The Quadriplegic Child

The majority of children in the ABR Program have the diagnosis of quadriplegic. This diagnosis refers to the outer extremities and suggests that both the arms and legs have been effected.

ABR recognizes that in order for these children to achieve functional improvement of the arms and legs, it is necessary to focus ones initial attention upon two fundamental functional elements:

• Head control

• Trunk strength and stability

Without acquiring significant head control and without having stability and strength within the trunk of the body, any discussion about weight bearing (internal Link zur Weight Bearing) upon the arms or upon the legs is fruitless. And weight-bearing ability always precedes the development of movement function!

No one would choose to build a twenty story building upon a foundation designed for a one family ground level dwelling. Yet the attempts to require a child with significant trunk instability or compressional weakness to stand or to walk could be compared to the described constructional fiasco.

In fact, it is the compressional weakness within the thorax and abdomen that result in the:

• lack of stability of head positioning

• insufficient range of movement of the head

• no head counter balancing movements

The same compressional weakness, on the other hand results in an obvious rigidity of the spinal column.

This spinal column rigidity ensures that the child exhibits:

• No side bending

• Limited rotational movement in the vertebral column

• Limited forward and backward movement of the trunk

• Difficulties with counter balancing

The description above outlines the initial targets of ABR work for quadriplegic individuals. Without improvements in these areas, it cannot be expected that such children can gain improvements in arm or leg function.

Countless ABR parents can confirm that improvements in the structural dysfunctions described above lead to improvements in the function and usage of the outer extremities for quadriplegic children.