of a physiotherapist, Acta Ortopaedica Et Traumatologia Turcica, 43(2):173-181. Papavasiliou, A.S. (2009) Management of motor problems in cerebral palsy: a critical update for the clinician. European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society, 13 (5), 387-396. Himpens, E., Van den Broeck, C., Oostra, A., Calders, P.,Vanhaesebrouck, P. (2008) Prevalence, type, distribution, and severity of cerebral palsy in relation to gestational age: a meta-analytic review. Developmental medicine and child neurology, 50 (5), 334-340. Versaw, D., Wood, B.,Wood, A. (2008). The Infant at high risk for developmental delay. J. Tecklin (Ed.). Pediatric Physical Therapy. Philadelphia: Lippincott Williams & Wilkins

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