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A Provider’s Point of View

| March 5, 2015

Heather Wilson, an occupational therapist at Ranken Jordan Pediatric Hospital, has spent her career making sure that each child she sees has the best chance of living a normal life. For the past six months, she and her team have partnered with the First Hand Foundation to do so.

Heather is in charge of Ranken Jordan’s constraint-induced movement therapy program (CIMT), which provides treatment for children suffering from partial paralysis caused by a variety of conditions—anything from pediatric strokes to traumatic brain injuries to seizure disorders. All of the children Heather works with have lost significant use of one arm and have difficulty performing everyday tasks such as zipping their coats or feeding themselves. And since most everyday tasks require the use of both hands, they have also lost a lot of their independence.

“CIMT is an intensive, one-one-one occupational therapy service that focuses on strengthening the arm and improving a child’s ability to use their hand functionally,” explained Heather. “It gives them the confidence that they can be more independent, and it really helps their self esteem because they learn they can do a lot more than what they thought they could.”

Children in the CIMT program receive three hours of therapy five days a week for two-three weeks—essentially taking a typical year-long therapy program and condensing it down to a few short weeks. During the program, the kids have casts on their stronger arms, forcing them to use the weaker limbs.

“The kids tend to be a little frustrated in the beginning because we’re taking away their good hand and forcing them to work really hard, but typically around the second week they are so proud of themselves and so excited to show you what they can do,” said Heather. “When they were doing therapy one day a week, it was such a slow progression. This happens a lot faster and they can really start to notice the difference, so they are more motivated to use their weaker hand. Using that hand on a daily basis just exponentially improves their function over time.”

Though research indicates that the intensive bursts of therapy and the use of the cast show more improvement than traditional therapy approaches, last year insurance companies started citing CIMT treatment as experimental. Ranken Jordan was no longer able to bill insurance companies for the services.

“The insurance denials really limit families’ abilities to participate in the program,” said Heather. “We try to keep our costs as low as we possibly can and are significantly lower than other programs in the nation, but even then, $3,000 for a family is not always something they can afford. Parents are frustrated because they see the progress and don’t understand the denials.”

Since last year, finding outside sources of funding (such as First Hand) has been critical for these families.

“Our goal for this program was always that it was not just a program where people could come to if they have money. We consider the kids first and to do what each child needs regardless of their ability to pay. But without organizations like First Hand, we would have no way for some kids to participate. You guys have been fabulous.”

So far, First Hand has helped fund the therapy for six children, including a five-year-old girl named Taylor who was born prematurely and has cerebral palsy with decreased use of her right arm.

“All of the kids First Hand has funded have done great, and Taylor is the perfect example of a kid who just did phenomenal during the program. She is very intelligent and had a lot of potential to improve her hand use. Two days into the program, her dad just looked at me and said, ‘This is unbelievable! I can’t believe how much progress she’s made in two days!’”

Heather and her team are very conscious of the types of families they request money for.

“This program depends a lot on parent participation. Before we apply for funding, we try to make sure that the families are invested in the program so we know the children receiving funds are the ones that are going to most benefit from it.”

For Heather, First Hand has brought her relationship with Cerner Corporation full circle.

“We actually went live with Cerner solutions just over a year ago and I was on the build team. It’s been awesome to partner with another side of Cerner. And it’s very cool for them to be involved in a different side of Ranken Jordan as well.”

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