How we work

Our rehabilitation method demands intensive work with the child and therefore parents play the main role in the rehabilitation of children, especially of children with neurodevelopmental difficulties. In order to make parents good “therapists”, they need to be educated and trained. This is the foundation upon which the clinic is built.
Details of the work itself naturally depend on the diagnosis of the child, but generally the following can be said:

The first contact with the child is officially called the initial examination. It consists of taking data from the parent, examining the child, establishing a diagnosis, and if necessary instructing parents to have their children undergo further examinations, some of which can be conducted at the polyclinic itself.

The need for further examinations depends on the particular child, but we routinely suggest that children with neurodevelopmental difficulties undergo further examinations including a cranial ultrasound, an examination by an orthopaedic specialist (both of which can be conducted at the clinic) and sometimes an examination by a neuropediatrician. The therapy will be discussed when the results of all of the examinations are obtained.

Rehabilitation program is individual. It depends on needs and problems of the child. It can consist developmental medical gymnastics (special exercises performed on or by the child), occupational therapy, therapy performed by special need rehabilitator. The exercises are usually performed on the child by the parent or by the child with the parent’s assistance, so it is necessary for the parent to be educated about all the exercises and trained in the performance of the exercises, into the smallest detail, the way they should look and their sequence. If the parents decide to go through with the rehabilitation process at our polyclinic, they make appointments for “training” with the particular therapist, depending on the program. Training of the developmental medical gymnastics is performed by a physiotherapist according to strict instructions of the physiatrist, or by the physiatrist him/herself, depending on the specified program. The number of training sessions can not be predicted because it depends on several factors: the age of the child (the younger the child, the less that can be done during one session), the rehabilitation program (the more extensive the program, the more time that is needed), and the parents’ skills (the greater the parents’ skills, the easier and quicker it will be for the parents to learn). Each training session lasts approximately an hour; it is impossible to predict everything with children. Training lasts until the expert, the physiotherapist or physiatrist, judges that the parent has completely understood the program and can perform it independently. This is very important because most of the children that come to our polyclinic come from outside of Zagreb, and there are a considerable number of children that come from outside of Croatia, so they cannot easily come to the polyclinic if something is not clear. However, it can be said that on average three or four training sessions are necessary.

If rehabilitation program contains other components, parent will be instructed by occupational therapist, speech therapist, special need educator, depending on the needs.

After the training sessions have been completed, parents come with their children for a check-up on average once every three weeks, but it can also be sooner if an important improvement is expected or if the parent calls us to inform us that something important has occurred. It can also be longer if no improvement is expected in that particular period. During the check-up the child is examined again and if necessary, the rehabilitation program is modified and parents undergo further training. The check-up is always conducted by a physiatrist, and parents are trained further by either a physiotherapist or a physiatrist. However, further training is never as intense as the initial training.
In the check-ups that follow, new diagnostic examinations or therapies are sometimes suggested, if there is a need for them. The roles of the speech therapist, special needs therapist, psychologist and occupational therapist are very important here and their work is an integral part of the rehabilitation. If these elements are required for a particular child, they are added to the rehabilitation program.
Considering the large number of parents that come outside of Zagreb, we try to solve some problems that come on the way by phone, e-mail or recording.

The possibility of examination and therapy in the home of the patient exist, whether as occasional or permanent. This is different from usual program in a way that here we don’t have training, but the rehabilitation program is performed by physiotherapist or occupational therapist. Intensity of therapy performed at home differs (according to the wishes of the parent, possibilities and needs of the child), and goes from one to several hours per day. However, even with the most intense therapy at home, part of the rehabilitation program is performed by educated parent.