In the context of child physiotherapy or child rehabilitation, prenatal, occurring during or after birth, Diseases that limit the child's physical and mental development (eagle: cerebral palsy, spina bifida, stroke, genetic disorders, muscle diseases etc.) being evaluated. In these diseases, problems occur in muscle tone and control and coordination of muscles.. Secondary damage to the musculoskeletal system in the future (such as contracture) may occur. Visual as well as musculoskeletal disorders, speech, Disturbances in swallowing and cognitive functions may also accompany.
Cognitive physiotherapy support; If there are physical problems and retardations at the source of the child's/person's learning and behavioral problems, a therapy program is created after a detailed evaluation in this area..
primarily autism, epilepsy, It is also used in the treatment of many different diseases, including psychiatric diseases such as attention deficit and hyperactivity.; It is a client-centered health profession that aims to increase health and well-being..
The primary goal is to increase the quality of life of the person and to ensure their participation in social life.. Mental, physical, sensory, image, social, environmental, having difficulties in emotional areas, needing special treatment, Having trouble speaking due to a problem in language development, It is applied to people who have difficulties in adapting because of behavioral problems.. Occupational therapy can be applied to people of all age groups..
Occupational therapists(occupational therapist) What people with such problems need to do, work with people and communities to gain or increase their ability to perform the pursuits they want to do or are expected to do by other people. In these studies, occupational therapists usually either change their occupations or try to speed up the treatment process of people by changing the environment.. Occupational therapists work one-on-one because occupational therapy is a person-centered healthcare profession., knowledge necessary to work collaboratively with groups or communities, Must have knowledge and experience. Occupational therapy education in universities aims at this and provides medical education to its students., social behavioral, psychological, should provide comprehensive training in the fields of psychosocial and occupational therapy science.
Occupational therapists also work with people who, for one reason or another, are excluded from society or restricted from participation, regardless of any physical condition.. One of these reasons; being a supporter of a social or cultural minority group or taking part directly in one of these groups..
People should actively participate in the occupational therapy process in order to get a positive result.. Since it is a client-centered health profession, the results seen on people after therapy will also be varied.. The state of increase in the ability of people in activity performance after therapy, The state of satisfaction of the person due to his participation in the activity is measured.
SENSORY INTEGRATION THERAPY
Sensory integration, It is a neurological process that enables a person to use their body in an environmentally friendly manner. 1972 in A. Described by Jean Ayres. In other words, sensory from one's body and environment, that is, the ability to organize sensory information..
Sensory integration, brain, focuses on behavior and learning relationships. So there is a link between sensory integration and learning.. Individuals with sensory integration disorder, learning and behavior, shows an unusual course of development. For this reason, it is very important to determine whether the cause of the problem in children is due to senses or emotions.. And in this determination phase, the biggest task falls to the experts.. It will be more effective and easier to reach the goal after the separation of the sense or emotional source..
The senses, which are the basis of learning and are the most problematic among sensory integration disorders; vestibular sense, which is the center of balance of our body, The proprioceptive sense, which is our muscular joint system and can also be called self-sense, and the interoceptive sensation that sends the stimuli we receive from our internal organs from our body to our brain., that is the inner sense. Learning as a result of supporting these senses at the therapy level, there will be a difference in the areas of behavior and socialization.
Genetic factors, changing living conditions, Increasing urbanization and preventing socialization from urbanization, The lack of parks and streets is one of the most important factors in the increase of children who have this problem in recent years.. Sensory integration problems may also be observed in children with mentally normal development.. More indoor growing at home, It is more common in children who are introduced to technological devices at an early age and do not play interactive games.
Treatment areas of Sensory Integration Therapy; attention deficit and hyperactivity disorder, language and speech problems, learning impairment, abnormal development, developmental coordination disorder, autism, down syndrome, cerebral palsy, eating problems, problems sleeping and socializing.
Sensory Integration Therapy is one of the pediatric physiotherapy and occupational therapy services.. With the determination of the appropriate treatment, generally positive results are obtained..
SENSORY AND ENGINE DEVELOPMENT MONITORING
It is a follow-up program that includes determining the sensory development and motor skills that should be supported in children with normal development and determining the appropriate physical activity program.. We evaluate and follow the development levels of children in the following areas:
- 0-1 age sense development (Sensory exploration)
- 1-3 age sensory-motor development (Self-care skills and daily life skills)
- 3-5 age perception-motor development (Engine planning and event sequencing)
- 5 age and older cognitive-intellectual development (Behavior and learning)
In our institution, also for premature babies, We make physiotherapy evaluations for low birth weight babies and babies born with multiple births and we prepare a therapy program according to the needs..
DEVELOPMENTAL FOLLOW-UP and EVALUATION TESTS
Denver Developmental Screening Test(DGTT)
0-6 It is a development applied to infants and children between the ages of normal development and borderline infants. testidir. To detect developmentally suspicious situations and to follow the developmental course Created for the specified age group. In this test, our goal is to assess the child's age-appropriate skills.. developmental problems providing an important opportunity for the early identification of pre-school children living in Personal – Social, Fine Engine, Language and Gross Motor about to 4 in the field 134 It is a test consisting of.
- 4 consists of subsections.
1. Social and Self-Care Skills
2. Fine Motor Skills
3. Gross Motor Skills
4. Evaluates in Language Skills sub-fields.
- 3 valuable in the core area:
1. Identifying possible problems in healthy-looking children,
2. Detection of functions suspected of developmental delay,
3. risky babies (eg prenatal problems, low birth weight or premature
born, multiple pregnancies, those with developmental problems in the family, assisted reproductive techniques
babies born with etc.) can be used in monitoring.
Ankara Developmental Screening Inventory(AGTE)
AGTE; especially when evaluated in terms of developmental delay and dysregulation, It makes it possible to identify babies and children thought to be at risk as early as possible and to take necessary precautions in advance.. Ankara developmental screening inventory, does not meet the purpose of diagnosis. For this reason, it is definitely not used at the point of diagnosis.. Ankara Developmental Screening Inventory Test, 0 ila 6 It is preferred in infants or children between the ages of. 0 – 3 starting from the month; 48 – 72 evaluates in monthly periods until the month of the month.. However, especially during critical periods that are considered to be risky.,
- 0 ay - 6 ay
- 12 ay - 18 ay
- 2 age - 3 age
- 5 age - 6 It is strongly recommended to be applied between the ages of.
via AGTE 0 age to 6 development of the child in the age range 4 are examined in a separate sub-area..
1. Gross motor development (crawling, which requires the use of large muscles in the body, sitting, Walk, bounce, running and similar actions)
2. fine motor development (holding something between two fingers, requiring a combination of attention and control with the use of small muscles, write and draw with a pen, grasping and similar actions using the palm)
3. Language cognitive development (time of first word, correct pronunciation of words, actions such as the correct extraction of sounds)
4. Social development and development of self-care skills (using a spoon or fork, the ability to go to the toilet unaided, helping with housework, ability to put on and take off clothes, tooth brushing and activities like that) can be listed as.
This evaluation is made in an environment where parents and children are together, if possible.. In addition to the questions directed to the parents by the practitioner, the child is also observed.. Every skill of the child is evaluated step by step..
Sensory Function Evaluation Test in Infants (TSFI)
Sensory function evaluation test in infants; sensory functions, behavioral, social and motor connections are learned, physiological, It is a test in which we obtain results from a developmental and behavioral perspective.. Studies evaluating sensory functioning in infants, BDFT is one of the three measurement tools that meet the evaluation criteria.. This test also helps to address early difficulties., sensory-behavioral-emotional-
allows us to distinguish physiological causes. Abnormalities in sensory processing and behavioral disorders occur in the brain of infants who do not receive adequate and appropriate sensory stimuli during critical periods of development.. This test is very important to know that it is not possible to pass to another developmental stage without completing one developmental stage and to organize the social and physical environment suitable for each developmental stage..
Criteria Evaluated in BDFT;
- Tactile Deep Pressure Response
- Adaptive Motor Functions
- Visual Haptic Integration
- Ocular-Motor Control
- Response to Vestibular Stimulus
Adjusted for normal development 24 This test, which screens infants 1 month and younger developmentally; 24 made up of matter, 20 done in one minute.
Turkish Early Language Development Test (TEDIL)
TEDIL, Test of Early Language Development (TELD-3) It is the adaptation of the language development test to Turkish.. Test, individually managed, norm referenced and 2 age 0 moon and 7 It is a test that aims to measure the receptive and expressive verbal language skills of children between the ages of 11 months.(Hresko et al., 1999). The test results can identify children with language disorders at an early stage., show the strengths and weaknesses of their language development, It can be used for purposes such as giving information about the development process and conducting research..
TEDİL consists of parallel forms, A and B.. Each form includes two subtests, namely Receptive and Expressive.. These subtests are the semantics of the language., It consisted of items measuring morphology and syntax domains.. total in each form 76 item exists. In some of these items, showing pictures or descriptions, and in others, fulfilling verbal instructions and answering questions verbally are covered..
TEDIL has five aims:
(a) Identifying children who lag significantly behind their peers in the development of early language skills so that they receive early intervention,
(b) identify individual verbal strengths and weaknesses
(c) determining the program and process in a language therapy that the child will likely receive
(ç) to serve as a scale for researching language skills in early childhood
(d) supporting other assessment techniques
TREATMENT OF NEURORELDELECTIVE PROBLEMS
Includes therapy programs developed for children with neurological background with abnormal development.. Cerebral Palsy problem, Physiotherapy and occupational therapy are applied to children with abnormal development due to genetic syndrome and neuromotor disorders.. In these treatments; motor skills, Organizing daily living spaces, including home and school environments, development of daily living skills, A support program is provided in areas such as communication and social skills development..
LANGUAGE AND SPEAKING THERAPY
Speech in children and adults, the heart, Contact, relates to the management and treatment of swallowing disorders.
BOBATH(NROGELİŞİMSEL THERAPYİ) THERAPY
It is the most widely used neurodevelopmental treatment approach with scientifically proven validity.. 1940This therapy method started to be applied by Physiotherapist Berta Bobath and his wife Neuropsychiatrist Karel Bobath in the 1980s., is an approach that is still open to improvement. Bertha Bobath, "We don't teach movement, We make the action possible ”summarized the treatment approaches.. It is stated that Bobath Therapy is the closest treatment method to the nature of the child, with the encouragement of movement and the provision of correct holding positions..
Bobath Therapist, Focuses on the central nervous system, which is the source of the problem in children with Cerebral Palsy.. Child's central nervous system, determines the needs of the child by comparing with the normal motor development stages. Muscle tone as well as normal motor development for the Bobath Therapist, reflexes, abnormal movement patterns, sensory issues, parameters such as perception and memory are also very important. The use of orthoses and adaptive assistive devices is very important in this therapy.. In this way, possible muscle problems are reduced..
Teamwork including the family, very important and effective in this therapy. Family, The education that the child needs for the developmental stages should definitely continue at home..
Treatment in the advanced stage of Bobath Therapy; pool therapy, sensory integration therapy, skip therapy, supported by methods such as kinesiotape and theratogs.
Bobath Therapy in Our Institution, Applied by experienced physiotherapists who have received the title of Bobath Therapist..
By Vaclav Vojta, Child Neurologist from Czechoslovakia, 1954 Some of the warnings he tried on a child with Spastic Diparesis, It is a treatment method initiated by observing the change in the child's spasticity..
0-1 Neurologist Vaclav Vojta, who studies age-old development, detected developmental reflexes and movements in this process, thus introduced an early diagnosis method that helps to diagnose delays in the movement system.. As a result of his kinesiology examinations, he determined the following developmental stages for a baby: 1. Double-sided rotation in the sixth month 2. Crawling in the eighth month 3. Beginning of standing from the eleventh month (verticalization).
Neurologist Vaclav Vojta, thus 1 pioneered in diagnosing under age. With the diagnosis of Central Coordination Disorder, reporting the possibility of future motor delay and movement disorders in children from mild to severe, suggested Vojta method as early treatment. Treatment, It is based on the principle of inducing some reflex reactions in the body as a result of the activation of sensory stimuli..
Neurologist Vaclav Vojta, revealed some muscle manipulations in school and preschool children in the following years, Later, he continued his studies in Germany..
Areas where Vojta Treatment is applied
1. Simple motor retardation,
2. Cerebral palsy,
3. Asymmetrical body growth,
4. Congenital arm paralysis,
5. Congenital neck curvatures,
6. Chromosomal disorders (Down syndrome, other syndromes),
7. Spinal opening (Plug bfida),
8. Post-accident paralysis,
9. Adult hemiplegia (Hemiplegia).
10. Congenital muscle diseases and body disorders (Skolyoz, drop foot deformity etc)
Floor time; autism spectrum disorder, down syndrome, language and speech impairment, attention deficit and hyperactivity, developmental retardation, It is a program developed for children with emotional and impulsive problems and their families..
Child Psychiatrist Dr. The main goal of this approach that Stanley Greenspan calls "play on the ground"; To enable parents to get to know their children and to communicate with them correctly and to make it easier for them to cope with the limitations they encounter in daily life.
DIR model, One of the building blocks of the Floortime technique. The main goal is to, to lay the foundations of emotional and intellectual skills. With the DIR model, the following three detailed assessment and intervention programs are developed for the child.:
1 – Developmental Section (Development)
There are six functional emotional development steps in the developmental part.. The child is evaluated according to these steps and allows the specialist to see which stage he is in developmentally.. These six digits; regulation and attention, coexistence, providing two-way communication, solving complex social problems and organization of behavior, representation of thoughts and abstract thinking.
2 – Individual Differences Section (Individual Differences)
It is different for every child to emotionally process the stimuli they receive from their environment.. A child may be hypersensitive or insensitive to sounds. This section looks at how the child responds / responds sensually to his environment and prepares a study program taking these into account..
3 – Relationship-Based Section (Relationship Based)
The child's mood of educators and parents, communicating with the child according to his developmental level and individual differences.. With this interaction, the child, begins to progress in functional and emotional development over time.
special education; It is an education program that supports the development and learning of a child or young person who is found to be significantly different from their peers.. In special education; cognitive, emotional, A program is followed to meet the needs of children and young people with physical and social differences.. By applying special education methods together with normal education techniques, it is ensured that children reach their own potential..
Treatment areas of special education; autism, down syndrome, other syndrome diseases, attention deficit and hyperactivity disorder, problems in cognitive development, problems in the emotional sphere, language and communication problems, traumatic brain injury, reading difficulty (dislection), writing difficulty (disgrafi), difficulty with math (dyscalculia), traumatic brain injury, all difficulties experienced in the field of learning, traumatic brain injury and orthopedic disorders.
With special education; developmentally different children, It is aimed to meet the needs related to daily life and to gain skills related to learning..
Purpose in special education, to ensure that the child benefits from the development and learning stages at the highest rate.. Adequate and effective special education for children who need special education, in future education life, Provides positive contributions to business life and other social areas.
People who have graduated from undergraduate and graduate special education departments of universities can provide special education support..
Problems with posture, evaluated under the name of posture disorder. Incorrect posture habits, problems in the body as a result of mental conditions (somatization) and anomalies in the body can cause posture disorder. Scoliosis, known as spinal curvature, is also a posture disorder.. The most common symptoms in posture disorders; shoulder pain, arm aches, lower back pain, muscle fatigue and weakness, leg aches, knee or ankle pain, nerve compression, stretching of muscles and connective tissues.
Lordosis, which is one of the major posture disorders in our institution (waist arch), posterior pelvic tilt (Burying the hip) ve kifoz (kamburluk) treatments are made.
Skolyoz, It is the curvature caused by the change of the spine. Trauma, Although it is stated that it is due to various reasons such as muscular diseases and congenital developmental disorders, the reason for the majority of scoliosis problems is unknown.. Spinal curvature may progress in scoliosis, can stay the same or improve. Non-surgical treatments are conservative methods in the treatment of scoliosis..
In the treatment of scoliosis; Vojta treatment in infancy, Physiotherapy approaches such as acupuncture and schroth treatments can be applied. In our institution, the following therapy applications are carried out by certified physiotherapists along with Vojta Treatment as scoliosis treatments.:
3 Dimensional Schroth Scoliosis Therapy
Scoliosis of the spine anteroposterior, from the side and the top 3 It is a deformity problem in which it changes in the plane. So this is also in the treatments. 3 corrective exercises should be applied on the plane. Request 3 in dimensional treatment approach, this is your spine 3 Corrective effect on the plane is targeted. 3 the basis of dimensional exercises, 1920It creates the Schroth method developed in the years.. Schroth Terapisi, It is an effective scoliosis treatment method that has been studied the most.. Schroth method developed in Germany, It is an accepted treatment in America and Europe.. Breathing exercises among the exercises applied with the Schroth method, proprioceptive warnings, learning and maintaining the correct posture, correcting the curvature side with different balance and movement exercises, There are exercises to give balance and normal movement. In addition, it is aimed to maintain the correct posture in daily activities together with posture correction in the treatment.. Cooperation with the family, is of great importance in treatment. In our institution 3 Barcelona Schroth Therapy, which is among the dimensional scoliosis treatments (BSPTS) and Lyon Concept are also applied.
Barcelona Schroth Terapisi (BSPTS)
Cognitive, is a treatment that aims to correct the curvature of the spine with sensory motor and kinesthetic studies.. In this therapy, After the treatment of the posture, both the patient and the family are made aware of protection and the awareness about daily life is ensured..
It is the oldest method in the world. 3 It is an exercise technique in which corset is included in dimensional scoliosis therapy..
CLINIC PILATES PROGRAMS
Pilates beautiful, back, pool, It is an exercise method that helps to tighten the muscles in the hip and leg area.. By Hubertus Joseph Pilates to overcome his own health problems (1912 in the year) is an enhanced physical activity. To benefit from Pilates, Correct breathing and focus are essential during exercise. In addition, the person who does pilates; body, proper nutrition in order to balance the mind and soul, Regular sleep, adopt a holistic approach where a lifestyle such as plenty of movement in clean and sunny weather is practiced.. To all of these considerations, actually it can be called pilates culture.
The first person to integrate the Pilates concept, which has become one of the most popular exercise methods in the world today, into physical therapy and physiotherapy is Orthopedic Specialist Dr.. Henry Jordan (1940 and after).
Clinical pilates used as a preventive exercise in physiotherapy rehabilitation; to posture disorders, joint pain, chronic waist, helps neck and back pain. Used as complementary therapy after standard physical therapy. It is also an effective treatment method for individuals with obesity disease or soft tissue rheumatism.. It is also used to prevent health risks associated with bone health and osteoporosis.. Clinical pilates, the back that spends the whole day at a desk and therefore due to misuse of the spine, Also recommended for office workers with back and neck pain. Individuals who do not have any health problems and who will start pilates for the first time can also be applied personalized clinical pilates after the examination..
WOMEN'S HEALTH PHYSIOTHERAPY
It is one of the physiotherapy fields that covers the treatment and education of women in various periods throughout their life. The treatment topics related to this field in our institution are as follows::
– Pregnancy in women, prevention of musculoskeletal functions associated with the birth and postpartum period,
– Pregnancy, birth, Evaluation and treatment of musculoskeletal and orthopedic pain during breastfeeding and baby care,
– Care with support and ergonomics in breastfeeding related problems,
– Postpartum rehabilitation by cesarean,
– Prevention and treatment of chronic pelvic pain,
– Treatment of pelvic floor muscle problems associated with endometriosis disease,
– Urinary incontinence, bladder pain and urethral pain treatments,
– Physical strategies to improve mental health in stress-related diseases (relaxation techniques),
– Fibromyalgia treatment,
– Preparation and treatment for changes in the menopause process,
– Healthy aging support.