When a child sustains a traumatic injury or illness that requires rehabilitation, it can be very stressful for the entire family. As your child becomes medically stable and their immediate medical needs have been met; your healthcare team may recommend rehabilitation. Pediatric rehabilitation is a subspecialty within the medical community. There are many unique factors about children and adolescents that must be addressed within their rehabilitation plan. It is important that the rehabilitation program provide a wide-range of services to meet the needs of the child and family, as well as helping ease the adjustment to school and other community organizations.
The Alexis Verzal Children's Rehabilitation Unit at Madonna's Lincoln Campus is accredited by CARF, the Commission on Accreditation of Rehabilitation Facilities, as a Pediatric Specialty Program in areas of comprehensive inpatient hospital, brain injury, spinal cord injury, stroke and comprehensive outpatient programs. According to CARF: "The essence of a Pediatric Specialty Program is family-centered care. Family-centered care is defined as having eight critical components. They are:
(Adapted from T.L.Shelton, E.S. Jeppson, and B.H. Johnson, Famiy-Centered Care for Children with Special Health Care Needs. Washington: Association for Care of Children's Health 1987.)
Scope of Services: The Alexis Verzal Children's Rehabilitation Unit is one of only seven in the U.S. that is accredited in both Brain Injury and Pediatric Specialty Programs, one of only two accredited in both Spinal Cord System of Care and Pediatric Specialty Programs, and it is the only hospital accredited in both Stroke Specialty Program and Pediatric Specialty Programs.
Madonna is the only free standing rehabilitation hospital in the region to house a separate, secured pediatric rehabilitation unit with dedicated, specialized pediatric clinical staff including a physiatrist, Dr. Adam Kafka.
The Pediatric Family Centered Rehabilitation Program recognizes the family as a constant in the patient's life and as an equal partner in the rehabilitation process. The child and family are not merely informed of the rehabilitation plan but are actively involved, to the best of their abilities, in decision making of all phases of the rehabilitation process.
To accomplish this, services provided are culturally sensitive, interdisciplinary, coordinated and outcome based. The primary focus of this program is to provide services to reduce disability, minimize handicap, prevent further impairment and to enhance the life of the child within the family, school and community. Individualized, developmental and age-appropriate care that acknowledges the child's need to learn and play is a primary focus.
The Adolescent and Child Rehab Program standards will be applied to all children and adolescents ages 0-18 (unless emancipated) on Alexis Verzal Children's Rehabilitation Unit, Acute Rehab Unit, Rehab Day Program, or outpatient setting.
Clinical Expertise: Each patient's rehabilitation program is directed by a physician who specializes in physiatry (physical medicine and rehabilitation) and the overall medical care by a pediatrician. Both doctors visit each patient daily Monday through Friday and are actively involved in treatment planning, meeting with the rest of the team on a daily basis. The core clinical staff who care for children and adolescents have completed pediatric competency training and testing, so have the skills necessary to integrate each child/adolescent's developmental as well as medical needs.
Environment: Children are provided rehabilitation in a dedicated, secure area designed specifically for children and adolescents. Each of 14 patient rooms is decorated in an age and gender appropriate manner, with a couch that folds out into a bed for family members to stay overnight. Each room is color coordinated, so that children will know which room is theirs by the color as well as the number. Each room has a private bathroom and shower, flat screen TV, DVD and Wi-Fi Internet access.
Rehabilitation: The Alexis Verzal Children's Rehabilitation Unit offers a large, comprehensive pediatric therapy gym. The gym includes three separate bays for a variety of therapeutic interventions. The unit also includes a developmentally appropriate toddler play area, as well as private and open common spaces for older children's activities. The indoor playground offers accessible playground equipment, a walking track and basketball court for children of all ages. Many adolescents and children find working and playing in our indoor, warm water therapeutic pool fun and highly beneficial. Adolescents and children also attend school in the Kit Scott Therapeutic Learning Center, a two-room modern school within the hospital.
Treatment Equipment: A pediatric Lokomat, the only one of its kind in Nebraska, and one of just a dozen in the U.S., can help some young people with certain conditions build the strength and coordination needed to regain mobility. Other technology such as the Body Weight Support Treadmill, Bioness functional electrical stimulation, environmental control units, custom seating and mobility systems, Tech Tots toys, and speech generating devices, are integrated into the treatment program throughout the continuum of care. The Snoezelen Multi-Sensory Therapy Room allows us to help patients achieve an appropriate sensory level to encourage learning early in a child’s recovery. This is achieved through discovering the right level of stimulating vs. calming activities that is unique to each individual. The ultimate goal of the enriched environment is to rehabilitate the nervous system so that patients are able to process information of increasing variety and complexity.
Vision: The ability to accurately perceive the environment is often affected following a brain injury and can result in difficulties with balance, walking, reading and attention. Madonna is the only rehabilitation provider in the region to offer a comprehensive vision program, led by Dr. Tanner Gates, Madonna's Neuro Optometrist. All the disciplines apply integrated vision treatment strategies, specialized techniques, and equipment to improve visual processing.
Community Re-Entry: Rehabilitation does not stop when the patient gains basic skills of self-care and mobility. Madonna Rehabilitation Hospital is the only facility in the region to incorporate a simulated community throughout its therapeutic space where patients may practice real life tasks such as grocery shopping, doing laundry, and completing household chores. This helps prepare adolescents and children for therapeutic outings into the Lincoln Community. Adolescents may also work on specific goals related to driving, school re-entry, or visit with a vocational rehabilitation counselor about school to work transition. Children and adolescents with physical disabilities are able to experience a variety of adaptive sports and recreation activities, such as swimming, power soccer, tennis, wheelchair basketball, fishing and others. The Alexis Verzal Children’s Rehabilitation Unit is also one of four Nebraska All Kids Ride Safe Center, designated and supported financially by the Safe Kids Coalition of Nebraska, Nebraska Office of Highway Safety, Riley’s Automotive Safety Program, AAA Cornhusker Motor Club Foundation, and the local Rotary Club. The role of the center is to operate a loan closet of specially adapted car seats and provide assessment and training regarding appropriate fit and use of the equipment.
Therapeutic Play: Children are not little adults. They have a constant need to play and learn, and things like family life, school and peer interactions are all very important. The Alexis Verzal Children's Rehabilitation Unit integrates play and peer interaction throughout its rehabilitation programming. Funding from the United Cerebral Palsy Association has helped the facility establish and maintain a special toy lending library called Tech Tots. Whether it is interacting with peers on the unit, in the gym, in TLC or going on an outing to Madonna's Child Development Center to interact with able-bodied kids, play and social interaction are key components of Madonna's programming. Madonna's Angel Dogs program also allows children to practice feeding, grooming, and walking a dog or cat.
Mild Traumatic Brain Injury: Many brain injuries are not initially recognized or treated because they are mild. Often the need for treatment may not be identified until months after the incident, when academic, vocational, personal or family adjustment difficulties arise. Madonna is regionally known for its Mild Traumatic Brain Injury services - a comprehensive 2-day assessment and treatment focusing on medical, physical, cognitive (thinking) and emotional aspects of mild traumatic brain injury. A separate team with pediatric competencies is now available for kids following concussion or other mild traumatic brain injury.
Sports Concussion: Madonna also offers a Sports Concussion Assessment for persons who have recently suffered a sports-related concussion and need assessment services for physical and cognitive changes and return to activities recommendations. Brain Injury Program Manager Lori Terryberry-Spohr, Ph.D. has completed research related to concussion injuries and leads educational efforts with local school coaches and parent groups.
The Adolescent and Children Rehabilitation Program offers pediatric rehabilitation across a wide continuum of care, including the inpatient acute pediatric rehabilitation program in the Alexis Verzal Children's Rehabilitation Unit, a Rehabilitation Day Program, as well as a Pediatric Outpatient Program.
The Alexis Verzal Children's Rehabilitation Unit is a 14-bed secured area for inpatient acute rehabilitation dedicated solely to young patients from infants to older teens. We offer comprehensive programming for adolescents and children with all types of diagnoses, from those who are still in the early stages of recovery following a very severe injury to those who have suffered a minor injury. We provide 24-hour physician and rehab nursing care for managing complex medical needs, an average of 3.0 hours of therapy a day, nutrition and respiratory therapy services, daily educational support, pharmacy, laboratory, and radiology services, on-site prosthetics and orthotics provider, and family training. Inpatient therapy scheduling takes into account meals, play time, free time and nap time.
The Adolescent and Children Rehabilitation Day Program is a unique program for those children and adolescents who are more medically stable; therefore, they need minimal physician and rehab nursing care. Families are able to live at home or housing units on campus and continue to come for intense therapy. The Rehabilitation Day Program is offered Monday-Friday from 8:15 a.m.-4:45 p.m. The RN and schedulers work with each individual family to balance therapeutic, academic, and rest breaks required for the child during their recovery.
The Adolescent and Children Outpatient Program is appropriate for children and adolescents who need to continue receiving therapy services, but don’t need as intense of a program. Your child will receive less frequent therapy based on their individual needs, often 2-3 times a week. Traditional outpatient pediatric services are offered Monday-Friday between the hours of 8:30 a.m.-6:00 p.m. The schedulers will provide orientation to the child/family regarding how to schedule appointments, how to sign in for appointments, and answer any questions.
The Adolescent and Children Comprehensive Assessments are ideal for families who are not certain what level of care their child needs. Madonna is one of the only organizations in the Midwest to offer an Adolescent & Children Comprehensive Assessment, where children/adolescents receive an individualized schedule of evaluations by a wide range of professionals. This includes visits by a physiatrist, as well as several other rehabilitation professionals such as neuropsychology, physical therapy, occupational therapy, and speech therapy. Other specialized services such as wheelchair seating/mobility, assistive technology and environmental control, advanced gait analysis, social-emotional adjustment, and school re-entry may also be added. The physiatrist and the therapy team will provide recommendations on an appropriate level of care.
The Adolescent and Children Clinics offer follow-up clinics for Madonna graduates to continue to monitor their progress over time. Individuals from outside Madonna are often referred by their primary physician for consultation.