Pediatrics

Children and adolescents require a different approach to rehabilitation. Madonna calls upon the expertise of experienced clinicians with in-depth knowledge of the unique needs of pediatric patients. The primary physician may be a pediatric hospitalist, a physiatrist who is board certified in rehabilitative medicine and/or a nurse practitioner. When necessary, specialty physicians are consulted. The primary focus of the medical team is to restore function and promote overall health in collaboration with the family throughout the therapeutic process.

Madonna therapists work in unison with physicians to help patients regain skills that may have been lost or impaired by illness or injury. For pediatric patients, this might mean helping an infant with grasping or sitting, or helping an adolescent patient return to their favorite sport. Physical and occupational therapists utilize specially designed spaces to simulate life at home and in the community to provide variety and keep patients engaged. Our indoor and outdoor playground spaces and warm water therapy pools are favorites among pediatric patients. Speech and language pathologists help restore communication, promote thinking and learning abilities as well as assist with feeding challenges. Staff neuro-optometrists can assess vision needs and prescribe vision therapy. Recreation therapy employs a variety of games and adaptive recreational activities, including off-site activities when appropriate to rediscover the fulfillment of leisure and fun. 

Madonna provides a full continuum of care for pediatric patients, regardless of the severity of illness or injury. Our hospitals are equipped to care for patients on ventilators or in a minimally conscious state, including patients who have suffered mild trauma or are recovering from disease. 

Once patients are healthy enough to discharge to their communities, our Rehabilitation Day Program (RDP) may be appropriate. Patients return to our campus two to five times per week for several daily hours of therapy, split among multiple disciplines of occupational, speech and physical therapy. A registered nurse is a team member on the RDP program allowing for closer medical management in collaboration with the referring physician to support the intensity necessary to continue recovery in the community. RDP allows for community reintegration while still benefiting from a rigorous therapy schedule.

Outpatient therapy is offered through Madonna’s TherapyPlus clinics. Frequency of treatment is unique to each patient. Outpatient therapy can include one or more discipline and vary in frequency depending on patient needs.

Offering multiple levels of care within the same organization allows for collaboration and communication between therapy teams, as well as a predictable and proven therapy model to maximize outcomes.

Adolescents and children participating in our rehabilitation program attend school in the Therapeutic Learning Center (TLC). The TLC is a learning environment within the hospital with licensed teachers who assist the patient’s transition back to school (elementary through college). The program enables students to stay current with their grade level and classmates whenever possible.

Registered nurses with pediatric experience and rehabilitation training are on staff at all times to care for patients. Madonna’s nursing model supports a 24/7 rehabilitative approach allowing patients additional opportunities to practice daily skills learned and supported by therapy throughout their stay, even outside of scheduled therapy sessions. Nursing staff also provides ongoing education and training for parents and other caregivers so they feel confident in caring for their child’s medical needs once they return home.

Madonna staffs licensed respiratory care practitioners at all times. Our respiratory therapists are able to provide arterial blood gas (ABG) services. Madonna is recognized as a Center of Excellence for Vapotherm and the Passy-Muir valve, specialized technology benefiting patients with tracheostomy tubes.

Madonna offers radiology services that include X-ray, CT scan, ultrasound, echocardiogram, venous doppler, arterial doppler, Holter monitor, sleep study and electroencephalogram (EEG).

Madonna's hospitals utilize in-house laboratory services to help diagnose and monitor patient conditions. Tests such as anticoagulation, hematology, chemistry, therapeutic drug level testing and urine analysis services with results often available the same day.

Madonna provides a full range of inpatient pharmacy services, including medication distribution, patient education and clinical/dosing services.

Madonna has registered dietitians and licensed medical nutrition therapists who are part of the care team and ensure the patient's individualized nutrition plan is met.

Neuropsychologists and rehabilitation counselors are an integral part of recovery at Madonna. They provide a variety of services, including educational testing, adjustment counseling, family therapy, behavioral management and education to the individual and caregivers following life-changing events that bring families to Madonna.

Assistive Technology Professional certified therapists provide seating and positioning evaluations for patients who require the use of a wheelchair for mobility. Additionally, computerized pressure mapping assessments for individualized wheelchair prescriptions and recommendations for driving and vehicle modifications are offered.

Spiritual care is an important component of healing. Madonna is committed to meeting the needs of our patients, regardless of their individual beliefs. Chaplains and other spiritual care professionals consult with the care teams and visit patients to provide direct support when requested. Chapels are available on both campuses, as well as ample green spaces for contemplation and respite.

Helping parents and other caregivers feel confident in caring for their child at home is a critical component of our pediatric program. The Parents Engaged in Rehab for Kids Success PERKS program meets weekly and is designed to target topics that ready families for community reentry and integration back into the home community.  Therapy and nursing staff work together providing education and one to one opportunities to practice daily living activities, medical procedures, operation and maintenance of assistive devices, transfers in and out of vehicles and other important skills necessary upon return to the community. When appropriate, families may practice new skills in a transitional living apartment when appropriate to confidently ready themselves prior to the transition home.

Successful transition back to the community is the primary goal of rehabilitation. With pediatric patients, this often includes their school environment and any recreational or leisure activities. Therapy goals are designed around each patient's individual interests. Off-site visits with therapists provide additional support for families in places like grocery stores, airports, houses of worship and other places they will visit frequently.

Feeding and swallowing problems (called dysphagia) are extremely complex and surprisingly common in children. Without treatment, these disorders can have lasting effects on a child’s physical and emotional development. The Pediatric Rehabilitation Program at Madonna offers a comprehensive assessment that takes into consideration a child’s unique individual needs relating to their feeding and swallowing problem. 

Madonna is the only hospital in the region to provide an extensive vision rehabilitation program delivered by specially trained experts who use state-of-the-art technology to help patients of all ages with visual impairments resulting from illness or injury to maximize their quality of life in home and community-related roles.

Madonna is committed to the lifelong success and wellness of our patients. When appropriate, we offer services such as home modifications, assistive technology, orthotics, prosthetics and emotional support resources for patients during and after their preparation to return home. 

Click to download pediatric scope of services document. 

A physical medicine and rehabilitation physician is available 24 hours per day and seven days a week. They manage all the health problems and complications as a result of the spinal cord injury and other medical conditions that may have existed before the injury. The physiatrist works in conjunction with the person’s hometown or family physician and other specialists, which may include an orthopedic surgeon, neurologist or internal medicine physician.

A pediatrician is involved in the daily care of individuals 18 years or younger.

The Neuropsychologist is trained to assess thinking skills including memory and problem solving and assists the person to understand spinal cord injury and implement compensation strategies. The neuropsychologist consults with the other clinicians on the treatment team if adjustment, behavioral changes or learning difficulties, are slowing progress in therapies. The neuropsychologist can work with the individual and family to help with emotional and adjustment issues which often accompany a spinal cord injury. The neuropsychologist is available to counsel with families, to support and encourage survivors and families and to enhance coping skills.

Certified Rehabilitation Registered Nurses are an integral part of any rehabilitation team. They have additional training and experience in rehabilitation diagnoses and their associated impairments, adaptive techniques for independent functioning, and potential complications. They develop and implement nursing care plans, provide patient family education, and supervise other direct care staff, such as nursing assistants.

A physical therapist (PT) assesses the person’s ability to move in and out of bed, a chair or car; the ability to walk or drive a wheelchair, as well as strength, balance and endurance. The therapist can provide a variety of activities to improve these areas. The PT also teaches family members and friends how to safely help the person out of the chair, into a car, to walk and go up and down stairs.

An occupational therapist (OT) assesses a person’s present abilities regarding activities of daily living, or ADL, with the goal of community re-integration. ADLs include skills such as dressing, bathing, toileting and eating, as well as homemaking and community skills. The OT works with arm and shoulder strengthening, vision changes and higher level thinking skills such as problems solving tasks, and job-related skills. The OT teaches the use of adaptive equipment to increase each person’s ability to complete ADLs with less assistance.

The speech language pathologist focuses not only on the person’s speech or ability to talk clearly, but also on all aspects of communication such as talking, understanding what others say, reading, writing, taking turns in conversation, concentration and memory. They help patients who cannot talk find other ways of communicating. They also evaluate and treat difficulties the person may have with swallowing.

To enhance leisure skills while at Madonna, individuals are offered therapeutic recreation after a referral from the treatment team. A recreation therapist discusses leisure lifestyle preferences prior to the injury with each person and family member to determine specific hobbies or interests. Leisure education sessions focus on relearning an activity or learning to modify a leisure activity by using equipment or different rules. The recreation therapist integrates the skills learned in other therapies for leisure activities. Community outings are available with the recreation therapist to practice skills needed to return back to the community.

Each person at Madonna has an assigned case manager who will lead the team in efforts to help recovery. The case manager communicates with representatives from the insurance company and keeps them informed of an individual’s progress plans. They will regularly visit with the person and his or her family members to see how the person and family feel the program is progressing and to help coordinate plans for discharge. This planning is to help assure a smooth transition from the rehabilitation setting to home or an alternative living setting.

The social worker assists the person and family with emotional and social concerns. He or she is available to assist the person, their family and friends to understand the effects of the injury and to learn how family and friends can adjust and be helpful in the recovery process. The social worker is able to assist survivors and their families to find support groups and communicate with other survivors of spinal cord injury and their families. At the time of admission, the social worker starts working on the discharge plan with family. The social worker will discuss community support services based on the team’s predictions of the person’s needs at that time.

The chapel is the center of Madonna, both literally and spiritually. It is open 24 hours a day for private meditation and prayer. The schedule of services is posted outside the chapel. Mission Services provides spiritual and religious support by offering daily Catholic Mass and regular Protestant services. A member of Mission Services visits regularly with every person to offer pastoral counseling. They also meet with individuals and their families on an on-call basis. Mission Services coordinates with the person's pastor when appropriate.

The Angel Dog program, an extension of Mission Services, combines traditional pet therapy with spiritual care. Trained handlers and their dogs can be referred to your family member for therapeutic visits.

The respiratory therapist (RT) provides specialized care for the individual with breathing and respiratory difficulties following spinal cord injury. The RT works with the team to wean the individual from a ventilator and/or tracheostomy. He or she also administers and monitors medications prescribed by the physician to improve a person's ability to cough, breath and resist infection.

Through the Driver Retraining Program, an occupational therapist evaluates the person's driving skills and retrains him or her, if appropriate.

Licensed medical nutrition therapists staff the Nutrition Therapy Department. A nutritional assessment is completed for each person during the first part of his or her stay. A person's diet history and food preferences are obtained, either from the person or from a family member. The nutrition therapist routinely assesses the individual's weight and dietary intake and adjusts his or her diet according to each individual's needs. When a person has a special diet, the nutrition therapist instructs him or her and family members about how to maintain the specialized diet while in the hospital and at home.

For school-aged individuals, the education specialist is the liaison between the rehabilitation team and the school. He or she coordinates school meetings, training and assists school personnel to make the necessary modifications for a smooth transition back to the educational setting. The education specialist also works with college-aged individuals or those persons who wish to earn a general education degree (GED).

A certified prosthetist specializes in the fit and production of an artificial limb for those with amputations. They work collaboratively with the physician and other team members immediately after the amputation to prepare the patient’s limb for a prosthesis, and then after the wound is healed regarding the fit and proper use of the device. A certified orthotist specializes in the fit and production of a limb brace. They work collaboratively with the physician and other team members to insure proper fit and use of the brace.