These may be the first signs of cerebral palsy. If a child does not follow an object with his or her eyes, or does not want to turn his or her head to one side or the other, this may also indicate that something is wrong. The same can be said if a child does not grab for things with his or her hands, or if he or she is delayed in rolling, crawling and sitting. Should this be the case, it is best to start your child’s treatment as early as possible.

In the first few months of life, a child starts going through the normal stages of development. He or she learns how to roll, sit up, crawl, and move his or her arms and legs. If a child misses one of these milestones however, it will have a snowballing effect on the rest of his or her progress.  For example, if he or she is not learning to get up and sit, it will impair his or her trunk mobility. As a result, the head or legs will not be used as much and the child will be unable to crawl properly. If we address these issues before they hinder a child’s growth and progress, we can minimize the effect of the condition in his or her daily life to a point where it is undetectable. That is why today, Debbie is completely cured, running and playing just like any child.

In many situations, both the medical and therapy community use a child’s diagnosis as a label accompanied by the claim of “permanent disability.” Yet, I have seen individuals with cerebral palsy who are able to lead independent, fulfilling lives. As a parent, it is up to you to teach your child about the world and to guide him or her through any difficulties he or she may come across.

So, if you see any behavior that seems atypical for your child, take initiative. Don’t be afraid to ask questions, and gather as much information as possible. Go to more than one physician, and make sure to consult experts who deal with neurological disorders more often than your general pediatrician. Also, even if your child does get diagnosed, don’t let yourself doubt his ability to develop and become the best he can be. You must believe in your child’s abilities, and focus on making realistic goals and teaching him or her how to achieve them.

My philosophy is that there is no treatment, only life. That is why as a therapist, I believe that there are no exercises to learn, only function. When I have a patient, I only guide him or her during the function so that he or she will learn to do it independently.  I also request parents to continue working with their child at home so that there is no disruption in the teaching and learning process. As a parent, don’t let anyone set your child’s future in stone, and remember: your child is capable of things no one can predict.

For any child, discipline and learning play an integral role in his or her growth and development. Whether at school or home, each child is taught basic things such as to be polite, respectful and kind. Unfortunately a lot of times once a child has been diagnosed, we suddenly forget these rules and automatically excuse a child for his or her behaviour.

Often, diagnosis become a kind of label accompanied by a prediction of everything from behaviour up to intelligence. When parents are told of their child’s condition, from that moment onwards the child lives under the umbrella of the word “disabled” and all that this term entails. As a result, behaviour such as punching, screaming and kicking may be seen as something that cannot be changed, when that is not the case.

With every child being different, you cannot make assumptions about what he or she can or cannot do. Every child comes equipped with his own personality, experience molded by his or her differing cultures and home environments. When I approach a child, I don’t presume how he will act. Instead, all I see is a regular child; a child that, for some reason, happens to have a disorder. With this in mind, I educate him in how to function independently–a very broad term, which includes communication (i.e. the ability to listen, understand and communicate), as well as how to respect himself and others. I listen to the child, and try to understand him. This is not a dictate, but a demonstration of two-way communication. If the child cries: why are you crying? Speak–I am here to listen, and to understand. Crying does not help, but explanation does.

Teaching is a process, and it doesn’t always go smoothly. Be calm, and remember: if you make a mistake, there is nothing wrong with asking your child for forgiveness. Similarly, if he does something that makes you angry or upset, tell him the reason why. He will understand. Often a child won’t do something, not because he does not want to, but because he just either does not understand or does not know how to do a certain task or function. In this case, explain, demonstrate and do this task together with your child. Be patient! Repeat it again in a different situation. Then repeat it again, again, and again. Eventually, it will become an easy task.

It is an official statement that Down syndrome affects a child’s ability to learn in various ways, but most have mild to moderate intellectual impairment. However, I believe that it is a child’s support system that will really determine what he or she may be able to achieve. Perhaps a child may need further explanation and elaboration to be able to do something, and there’s nothing wrong with that. It is up to you to guide your child, and to show him or her how beautiful the world is, or how ugly its face can be. There are cases where these individuals go on to university, participate actively in their communities, and succeed in making a difference. For your child, love, patience and respect will definitely go a long way.

So, try to communicate with your child. Ask questions, and don’t assume everything based on medical advice or your own opinion. Remember, discipline is not about restricting your child, but being there to assist and guide him in every aspect of his life.

For a child with a neurological disorder, the future seems clear. Or at least it is in everyone else’s mind. Everyone seems certain about what the future holds for this child – what therapy will be needed, what disability this child will have in life.

But the funny thing is that these very people who are so absolute about this child’s future have probably never even really looked at or talked to the child. They’ve never asked the child what he wants or needs. They’ve never given him a chance to decide for himself. Basically everything is decided for the child, right from the start.

Take the case of Alexandra, an eleven-month-old beauty queen who came to our LIFE Program from the United Kingdom.  According to her paediatrician and pediatric neurologist, Alexandra has mild cerebral palsy, and can be put passively into a sitting or kneeling position. She cannot turn from side to side or transition actively from a lying position to sitting and kneeling. Needless to say, she is not crawling and standing either.  After the first session, her father told me: “This is hard for her; I mean this kind of exercises.” My reply was: “have you seen any exercises? This is her life function.” With the LIFE Program, an approach I pioneered in my clinic, there are no exercises. In real life, people might exercise for many an hour or two each day in a gym. But everything else they do is just daily function. So why should a child with a neurological disorder be put through exercises when what that child really needs to learn is function?

Alexandra progressed nicely in the LIFE Program and her parents were hopeful. Everything was going great until one day, when I came into the office and our secretary told me, “Natan, do not go to the kitchen. Alexandra’s parents are crying there.”  I quickly learned why. The previous day, our clinic had received a fax from the U.K. containing a description of Alexandra’s MRI test. The test described what parts of the brain were affected and the diagnosis. Alexandra’s parents had then called their pediatrician in the U.K., who told them that their child’s future was not looking good and that they needed to talk to a pediatric neurologist. They were devastated.

I’ve worked in hospitals, were I saw on several occasions how a patient can walk into physician’s room on his own but, once he learns of his bleak diagnosis and prognosis and is put into a wheelchair, he never gets up again. It is unfortunate that today many doctors rarely look at their patients but instead base their diagnoses and treatment decisions on tests.  I find this interesting and somewhat ironic since tests are described in medical books as an excellent tool to either support or exclude a diagnosis. Think about it. Tests do not diagnose. They just help physicians make a diagnosis. And tests cannot predict the future of the patient.

Tests can show what part of the brain or body is affected, helping us gain a better understanding of what is happening. But they are just a part of the entire picture, especially where children are concerned. As a child grows, his  brain is developing. So given appropriate stimulation – in particular, function – a child’s brain can and will turn to a pathway other than the affected part to  build function. This was exactly what I told  Alexandra parents.

If, like Alexandra’s parents, you ever feel discouraged about your child, try doing this: When you work with your child – which is basically what you do 24/7 – observe and compare your child now to the way your child was one month ago or one week ago. Then you will see the difference. Remember: tests show what is inside. But no MRI, CT, physio test or occupational therapy test will ever truly show your child’s level of function. Remember that your child is a smart human being who is aware that a test is being conducted and will not behave as he or she behaves in a normal, everyday setting. Therefore the best test is  daily life. And the best assessor, aside from your child’s therapist, is you – the parent, who knows your child best.

So listen to physicians and therapists, but observe your child and make your own conclusions. Talk to them, but talk even more to your child. Ask questions, but compare their answers with what you see in your child.

Do not doubt your child for even one second. Remember that your child is capable of doing things that nobody and no machine can predict. So don’t let anybody decide and write off your child’s future.

I’ve been asked a lot of questions about this treatment, so I have decided to discuss it in this blog.

Stem cell treatment is an experimental treatment that is still in the research stage. Even though the treatment is performed in such countries as German, China, Israel, and in research trials in Canada, the effects of the treatment and its long-term side effects are not fully known.

In some cases it helps, in other – it does not.

The logic under the treatment goes as follows: stem cells are extracted from patients’ bone marrow, cultivated in the laboratory and injected back into the body of the patient. These new cells have ability to rebuild damaged organs or neurological pathways. According to the Cell Center in German (http://www.xcell-center.com ), this is a surgical procedure. Therefore the claim that this is a “non – invasive type of therapy” does not apply.

Usually the signs of improvement become evident within three to six months after the procedure. In some cases, according to some patients’ accounts, the improvement can be seen almost right away.

Personally I have seen children and adults after they’ve been through stem cell treatment. Please do not get me wrong, I do not want to sound like a skeptic – actually, I am praying for the success of this research – but these patients emerged from stem cell treatment in the same condition as they were before the procedure.

If you have had a different experience with stem cell treatment, I invite you to share this information. The more we know about this treatment, the better we can make decisions that will benefit our children.

At this point, the question we really need to consider is: does stem cell treatment cure and resolve the functional limitations of the patient?

I would say that it definitely does not. In best case scenarios, stem cell treatment can rebuild neurological pathways, but it will not teach your child how to roll, crawl, sit, stand and walk, as well as how to talk and socialize.

To make the story short, it will not teach your child to become INDEPENDENT in every aspect of his of her life. This procedure as any other does not replace the need to teach your child the everyday functions necessary to lead an independent life.  As parents and therapists, we will continue to have this responsibility.

So what is going on?

I think a key issue is that many therapists, and medical community alike, take a standard / template approach to children with neurological disorders. We, in a lot of cases, don’t take the time to really get to know each child’s personality, level of perception and ability to process information, and just at the end to look at his disorder.

There’s also a tendency amongst therapists and medical profession to put “all eggs in one basket” and attribute everything the child does or doesn’t do to his or her disorder. In most cases, this is done with good intentions since the therapist is merely trying to “alleviate stress” from the kid, who is viewed as “suffering already.” So a child’s aggressive behaviour is often excused because of the disorder, or blamed on the disorder. At the same time, the therapist structures treatment not as a time for learning but as a time for playing – again because of a desire to lessen the child’s stress.

These approaches simply do not work. The question is: what stance and approaches will work?

First of all, I’d like to say that parents and therapists aren’t doing the kids any favours by trying to always spare their feelings and alleviate their stress. Therapy is work, so why not let the child know that’s what they’re coming in for instead of making them believe they’re coming in to play? Do we hide from a “regular” child the fact that he or she is going to see the doctor or the dentist? No, we don’t. So why go through this deception with a child who has a disorder? Although games are often part of therapy, therapy is simply not play. It’s a learning process and game is a function in which learned skill is integrated.

The more we hide from the child, the less connection and trust we build with the child. This applies to all aspects of life, not just therapy.

My approach to children with ANY neurological disorder is to treat them as “regular” children who happen to have a certain disorder. And my job is help them become  independent in EVERY aspect of their lives.

I want to share with you the story of Helena and Alex, who came to our clinic from Poland.  Alex, who is three years old, has Down’s syndrome. We started to work. The next day Helena came to the clinic, and told me: “Alex was fighting with you. I think the treatment was powerful for him. Please do not push him.” I changed the way of the treatment right away. I started to give instructions to Helena, and SHE started to work with Alex. In a few minutes, Alex started to cry. Then he tried refusing to follow his mother’s commands and requests.

“He is trying to fight you. Just explain to him what to do and why it needs to be done, and continue” I said to Helena. She agreed.

Was my treatment on the first day of treatment pushy? I don’t think so. I am always respectful and careful with every child. But it was his first day and he was in a completely unfamiliar environment. He did not know what to expect. In addition, I asked him to do things which I NEEDED HIM TO DO, and not what he wanted to do. Of course he was showing his displeasure. I was really happy when next day Helena walked in the clinic and said: “I do not know what you did, but he is so much better!” She just made my day.

There is no just motor function without cognitive. I cannot teach Alex – or any child for that matter – motor function without explaining the purpose of the function. But I cannot explain anything to him unless he learns how to listen, perceive and process information. Violence, screaming and hysteria are a consequence of not being understood by others, and of an inability to do certain things which “others” can. All of these lead to frustration. Therefore my mantra is: respect, observe, explain, show and repeat. This will eventually lead to the child learning the function. Never let yourself to be sorry for your child. This is not what he is looking for. He is looking for understanding and for someone who will teach him how to be himself, and not somebody else. The same as any other “regular “child.

The logic and reason for vaccination is this: the weak virus – which makes up the vaccine – triggers a response from the body’s immune system, which in turns starts to develop disease-fighting antibodies. This puts the body on alert to react to the particular disease caused by the vaccine virus.
Vaccination policies are different in every country. In some countries vaccination is mandatory, in others it is voluntary. In the United States, children have to be vaccinated unless they are granted an exemption due either to health reasons, religious beliefs, or a strong objection to vaccination. The same rules pretty much apply in Canada.
In a May 2005 article in the journal Pediatrics, the author writes: “What is the pediatrician to do when faced with a parent who refuses immunization for his or her child? First and most important, the pediatrician should listen carefully and respectfully to the parent’s concerns, recognizing that some parents may not use the same decision criteria as the physician and may weigh evidence very differently than the physician does. Vaccines are very safe, but they are not risk free; nor are they 100% effective. This poses a dilemma for many parents and should not be minimized. The pediatrician should share honestly what is and is not known about the risks and benefits of the vaccine in question, attempt to understand the parent’s concerns about immunization, and attempt to correct any misperceptions and misinformation”
Most of us have been vaccinated at some point in our lives. I was born in 1965 in the former Soviet Union and of course I was vaccinated. But back then we did not have vaccinations from flu, MMR (mumps, measles, rubella), chicken pox, meningitis or hepatitis. Today all these are mandatory vaccinations. In addition, we did not have “all in one”, or multiple (MMR – like) vaccinations. We had one vaccine in one shot. Which I think makes a difference. Because none of us, never had to fight Mums, Measles and Rubella at the same time.
Did we have a lot of cases of autism in those days? No. Allergies? No. Asthma? No.
So, should vaccinations be blamed for all these diseases and disorders? Personally, I do not think so. I think these conditions are the result of a combination of factors: junk food, pollution, and change of the lifestyle from active to sedentary – all factors that lead to a weakened immune system. And this is where the cause-and-effect link to vaccine comes into play, because when a child with a weak immune system is vaccinated, then yes I do believe that it can trigger certain damage.
When my wife was giving birth to my son, I loved the anaesthesiologist who told her: “First of all there are no safe drugs.” A vaccine is a drug. And of course it does have side effects. For example, according to the U.S. Food and Drug Administration, Tamiflu vaccine side effects include panic attacks, delusions, delirium, convulsions, depression, loss of consciousness and suicide.
Therefore before deciding whether to vaccinate your child for a certain disease, it’s important to research the possible side effects from that particular vaccine.
The timing of the vaccine is also an important factor to consider. My son was in critical condition for 10 days after he was born. Then, when he was two month old, he developed severe anemia, or iron deficiency. We took him to his paediatrician, who said she wanted to administer the DTaP-IPV vaccine for diphtheria, tetanus, whooping cough and polio. I refused. My argument was that my son’s anemia would make him more vulnerable to the vaccine’s potential side effects. Once he recovers, then giving him the vaccine should be no problem.
Your child immune system has to be able to adjust and in some cases to fight the disease which is being introduced through the vaccine. Therefore your child has to be completely healthy when getting the vaccine.
Some vaccines are necessary, and some are not. For example, flu shots. Flu mutates every year which means the vaccine we’re getting this year is unlikely to address the new strain of influenza virus.
If your child has a certain disorder and is already on medications, then think carefully about possible side effects as well as the interaction between the vaccine and your child’s medications. Research CREDIBLE information. Put the pros and cons on the scale and weigh them carefully. Then and only then should you make your decision as to whether or not to get your child vaccinated.
When your child’s health and life are on the line, any decision you make must be an educated, thoroughly researched decision. Your child deserves nothing less than that.

Botox injections become extremely popular in cosmetic and medical use. But what has me worried these days is its increased use in children with hyper tone cerebral palsy. In fact, almost every day in my practice, I hear about another child whose doctor has recommended Botox injections. And I ask myself: Why – what for?

But, let’s just step aside for a moment to analyze the Botox injection itself and its supposed “local effect.” Botox is derived from the botulinum toxin, a neurotoxin that interferes with nerve impulses and causes muscle paralysis – including breathing disorders leading to death – muscle weakness, speech disorders and swallowing problems. Depending on the introduction of the botulinum to the human body, 90 to 270 nanograms of this toxin is enough to kill a person weighing 200 pounds or 90 kilograms.

Botox itself contains a very small dosage of botulinum toxin. Interestingly enough, the American Food and Drug Administration cautioned about the use of Botox in children – a warning it reissued in April 2009. Moreover, the FDA did not approve Botox injections as a treatment for spasticity in children. In a document called Early Communication about an Ongoing Safety Review of Botox and Botox Cosmetic (Botulinum toxin Type A) and Myobloc (Botulinum toxin Type B), the FDA states that it is “aware of the body of literature describing the use of botulinum toxins to treat limb spasticity in children and adults. The safety, efficacy and dosage of botulinum toxins have not been established for the treatment of limb spasticity of cerebral palsy or for use in any condition in children less than 12 years of age.”

The FDA goes on to say that “the pediatric botulism cases occurred in patients less than 16 years old, with reported symptoms ranging from dysphagia to respiratory insufficiency requiring gastric feeding tubes and ventilatory support. Serious outcomes included hospitalization and death. The most commonly reported use of botulinum toxin among these cases was treatment of limb muscle spasticity associated with cerebral palsy.” You can read the FDA’s comments in full at http://www.fda.gov.

Yet in Canada, Botox injections have been approved as a treatment for children with hyper tone cerebral palsy and other neurological disorders. As a practitioner, I have read accounts about “the whole world of abilities” which Botox injections have given to one child or another. Personally I have seen quite a few children after they’ve received Botox injections and have not seen any improvements. In some cases, I saw even deterioration.

The spasticity and / or hyper tone come from the central nervous system or the brain. Each child is born with hyper tone, but this tone becomes balanced and normal coordination of movement is built up when the child starts to move his or her head, roll from side to side and develop. The child who does not experience this “normal development” is developing abnormal “hyper or hypo tone.” In other words, this child is in the “evil circle” of inability to move functionally, which in turn leads to hyper or hypo (low) tone.

In my professional and personal opinion, the most important thing is to teach the child all functions all the time. This constant learning will normalize the child’s tone. If there is spasticity, followed by deformation of the joints, then there may be a place for Botox in your child’s treatment program. But keep in mind that there is no such thing as “local injection.” Any agent injected into the body will be absorbed and distributed by the blood throughout the whole body.

So given all this, before you to decide to allow your health practitioner to use Botox on your child, please consider your child’s age and condition and what gains your child stands to make as a result of the injection. And don’t forget that the effects of Botox wear out over time and that your child would need repeat injections at regular intervals.

Most important of all, keep in mind that Botox injection is not a simple, harmless shot. It does pose health risks for your child. The decision is yours, so make it wisely.

Max was standing in the corridor, looking somewhat puzzled as I – along with his mother and massage therapist – tried to get him to walk without assistance. At first, he made it clear that he was unhappy with the task by talking to us in a language none of us could understand. But after a while, we managed to convince him to walk on his own to the massage therapy room.

Later in the day I took a break from work and went for a walk in the park with my son. David had never before seen a child with autism and said to me: “Dad, I was scared of that kid.” he said. When I asked him why, he explained “Well… he is so loud, and he is not talking.” I explained to David that Max was actually talking, in the only language he knew to express himself. “He does not know any other way yet,” I told David. “But he will.”

The next time David saw Max again, he approached him and they played together!

We live in such an interesting society. On one hand, people are eager to help each other. But on the other hand, when we see something we are not familiar with or do not understand, we get scared. And then we try to hide our fear or disconnect ourselves from what we fear. God forbid that such a thing should happen to me or someone I love, we tell ourselves.

When it comes to people with neurological disorders, I think the lack of understanding of these conditions often makes us feel it’s necessary – and perhaps convenient – to use labels. So we refer to a child with a neurological disorder such as autism, Down syndrome or cerebral palsy as a disabled child or a special needs kid. I think in some strange way, using a label helps us define what we don’t understand and gives us some guidance as to how we should act around this person and what we should expect from this person.

The truth is, the only thing labels do is dehumanize people. So the child with a neurological disorder becomes defined strictly by his or her condition and we fail to see the personality behind the person.

For children with neurological disorders, being labelled as “disabled” has the terrible effect of reinforcing the idea that they are limited by their conditions. So they grow up thinking they cannot do things by themselves.

As an example, I’d like to tell you about Rose, a 18-year-old girl with hyer tone cerebral palsy. Rose walked into my treatment room with her hands up and legs bent at the knees. “Rose, please put your hands down and try to straighten up your legs,” I asked her. Her reply? “I am abnormal. I have cerebral palsy. I am disabled.”

“Is that your excuse?” was my to reply to her.

In order to enable our kids with neurological disorders, society needs to shed its prejudices and start treating these children with the respect they deserve. And when I say respect, I mean treating and viewing them as any other abled human being – not as helpless creatures who cannot do and decide anything for themselves.

Since we are society, then this change needs to start with us. We need to stop thinking that our kids cannot do anything unless we do it for them. We need to stop deciding what they will wear, eat and do. Instead, we should start giving them choices and let them know that they are in charge of their treatment and development. We are there to guide them, but they are the ones who need to do the real work.

In my first blog, I said “No excuses. No Pity.” To this let me just add “and no Prejudice.” Whether you’re the parent, caregiver or therapist of a child with a neurological disorder, the best thing you can do for this child is to help him or her become independent – without excuse, pity or prejudice.

Elaine is the mother of Naomi, a beautiful four-year-old girl with hyper tone Cerebral Palsy. Because of hyper tone in her adductor muscles, Naomi’s legs are pulled in and she cannot walk.

“We have everything we need right here,” I told Naomi’s mother.

I asked Naomi to lie down on the mats on the floor, and we started to work. Why on the floor? The answer is simple: when they’re at home, most children spend a lot of time on the floor. This is a safe environment for them. Also, since I’m a firm believer in taking in-clinic therapy and integrating it into daily activities, working on the floor makes sense for me and for my patients. Every home has a floor, but a therapeutic table? I’ve yet to see one in someone’s house. So why would I introduce my patients to therapy they would find difficult to apply at home?

Yet I understood Elaine’s initial concern about the lack of equipment in my therapy room. In fact, I expect it, and almost every parent asks me the same question: “Is there is any special equipment?” It seems to be a common line of thinking today, that children with “special needs” need special rehabilitation equipment, special treatment, special food, special clothes – in short, special everything.

Please don’t get me wrong, I am not an extreme “NO” person, but there does need to be a fine line. Yes, there may be a need for a walker, or splints, or a quadripod cane or crutches. But not everything has to be specially adapted, because doing this hinders children with neurological disorders from physically and psychologically pushing themselves to adapt to their environment and the requirements of their daily lives.

During my years of practice I have seen many kids who, according to their parents, had made improvements in another therapist’s treatment room but who couldn’t seem to function as well when they were home. This was hardly surprising to me. The treatment tables, electrical stimulation machine, and sensory integration equipment in the therapist’s clinic are left behind when the parents and children go home. So the therapy is also left behind in the clinic, instead of being continued everyday at home. Even when the therapist teaches you exercises to do at home with your child, these are still not seamless continuations of what is done in the clinic.

Having seen the results – or lack of, really – of this disconnect between therapy and home life, I came to the conclusion early on in my practice that what children with neurological disorders need is not special equipment but functional therapy. This means everything we do in my clinic has to be relevant to the functions and movements of daily life. If the immediate goal is to get the child to sit up, then I will teach the child – and the parents – the sequence of movements and verbal commands that will enable the child to complete the act of sitting up. And most important of all, I will emphasize the need to incorporate these movements and commands into the child’s daily life. That’s it. No special equipment, just the child and the parents learning how to move the body and condition the mind so that, eventually, the movements become automatic. This is how a child learns to develop and become independent.

We do use certain items in my treatment room that I ask parents to buy and use at home. We use toys, balls with different textures, plastic spoons, plates and cups – all items that can be bought at any toy store or even a dollar store – as part of sensory integration. By using these items, parents can teach their child to eat, play, sense, and feel objects. In other words, they can help their child discover the world around them – a critical component in any child’s development.

By minimizing, or even eliminating, the use of special equipment in the clinic, therapists can remove the wall between the treatment room and the home. And when therapy and daily life become one seamless, continuous activity, then there will be no barriers to your child’s ability to become functionally independent.

A long time ago, the mother of a 23-year-old woman with a brain injury told me that after her child sustained the injury at the age of five, physicians told her that her child would be a vegetable for the rest of her life. The mother did not believe it and fought for her daughter. Today, this girl has grown up to be a bright, intelligent and independent woman. Yes she has some impairment, but so what? She is definitely not a vegetable!

Day after day I hear the stories like this. The most recent one involved the parents of a two-year-old child with multiple neurological disorders. Doctors told the parents: “Do not bother to give her any therapy – she will die anyway. So let her die in peace.” In other words, they were telling the parents to just give up on their child because there is nothing to hope for. These kinds of statements make me angry.

This subject reminds me of a very old movie – so old I can’t even remember the title – which has a scene where the patient is in the hospital and a priest pays him a visit. The patient starts to cry and says that he was told he has just four days to live. The priest asks him: “What would you want to do the most?” “To go home,” replies the patient. “So, just go home,” the priest says. “But I have just four days to live,” says the patient. “Who told you this?” asks the priest. “The doctor,” says the patient, to which the priest answers: “Is he a god?”

Unfortunately therapists and physicians sometimes forget that we are just tools in the hands of God. People often view medical and rehabilitation practitioners as absolute authorities who knows everything. But NO, we do not know everything. We are just messengers. The fact is, it is you who knows your child much better than any other physician or therapist. So you have to ask questions and make sure your get complete answers. If surgery is required, then find out what’s involved, what results are expected, and what are the risks? And then what you do need to do post-surgery to ensure the ongoing success of your child’s treatment?

There are no stupid questions, so do not be afraid to be a pain in the you-know-where. You are, after all, deciding for your child. To make an appropriate decision you have to know all pros and cons. Do not trust, but research. And when in doubt, push for explanations and get a second, perhaps even a third, opinion.

During my over 23 years of practice I have treated a lot of people and seen a lot of amazing outcomes with my patients, some of them a complete surprise to me. But I do know that when you work hard, believe in your patients and encourage your patients to believe in themselves – well, then sky is the limit.

There are a lot of treatments, concepts and medical procedures out there. But remember that as a parent, you are your child’s best therapist and advocate. Your child trusts and believes in you more than any other person in the world. So you must, in turn, be your child’s most ardent believer and supporter.