newsletter february 2009 - sandta · south african neurodevelopmental therapy association...

SOUTH AFRICAN NEURODEVELOPMENTAL THERAPY ASSOCIATION NEWSLETTER

THE NEC Chairperson: Faatima Ebrahim-Abbas 082 3626045 [email protected] Vice Chairperson & Adult Liaison: Nina Strydom 084 5661281 [email protected] Treasurer: Sonja Berry 082 297 1519 [email protected] Secretary: Elmien van den Heever 082 3369643 [email protected] Professional & Public Relations: VACANT AT PRESENT Website: Shelley Broughton 031 7081785 824123310 [email protected] Newsletter: Eunice König O21 7946903 082 927 7776 [email protected] Education: Corneli Strydom 082 950 4289 [email protected] Branch Liaison Jenny Bradshaw 083 7751995 [email protected]

Newsletter February 2009

CONTENTS

Effect of a Supination Splint on Upper Limb Function of Children with Cerebral Palsy Following Injection with Botulinum Toxin A Madalene Delgado .......................................................2 Play as a Vehicle for Promoting Development In Children With Cerebral Palsy in a Poorly Resourced, Rural Community Marie Vorster………………….………............................8 Malamulele Outreach 2009..........................................12 CPD NEWS..................................................................13 SANDTA Courses........................................................14. INFORMATION NAPCP ANNUAL CONFERENCE.............................19 SOUTHERN AFRICAN NEUROLOGICAL REHABILITATION ASSOCIATION - Call for Abstracts..........................................................21 Branch News................................................................21 Job Adds......................................................................23 Branch & General Info.................................................24

SANDTA CONTACT DETAILS Address:

P.O. Box 39976

Queensburgh

4070

Cell: 076 374 6739

email: [email protected]

website: http://www.sandta.org.za

SOUTH AFRICAN NEURODEVELOPMENTAL THERAPY ASSOCIATION NEWSLETTER 2

Effect of a Supination Splint on Upper Limb Function of Children with Cerebral Palsy following Injection with Botulinum Toxin A

Madalene Delgado

Splints are used in the management of cerebral palsy, but are often static/rigid ones. Rigid splints are often poorly tolerated as they are uncomfortable to wear for long periods of time and they interfere with function as they prevent motion and limit sensation. This could also lead to further learned disuse of the affected arm. Rigid splints position the hand statically and limit the sensory feedback that occurs during normal use and movement. Thus the need to find a splint that would allow some movement while positioning the upper limb in the optimal position for function, namely the forearm midway between pronation and supination, the wrist in extension, the thumb in abduction and the digits in moderate flexion. This elastic supination splint gently pulls the arm into supination but it is still able to move within a prescribed range of both supination and pronation. This study was done to see if a functional improvement was noticed in the upper limb of children with cerebral palsy after Botulinum Toxin A and the use of a supination splint? Relevance of the Study

• To assess a treatment modality that improves upper limb function while allowing the child to participate in everyday activities

• To assess the efficacy of a management adjunct that is non-invasive, comfortable and easy to apply

• Help doctors and therapists in recommending a suitable therapy and management of cerebral palsy.

As the wide variation of motor and sensory deficits in cerebral palsy makes the selection of matched controls virtually impossible, a prospective Quasi experimental design was used where each subject acted as his own control. The data gathered before the intervention was used as a basis for comparison with the data collected for a six month period following the intervention. The study was done on 10 children who had been diagnosed with cerebral palsy, presenting with increased muscle tone in one of their upper limbs. Results were taken from 8 of these subjects as 2 dropped out during the study.

Sample Size


Methodology Inclusion Criteria included

• Children who were receiving regular therapy: occupational and/or physiotherapy at least once a week

• They needed to have been recommended by the treating occupational or physiotherapist and plastic surgeon.

• Children whose parents/caregivers were reported as being compliant. Exclusion Criteria included

• Children who had had previous Botox® in their upper limbs.

• Children who presented with fixed contractures Outcomes Measures

• Spasticity The Modified Ashworth Scale was used. It is a simple 6 point scale that quantifies the amount of muscle resistance felt while manually moving a limb through its full range of passive movement

• Joint Range of Movement Active & Passive range of movement was measured with a goniometer at the elbow, forearm, wrist and thumb CMC joints. Passive range of movement was measured by applying a 1kg external force. An adapted goniometer was used to measure forearm supination & pronation.

• The Quality of Upper Extremity Skills Test (QUEST) This is a standardised test that was developed to assess the qualitative components of movement in children who have a neuromotor dysfunction with spasticity. Quality of movement was assessed in three domains: dissociated movement, grasps, and weight bearing. These movements are part of normal development and are the basis for upper extremity function.

• Hand Function The hand function assessment was a non standardised assessment made up of a series of preset tasks that were based on modified play activities. It required the subjects to perform specific upper limb movements and their function was measured through clinical observations. The hand function test consisted of tasks such as threading beads, transferring tubes, turning play barrels over, cutting a piece of paper and carrying a plate. Intervention

• Botulinum Toxin A (Botox) Botox was injected according to child’s most affected muscles, but predominantly into biceps, pronator teres, flexor carpi ulnaris, flexor carpi radialis and thumb adductors. All the children had botox injected into their pronator teres & FCU.

• Home Programme A home programme was given to the parents. It consisted of massaging the injected muscles and stretching the affected joints. These exercises were based on Roods’ theory including stretch pressure, tendinous pressure, maintained stretch & myofascial release stretch techniques. They were instructed to do these exercises twice a day on application and removal of splint for approx 20mins each time

• Supination Splint The supination splint is a soft splint made out of Tensowrap fabrifoam. This is a soft breathable fabric as it wicks away perspiration, keeping the skin cool and dry and making it comfortable to wear. It allows some active movement while simultaneously positioning the


upper limb in the optimal position for function, which is the forearm midway between pronation and supination, the wrist in extension, the thumb in abduction. The supination splint is circumferential thus it provides neutral warmth and an even cutaneous pressure to the area of the skin that is covered by the splint.

The supination splint is applied by placing the child’s thumb through the splint’s sewn loop. It is then taken round to the dorsum of the child’s hand and brought around onto the volar surface to cover the hypothenar muscles.

It is then wrapped continuously up the forearm keeping it snug. The splint is secured around the elbow proximal to the epicondyles The strap at the thumb is pulled slightly so that it abducts the thumb.

It was worn for an average 10.43 hours a day

Results Spasticity Improved ratings in the Modified Ashworth Scale were generally found. The muscle groups with the biggest mean change in spasticity were the forearm pronators, wrist flexors and the thumb adductors. The forearm pronators and the wrist flexors were found to be statistically significant throughout the study Spasticity decreased in the first four months and then gradually started increasing, but not to the level it had been prior to the administration of Botox®, as was the case in previous studies(Friedman et al 12) when only botox was used. In Friedman et al’s study the subjects continued with their therapy programme unaltered. Similarly, in this study no changes were made to the subjects’ therapy programmes, as they too continued with their regular therapies. Friedman only used Botox and the spasticity levels returned to the same grade as before. In this study, in addition to the Botox® subjects wore a circumferential supination splint.

The gradual increase in spasticity that started occurring in the fourth month was initially quite sharp until the fifth month and became mild by the sixth month. This sharp increase during the fourth month coincided with the school holidays and the

mild increase occurred while the children were back at school and into their usual routine.


During the school holidays the children did not receive their regular weekly therapies and they wore their splints for a shorter time period unlike during the school term when they attend their regular therapy and wore the splint a for longer time period. Thus the increase in spasticity during the fourth month may have occurred as a result of insufficient weekly therapy and reduced splint usage, possibly indicating the crucial role weekly therapy and ten hour splint usage have on decreasing spasticity. Joint Range of movement As spasticity decreased, the splint applied a gradual force to elongate the pronator and wrist flexor muscles and in so doing, allowed a slightly larger range of supination and wrist extension movement.

A significant statistical difference was evident in forearm supination and wrist extension from the first month after Botox® and splint usage. The active range of movement increased rapidly in the first two to three months. Thereafter it slowed down or began to decrease slightly.

The mean increase from pre intervention was significant at all follow up assessments and ranged from 17° - 60° supination and 11° - 54° wrist extension, with the biggest increase occurring in the 5th month for both supination and wrist extension. Hand Function Despite the subjects having decreased spasticity and slightly increased active range of movement by the second month of intervention, their hand function had not had any significant improvement. But as the children learnt to make use of their newly acquired active range of movement and lengthened muscles, their mean scores in the hand function assessment increased significantly. The subjects needed a larger active range of movement, strength and time to practice the movements required for functional use of the upper limb. The individual preset tasks showed some statistical significance but only in the later months. Of particular interest was the significant improvement in bilateral hand use from the fourth month onwards. It may be assumed that the hand was able to improve to such an extent that it could assist the other hand in functional activities with much greater ease. The improvement in unilateral activities was not as yet evident. A clinically and statistically significant improvement in quality of hand function was seen at one month after the subjects had been wearing their supination splints. The subject’s overall quality of movements improved by 22.07% during the six months that they wore their supination splints. QUEST The supination splint allowed the subjects to actively extend the wrist without the forearm being pulled into pronation. Thus the subjects were able to perform dissociated movements with more ease. The dissociated movements subtest of the QUEST showed evidence of the most improvement while the “grasps” and weight bearing subtests only became statistically significant in the third month of splint usage.


As with spasticity, the school holidays affected the quality of movement causing an 8% decrease in the mean total scores between the fourth & fifth month. This once again indicating the importance of regular therapy & extended (10 hour) usage of supination splint for optimal improvement in the quality of upper limb movements

Subject 2 had a remarkable decrease in spasticity in the first three months, especially pronators & wrist & elbow flexors. During the same period his range of movement increased dramatically.

Supination from 15°pre to 60°at 3 months & 65° at 6 months post Botox, his wrist extension from 30° pre to 70° at 3mnths & 60° at 6mnths post. The improvement in hand function was more gradual. The function was still improving despite the Botox effect having worn off, possibly due to muscle weakness & poor quality of movement. The QUEST also illustrated that before intervention this little boy would use his mouth/teeth to assist him with bilateral tasks. During the study however, I saw him opening a packet of Simba chips using both hands.

Subject 5 also shows a similar picture; decrease in spasticity as range of movement increased. Supination improved from 0° pre to 60° at 3 mnths post & 40° at 6 mnths post Wrist extension from 45° wrist flexion pre Botox to 20° wrist extension at 3 mnths & 50° at 6 mnths post.

A gradual increase in quality of movement & hand function was still ongoing after Botox had worn off. Conclusion The aim of this study was achieved as it provided evidence that the supination splint had an effect on improving the upper limb function of children with cerebral palsy after they had received Botox® injections. Botox creates a HUGE window of opportunity for us to bombard children with cerebral palsy with available therapy of which appropriate and effective splinting is essential and crucial. By providing them with the possibility of participating in functional activities, one is enabling the child to contribute and interact with their environment in a more independent way.


References Outcomes Measures

Bohannon RW, Smith MB. Interrater reliability of a modified Ashworth scale of muscle spasticity. Phys Ther. 1987; 67:206-7. Flowers KR, Stephens-Chisar J, LaStayo P, Galante BL. Intrarater reliability of a new method and instrumentation for measuring passive supination and pronation: A preliminary study. J Hand Ther. 2001; January: 30-35. DeMatteo C, Law M, Russell D, Polock N, Rosenbaum P, Walter S. Quality of Upper Extremity Skills Test. Hamilton, Ontorio (Canada): Neurodevelopmental Clinical Research Unit; 1992

Home Programme

McCormack GL. The Rood Approach to Treatment of Neuromuscular Dysfunction. In: Pedretti LW editor. Occupational therapy - Practice skills for Physical Dysfunction. 4th ed. Missouri: Mosby; 1996. p. 377-399. Law M, Cadman D, Rosenbaum P, Walter S, Russell D, DeMatteo C. Neurodevelopmental therapy and upper-extremity inhibitive casting for children with cerebral palsy. Dev Med Child Neurol. 1991; 33: 379-387. Wilton JC. Hand Splinting - Principles of design and fabrication. London: WB Saunders Company; 1997. Fabrifoam [homepage on the Internet]. ProWrap [ cited 2005 Sept 21]. Available from: http://www.fabrifoam.com/p-prowrap.html Fabrifoam. Homecraft AbilityOne 2005 Catalogue; p23.

Other

Friedman A, Diamond M, Johnston MV, Daffner C. Effects of Botulinum Toxin A on upper limb spasticity in children with cerebral palsy. Am J Phys Med Rehab. 2000; 79: 53-59. Graham HK, Aoki KR, Autti-Ramo I, Boyd RN, Delgado MR, Gaebler-Spira DJ et al. Recommendations for the use of botulinum toxin type A in the management of cerebral palsy. Gait Posture. 2000; 11: 67-79. Wilton J. Casting,splinting, and physical and occupational therapy of hand deformity and dysfunction in cerebral palsy. Hand Clin. 2003; 19: 573-584. Tardieu C, Heut de la Tour E, Bret MD, Tardieu G. Muscle Hypoextensibility in children with cerebral palsy:I.Clinical and experimental observations. Arch Phys Med Rehab. 1982; March: 97 -102.

The QUEST Manual can be downloaded from

http://www.canchild.ca

type: QUEST in the search block


PLAY AS A VEHICLE FOR PROMOTING DEVELOPMENT IN CHILDREN WITH CEREBRAL PALSY IN A POORLY RESOURCED,

RURAL COMMUNITY. Marie Vorster (Occupational Therapist)

January 2009 While attending one of the Malamulele Onward outreach weeks in the Eastern Cape in 2008, our vehicle had a puncture. While some of the therapists were changing the tire, I took the opportunity to sit and observe my environment. Everywhere around me were huts, green grass, cows, goats and people.

There were children playing games, running around and using the objects in the environment as toys. Occasionally a grown-up would call the children, but they played without any interference or guidance. Mostly, this is how children in the rural communities play; without adult intervention. Were the parents aware of the importance of play in their children’s development? Were they aware of their important roll in helping a child with a disability to play? We as therapists are aware of the importance of play in the child’s development, especially in the development of attention, cognition and communication skills. Play provides a non-threatening environment where a child can experiment, explore and practice various skills and roles. NDT trained therapist strive to achieve more typical patterns of movement and postural control; while the child is engaged in functional, purposeful and meaningful activities. Play has been said to be the main occupational activity of children; often linked to the child’s work. “If play is the vehicle by which individuals become masters of their environment, then play should be among the most powerful of therapeutic tools” (Anita Bundy, 2002, p.233) When working with children with Cerebral Palsy in the community, whether this is in the Eastern Cape, Khayelitsha or Nomzamo we need to help parents understand the importance of play in the child’s development and also as a tool to promote movement and postural control while they are engaged in a fun and meaningful activity. The restrictions to play or the development of play in a child with Cerebral Palsy are mostly due to problems with movement, sensory processing, perceptual deficits, etc. but often also due to lack of experience and exposure to play and appropriate toys. Therefore we need to: 1. Talk to the parents about play. Why it is important for development, why their child with

Cerebral Palsy is limited in play and how they can promote play and a playful attitude in the child.

2. Guide parents to the best positions that will allow maximum freedom of movement while providing sufficient support.

3. Select toys the child can play with. This can be made of “discarded/rubbish” material, available to parents. It is very confusing for the parents and also frustrating for the child if we only play with high tech toys in therapy and then tell the parents to play at home and they have no toys available. I try to show parents how to make toys from rubbish and ingredients available n the house.

4. Help them to adapt the toys with straps and loops for the child or stabilize the toy. 5. Show them what play activities could promote the required movement that the child needs.


Ideas for toys made of house-hold refuse, utensils and ingredients: Sock Hand puppets Use odd socks, buttons and pieces of fabric to make hand puppets. This is a good tool to use to promote visual skills, communication and head control.

Rice/pebble Rattles

Hand and Foot Rattles

A quick way to make a hand or foot rattle for a baby is to stitch a small existing rattle, or a few buttons tied together, onto a bootie or mitten. Then place onto the baby to produce a rattling sound when they move. Nice way of getting hands to feet! Beware choking hazard though if baby starts getting hands/feet to mouth!!

Balls

If you have some left-over scraps of material, particularly in different textures, sew together to make a little ball and stuff with more scraps, and if you like insert a small bell inside before stitching up well. (Plastic bags can also be used for stuffing.)

Baby Books

Very first books for children can be made in a concertina formation. Use a sheet of cardboard and cut to a size that is easy to handle. Fold into three or four equal sections and decorate each section with either bright painted colors or use cut out pictures from a magazine and stick onto the cardboard. It is a good idea to use different textures glued onto the page – this gives opportunity for sensory experiences.

Stocking Scrunchie

To make one of these, insert some shiny crinkly wrapping paper or foil packets into an old stocking or pantyhose leg, and tie at each end. You can make short ones, or long ones that can be tied to a pram or mobile gym for entertainment.

Chip packet (inside) ‘vision stimulator’:

Use the inside of chip packs to attract visual attention; improve ocular pursuits. This also makes a noise and has a different feel when scrunched and touched.

A handful of rice or pebbles inside a small plastic bottle or a container will make a nice gentle rattle. Use a bottle the size that will promote the required grip. Different objects inside will give different sensory (auditory) experiences.

(Secure the lid on tightly and remove from the child once they become capable of taking lids off.)


Visual stimulation box:

Use a card board box (big enough for the child’s head and shoulders inside the box) and decorate with chip packet paper (both inside and outside of the packet), pieces of fabric, utensils like spoons and a small container filled with rice or pebbles tied to box with a string.

Lid Chains

Save plastic tops from soft drink bottles. Punch a little hole into the top of each plastic top, thread onto a piece of string to create a chain of lids that rattle.

Baby Mobiles

Decorate a coat hanger with pieces of Christmas tinsel, strips of fabric, small soft toys, rattles, brightly colored cut-out pieces of cardboard in fish shapes, ribbons, strips of crepe paper, or anything you can find to make and interesting mobile. Hang over baby's cot safely out of reach.

If you have a plastic clothes dryer in a circular shape with pegs attached (for drying underwear and socks), the things you hang on the mobile can be changed regularly to provide changing stimulation.

Play Gyms

A piece of smooth wood (i.e. a broom handle) can be made into a play gym that can be placed over the top of two chairs securely or hung somewhere for baby to play with. Attach things that are safe to be chewed and touched by short pieces of string so as to avoid baby getting tangled in them. Things like rattles and teething toys, stocking scrunchies, small soft toys, large plastic cotton reels, plastic lids from hair spray cans, robust plastic spoons work well.

Rattle Cans

Using an empty formula or large coffee tin, put in a handful of acorns, pebbles, or maize kernels and then secure the lid tightly. The tin can be covered and decorated. A baby learning to crawl or roll can rattle these around the floor.

Drums

Pots, mugs and formula or coffee tins can become drums. Provide a stick or a spoon to beat on the drum.

Hide and seek:

Play Peek-a-boo with a small blanket or cloth nappy. Take turns by covering the parent’s and then the child’s face.

Show children house hold utensils, cover with a cloth and ask them where it has disappeared to. Object permanence can develop through this kind of play.


Posting Box

To make a simple posting box toy, cut a suitable ball size hole in the lid of a cardboard box or a plastic two-liter ice cream container. Hinge the lid on by securing with masking

tape at one side, and then provide some safe objects that aren't too small to be swallowed to post inside the box. A more advanced one would have different shapes and sizes. This is a winner with all the children.

Sock Balls

To make a quick ball for a baby to practice gripping and throwing, simply roll a clean pair of socks into itself. If need be the ball can be more oval to help improve the child’s grip. Play with posting it in a box/ ball poster to work on release.

Play Mats

Using an old cloth nappy or small blanket as a base to start, sew on bright pieces of fabric in different textures or even small pieces of tough plastic shopping bags to create a play mat. A ribbon sewn to one corner can be tied into a bow, pulled apart and re-tied. A teething rattle/ring attached to the mat could increase the entertainment value.

Covered Boxes

A cereal box can be covered with plain paper to begin with, and then add pictures of people's faces, flowers, and animals. Cover with plastic or cover-seal. Baby will enjoy turning the box over and over in their hands to see the pictures.

Stacking Toys

Plastic lids from shaving foam and hair spray cans make good stacking/nesting toys. They are also good for bashing together to make noise.

Songs and movements

Show parents how to position and move child while singing and copying motions following the words of the song. This is fun and a lovely way to move and learn.

(Photograph used with permission from Malamulele Onward)

Board games (i.e. snakes and ladders)

Draw the game on a big piece of paper and use door knobs or bottle tops as tokens.


Very Special Play Dough recipe (This feels fantastic, is not sticky and lasts in a plastic bag for more than a year.) Ingredients: 4cups flour 4 cups water 1 cup salt 30ml cream of tartar 100ml cooking oil Food colourant Method:

1. Mix all the ingredients, except food colourant in a pot over low heat. Mix and stir until it forms a ball in the middle of the pot (lots and lots of elbow grease!!).

2. Remove from pot and knead through. 3. Add food colourant and knead again. 4. Place in airtight container; does not need to be placed in a fridge.

References: Lisa Rappaport Morris, Linda Schulz. Creative Play Activities for Children with Disabilities – Human Kinetics Books 1975

Anne G. Fisher, Elizabeth A. Murray, Anita C. Bundy. Sensory Integration Theory and Practice. F.A.Davis Company 1991

Doreen Greenstein. Backyards and Butterflies. Brookline Books 1993

This year we will be returning to Butterworth/ Tafalofefe in the Eastern Cape and to Madwaleni/

Zithulele in deep rural Eastern Cape, near Elliotdale.

The provisional dates of the therapy weeks are as follows:

Madwaleni 30 March - 3 April 2009 (School holidays)

Tafalofefe (group 1) 28 Sept – 2 October 2009 (School holidays)

Tafalofefe (group 2) 5 – 9 October 2009

If we are successful in obtaining more funding, we will also go to a new site in the Vhembe district of

Limpopo. This will also take place in the second half of 2009.

All the children in the Tafalofefe group need GMFM assessments done before and after the therapy

intervention. If you are interested in doing GMFMs, please let us know. You will receive training and

also be paid for doing the assessments.

Your accommodation and travel costs (within South Africa) for the therapy week are covered. You will

also receive 10 CEUs for the week. All we need is from you is your time!

If you are interested in becoming a Malamulele Onward volunteer, please contact Gillian Saloojee at

[email protected] or on 072 483 5766. You can also visit our website www.CPchildren.org for

more information on what we are all about.

CPD INFORMATION

CALLING ALL

NDT THERAPISTS

OUTREACH DATES FOR

2009

Directors : Dr. GM Saloojee, JA Snyman, E. Brown, T. Seon (Can), B. Harrison (Can), S.

Broughton, Prof. AD Rothberg, Dr. MR Mphahlele, JC Whitter, T. Ralintja


SANDTA has successfully applied to be an Accredited Service Provider since 2007 and we continue to do so every year. As a service provider the organization can offer a far better service to the members of SANDTA. SANDTA will provide 7 articles along with questions to be answered to CPD solutions. Members will be able to accumulate up to a maximum of 21 CEU’s for submitting correct answers in this CPD activity. CPD information has previously been supplied to branch representatives by Faatima Ibrahim-Abbas but is repeated here: 1. A CPD 2A form has to be filled out for each course/ activity that is to be accredited. Level

of activity and number of CEU's applied for should be left blank. That will be completed by the CPD officer.

2. In addition to that I require the program of the activity and the CV’s of the presenters in

full. 3. You are also required to create an attendance register that has to be signed by the

participants at the beginning and end of each day of the activity. These will have to be faxed or scanned and emailed/posted to Dorothy Russell within 1 week after the activity for our records and as proof of attendance.

4. A complete list of the attendees and their HPCSA numbers should be send in advance of

the course, if known, in order to generate CPD Certificates for the attendees. The costs of these will be R15 per certificate - this includes the cost of accrediting the activity with CPD points as well as the certificate.

Payment for certificates is to be made to: 5. Once proof of payment is received I will email the certificates to you in a PDF format

which you can print and then handout. 6. Activities that do not qualify for CEU’s 6.1 Time spent in planning, organising or facilitating any activity 6.2 Published congress proceedings 6.3 Non-referenced letters to the Editor of accredited journals 6.4 Daily ward rounds 6.5 Written assignments 6.6 Compilation of student training manuals for internal use 6.7 Staff and/or administrative meetings 6.8 Tours and/or viewing of exhibits and technological demonstrations 6.9 Membership of professional bodies, boards or associations 6.10 Holding a portfolio on the professional body’s executive or council structure 6.11 Presentations and publications to the public 6.12 Meetings arranged by pharmaceutical companies and manufacturers or importers of

products and technical devise or their representatives purely for the purpose of marketing and/or promoting their products are not eligible for accreditation.

Please fax confirmation to: Wiseman Makhatini

at 031 708 1789

SANDTA Standard Bank

Westville Branch Branch code 045426

Account number: 053103130


For all new SANDTA CPD queries for 2009

For all back dated SANDTA CPD queries please contact SHELLEY BROUGHTON at:

[email protected]

Application Form for SANDTA Courses attached as a separate document to the Newsletter,

both as a PDF and WORD document.

The application form can also be downloaded from: http://www.sandta.org.za

Please note that Level II Courses are only open to therapists who have

successfully completed the 8-week basic NDT/Bobath course.

A short SMS User’s Guide by CPD Solutions is attached to the newsletter as an extra for you to print and keep handy

A complete SMS user guide is available from the help section on their website at:

http://www.cpdsolutions.co.za

KZN

Dates: Block 1: 6 July – 7 August 2009 Block 2: 28 Sept. – 16 October 2009

Course Leader: Estelle Brown (Senior SANDTA Tutor) Venue: Pietermaritzburg (Actual venue to be finalised) Cost: R 10650 Discount applicable to: South African Therapists and Therapists working in Africa: R 9765 SANDTA members registered and working in Africa: R 8875 Contact: Estelle Brown Tel: (011) 674 5272 / 073 148 2178

Fax: 086 666n7452

E-mail: [email protected]

ADVANCED LEVEL II COURSE

Perception in CP

Date: 10 – 14 August 2009 (5 days)

Venue: Johannesburg, Gauteng

Course Leader: Carolyn Simmons- Carlsson (Senior OT tutor from New Zealand)

CANCELLED.

SANDTA wishes Carolyn a speedy

return to good health

CPD portfolio SANDTA DOROTHY RUSSELL

083 375 5058

[email protected]



ADVANCED COURSE IN MANAGEMENT OF FEEDING, ORAL-SENSORY

MOTOR AND SPEECH PRODUCTION DISORDERS IN CHILDREN WITH CP

This course is open to therapists who have completed the 8-week basic NDT/Bobath course.

We will re-visit the management approach within the Bobath/NDT concept to feeding,

oral sensory-motor and speech production disorders in children with CP and evaluate

relevance of treatment against latest research evidence. There will also be a focus on

the use of the ICF framework in assessment and intervention plus using GAS goals (Goal

Attainment Scaling) in this clinical population. Various assessment protocols will be

evaluated in terms of usefulness as outcome measures in support of evidence-based

practice. Participants will engage in problem solving complex cases and in refining

practical handling skills aimed at impacting function. Inter- and transdisciplinary

management of the targeted problems will form part of workshops, discussions and

problem solving.. The course will be accredited attendance certificates and CPD points.

Venue: Aurora Special Care Centre

Port Elizabeth, SA

Dates: 26 -30 October 2009 (8h30 to 16h30)

Tutor: Rina van der Walt, Senior Speech-Language Therapy NDT/Bobath Tutor

Fee: R2, 050 – SANDTA members; R2, 250 non-members

Download e-mail or fax version of application form from SANDTA website:

http://www.sandta.org.za

Send form to: [email protected] or

FAX Rina van der Walt at: 00 44 141 9490022 (Scotland)


THE EARLY EVALUATION & TREATMENT OF INFANTS

WITH CEREBRAL MOTOR DISTURBANCES

Dates: 26 October – 6 November 2008 (10 days)

Course Leader: Estelle Brown (Senior SANDTA Tutor)

Venue: Bloemfontein (Actual venue to be finalised)

Cost: R4000

Contact: Estelle Brown

Tel: (011) 674 5272 / 073 148 2178

Fax: 086 666n7452




FACILITATION : “LESS IS MORE”

COURSE LEADER : Jean-Pierre Maes, Senior Bobath tutor (London), assisted by Dr. Gillian Saloojee, Senior SANDTA Course Tutor

LENGTH : 6 days

DATE : 23 – 27 November 2009

VENUE : Johannesburg, Gauteng (exact venue in Johannesburg to be confirmed)

This is a very practical course with the emphasis on improving participants’ clinical handling skills.

The format includes clinical practical sessions, demonstrations, practical sessions and lectures.

Cost: R3300

CLOSING DATE FOR APPLICATIONS: 24 April 2009

Due to the very practical nature of the course, places are limited to 16 participants. To avoid disappointment, please send in your application form as soon as possible.


FACILITATION : “ATHETOSIS”

COURSE LEADER : Jean-Pierre Maes, Senior Bobath tutor (London), assisted by Dr. Gillian Saloojee, Senior SANDTA Course Tutor

LENGTH : 6 days

DATE : 30 November – 5 December 2009

VENUE : Johannesburg, Gauteng (exact venue in Johannesburg to be confirmed)

This course is a follow-up to the “Facilitation: Less is More” course and is only open to therapists

who have done the “Less is More” course. It is also a very practical course with the emphasis on

improving participants’ clinical handling skills when working with children with athetosis. The

format includes clinical practical sessions, demonstrations, video case studies and lectures.

Cost: R3300

CLOSING DATE FOR APPLICATIONS: 24 April 2009

Due to the very practical nature of the course, places are limited to 16 participants. To avoid disappointment, please send in your application form as soon as possible.

For further information on both the above courses, contact:

Gillian Saloojee on 072 483 5766 or by e-mail at [email protected].

Application forms should be faxed to Mary Murray at 011 892-3893 or e-mailed to [email protected]


INTRODUCTION TO THE ASSESSMENT AND TREATMENT OF CHILDREN WITH CEREBRAL PALSY

This 5-day Introductory Course is aimed at physiotherapists, occupational therapists and

speech therapists working with children with cerebral palsy in clinics, public service

hospitals or institutions. The course is specifically targeted at community service

therapists and junior therapists. This course will help therapists to effectively assess

and manage children with cerebral palsy within a busy public service setting.

All courses require full attendance for certification and all are accredited for 35 CEUs.

GAUTENG COURSES PLANNED FOR 2009

Presenter: Dr. Gillian Saloojee, Senior SANDTA Tutor

Dates : 18 – 22 May 2009

25 – 29 May 2009

Venue: CP Clinic, Chris Hani Baragwanath Hospital, Gauteng

Cost: R2000

Contact person for enquiries and application forms:

Mary Murray Tel : (011) 917-5747 ; cell 083 462 6240

e-mail : [email protected]

************************

EASTERN CAPE COURSE PLANNED FOR 2009

Presenter: Estelle Brown, Senior SANDTA Tutor

Dates : 8-12 June 2009

Venue: East London

Cost: R2000

Contact person for enquiries and application forms:

Estelle Brown

Tel: (011) 674 5272 / 073 148 2178

Fax: 086 666n7452

email: [email protected]


BASIC COURSE ON THE EVALUATION AND TREATMENT OF

ADULTS WITH NEUROLOGICAL LESIONS (THE BOBATH CONCEPT)

Internationally recognised IBITA Basic Course

CPD points applied for

Instructor: Gakeemah Inglis (University of Stellenbosch)

Assisted by: Sheena Irwin-Carruthers

Elsje Scheffler (Western Cape Rehabilitation Centre)

Dates: 11 – 29 May 2009

Venue: Western Cape Rehabilitation Centre

Highlands Road

Mitchell’s Plain, Cape Town

Cost: R3 500-00 SA citizens; R5 000 (foreign nationals)

Applications: Closing date: 11 April 2009.

Send email to Mavis Gidigidi at [email protected]

Telephone: 021 370 2463

On receipt of your email, an application form, payment details and a

programme will be e-mailed to you.


022-245 NPO

Enquiries/ Navrae: J H Viljoen Ref/Verw: 29 13 November 2008 TO: AFFILIATED MEMBER ORGANISATIONS/INSTITUTIONS

CP MANAGEMENT COMMITTEE

ASSOCIATE MEMBERS

MEMBERS of NAPCP STAFF

MR FANIE DU TOIT

MEMBERS EDUCATION COMMITTEE

GOVERNMENT DEPARTMENTS

UNIVERSITIES AND TECHNIKONS

AFFILIATED ORGANISATIONS MUST PLEASE ENSURE THAT COPIES OF THIS CIRCULAR ARE MADE AVAILABLE TO THEIR TWO VOTING REPRESENTATIVES ON THE NAPCP. ANNUAL CONFERENCE OF THE NATIONAL ASSOCIATION FOR PERSONS WITH CEREBRAL PALSY (NAPCP) 2009 BENONI - GAUTENG The Gauteng Cerebral Palsy Association will be hosting the 2009 annual conference and meetings of the NAPCP to be held in Benoni.

Dates: 18 to 20 May 2009. Venue: Kopanong Hotel, Benoni, Gauteng. The following documents are attached to this circular for your attention: (attached as extras to SANDTA newsletter) First call for papers plus Intention to Present form Registration form Accommodation form

NATIONAL ASSOCIATION FOR

PERSONS WITH CEREBRAL

PALSY

Tel: [011] 726-8040

Int: +2711726-8040

Fax: [011] 726-5705

NASIONALE VERENIGING VIR

PERSONE MET SEREBRALE

GESTREMDHEID

P O Box/Posbus 426

MELVILLE 2109

Republic of South Africa

Republiek van Suid Afrika


E-mail [email protected]


PLEASE NOTE THE CONTACT DETAILS ON THE VARIOUS FORMS. DETAILS AND A TIMETABLE OF THE VARIOUS MEETINGS AND CONFERENCE WILL BE CIRCULATED WITH THE 2ND CONFERENCE CIRCULAR EARLY IN 2009.

ACCOMMODATION Delegates are required to make their own accommodation arrangements. Should there, however, be any matters they would wish to clarify, delegates should please contact the host organisation. REGISTRATION FORM AND PAYMENT OF REGISTRATION FEE Members and delegates must please note that the registration form must be sent to the host organisation together with proof of payment of the registration fee. Details of the bank account of the Gauteng Cerebral Palsy Association, to be used for this purpose appears on the registration form. PLEASE NOTE THE RETURN DATES AND DATES FOR PAYMENT OF THE REGISTRATION FEE AS STIPULATED ON THE FORM. TRANSPORT REQUEST FORM Information on transport arrangements will be notified early in 2009.

AGENDA ITEMS FOR MEETINGS OF CP MANAGEMENT COMMITTEE AND THE BUSINESS MEETING OF THE NATIONAL ASSOCIATION – MAY 2009

Affiliated organisations/institutions wishing to submit items for inclusion in the agendas of the Business meeting and the Management Committee of the NAPCP, must please furnish well motivated information, as early as possible in the new year to:

Mr Johan Viljoen National Director NAPCP at the contact details on this letter head.

Principals of Special Schools are invited to submit summarized reports early in 2009 for circulation with the agenda for the business meeting. These reports to be sent to the national office as per contact details on this letterhead.

An opportunity will be provided at the business meeting of the NAPCP for representatives of Government Departments to submit brief reports on the activities of their Departments.

JOHAN VILJOEN NATIONAL DIRECTOR


SOUTHERN AFRICAN NEUROLOGICAL REHABILITATION ASSOCIATION

presents

Neurorehabilitation 2009

“Bridging the Divide”

26 – 28 August 2009

JOHANNESBURG, SOUTH AFRICA You are invited to participate in the 4th SANRA Conference taking place in Johannesburg in

August 2009. The theme “Neurorehabilitation 2009: Bridging the Divide” will focus on

functional measurement techniques and innovative therapeutic developments, encompassing

both the scientific and the clinical spectrums of neurorehabilitation.

The keynote speakers are:

Dr Steven Small

Dr Derick T Wade

Michele Gerber

Dr Leigh Ann Hale

CALL FOR ABSTRACTS: PLEASE SEE ATTACHMENT.

If you know of anyone who will be interested in this conference please send their email

address to [email protected]

The WESTERN CAPE is proud to present the following workshop:

Cerebral Visual Injuries This workshop will help you to understand the visual system and the functional use of vision, identify abnormal functional vision and to understand the influences it has on the rest of the person/child. It will look at principles and understanding of treatment in a functional manner. Vision training is not isolated; it is incorporated in the NDT approach Presenter: Christa Scholtz

Date: 18 April 2009

Cost: R300 (SANDTA Members) R350 (non-members)

Venue: Bel Porto School, Lansdowne

Time: Registration at 8h00. Course will finish at 15h00

CPD: We have applied for continuous education points

Places are limited, so please book early to ensure that you can attend.

Please contact Jenny Bradshaw for more information

083 775 1995 or 021 696 4134 (during school hours), [email protected]

NB NB NB NB Please send in your application form ASAP. There are limited spaces and priority will be given to SANDTA members. An e-mail will be sent to you confirming your place on the course. Only once you have a confirmed place, please deposit the money into our account.


EASTERN CAPE - Clare Hubbard

Basic Paediatric NDT Course Port Elizabeth hosted a Basic 8-week NDT Paediatric course in September and November 2008, led by Estelle Brown and assisted by NDT Tutor in training Malka Haimiy, from Israel. Rina van der Walt, Speech Therapist and NDT Tutor (visiting us from Bobath Scotland where she is now based) and Christa Scholtz, Occupational Therapist from Klerksdorp delivered 2 fantastic and full weeks focusing feeding and language and vision, hand function and play respectively, allowing us enrich and consolidate our basic handling skills. This course took 2 years to plan with the therapists from Cape Recife and Merrivale Schools and Aurora Special Care Centre and we are grateful to Estelle for organizing a magnificent course in the Eastern Cape. The highlight for many of us was the community week in the second block in which we offered therapy and some management strategies to 12 CP children and their caregivers at a new Centre in the northern suburbs … this done in the midst of a taxi strike in PE. We had an amazing group of participants, with 2 participants from Switzerland, 5 from Cape Town, 2 from the Transkei, 8 from PE and the remaining participants from around the country. The Course was tough and we also played and socialized hard! There is no doubt that doing an NDT Course bonds people together in a way that we will all remember forever. The ‘graduation’ ceremony was a highlight … as all the secrets were revealed. Thanks to all involved in the Course – to the tutors, Estelle especially, other therapists, the participants, the schools, parents of the children and to the children who so willingly let us prod, move and manipulate them as we gained our basic NDT Skills.

****************** As a mature therapist, the NDT course was a good motivator and gave me a fresh approach to my work, not only with children with CP but all the clients I work with. It gave me a different view of function and how to build it into the sessions. As an OT trained in function, it was a different perspective on using it in different situations and helped me to know what to expect and how far I must go to compel change. The changes in the field of NDT over the past 20 years have also been remarkable and it was good to bridge that gap. There is more focus and direction in the tasks that are performed and the goal direction was apparent allowing children to be treated for blocks of time rather than indefinitely. The course also offered a lot of good social interactions, especially as a therapist from out of town and single with time on my hands. Port Elizabeth was a lovely place to explore although I think they’ve had enough of us for a while.

Cath Pitt, Occupational Therapist, Cape Town The Paediatric NDT course was one of the highlights of my 'career' as an OT thus far. To participate in 2 months of intensive full time practical study in a challenging environment with such experienced mentors and teachers, was incredible. The course and the NDT approach has changed the way I think about my clients, the way I consider and involve the child's parents and my understanding about what is important to achieve for each individual child. I know now that the NDT/Bobath approach is analytical, flexible and applicable and that it delivers clinical and functional results. As an OT if has given me licence to treat a child using techniques and thought processes that I have always known are necessary to gain functional movement, but somehow felt were outside the realms of OT. The transdisciplinary nature of NDT is one of the aspects I appreciate most about it. Estelle, I am converted!

Janet Michaelides, Occupational Therapist, Knysna,


Nelspruit: A dynamic physiotherapist required

to locum in a rehabilitation practice from

1 April 2009 to 31 August 2009.

Patient case load covers

neurological conditions,

spinal conditions

and CP.

Please contact Elzette Kruger at

082 446 2282.

(F) 086 600 5303

Vista Nova School, Rondebosch, Cape Town

Full-time

Physiotherapy Maternity Locum

Mid- June 2009

till end Nov 2009.

NDT Experience preferable

Please contact Louise on

021 689 5323for enquiries

and

fax your CV to

021 685 2402

Lorraine, Port Elizabeth

NDT experienced physio needed.

NDT qualification would be an extra

advantage.

Afternoons only, 2-5pm, (hours

negotiable) Monday to Friday.

Some Saturday mornings on request.

Would see mainly children with Low

Muscle Tone, (bulk of practice)

Strokes, Head Injuries, Cerebral

Palsy. Also some orthopaedics.

Contact Renee Dippenaar

0413674425 / 0823261771,

Please e-mail CV.

[email protected]


BRANCH CONTACTS

SOUTHERN GAUTENG Sarah Vorster [email protected] 082 370 6730

NORTHERN GAUTENG: Gina Loudon [email protected] 082 665 8385

KZN Jane Markham [email protected] Tel: 031 700 3535 Cell: 084 421 5062

WESTERN PROVINCE: Jennifer Bradshaw: [email protected] 021 696 4134 (work) 021 696 8228 (fax) 083 775 1995 (cell)

EASTERN CAPE Clare Hubbard [email protected]

TEL. (041) 3733780 FAX (041) 3733781 CE Mobility 80 Cape Road Mill Park 6001

OFS Corina Botha: [email protected] Tel: 082 2025952 051-5201234 (W) 051-5201231(F)

FS Goldfields (interest group)

Rina van Zyl: Tel: 057 388 4543 [email protected]

Submission of material for inclusion in body of newsletter:

To simplify editing, please use Word

documents or plain text Paper size – A4.

Font: Ariel Font size: Titles 14 pt.

Body of document 11 pt. Any photos/pictures to be sent separate from text with a labelled text box in the

document at insertion point.

Advertising Rates:

In body of Newsletter

Full A4 page - R 200

Textbox A5 size - R 100

Textbox ½ A5 size - R 50

Scanning if not in electronic format

R 50/page.

Inclusion of flyers (postal & electronic)

R 100/page – to be supplied ready for inclusion - Printed and Electronic form (PDF).

NO CHARGE FOR SANDTA RELATED

COURSE ADDS

Schools/Centres/Clinics catering for people with cerebral palsy will be charged a nominal amount (R50) to help cover printing and postage.

To negotiate rates please contact the editor: e-mail: [email protected] tel: 021 794 6903 (preferable ) or cell: 082 9277776

Newsletter deadline Submissions for the newsletter

must reach the editor before

30 April 2009

newsletter february 2009 - sandta · south african neurodevelopmental therapy association...

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