Olivia’s Place

Getting a Knock to the Head: An Introduction to Concussion in Children

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Dr. Becci Dow,  Clinical Psychologist and  Clinical Manager, Shanghai

Dr. Becci Dow, Clinical Psychologist and Clinical Manager, Shanghai

Falling over and hitting your head is a really normal part of growing up. As parents you will undoubtedly recall many occasions where your child tells you that they have hurt their head, maybe the tell tale lump or redness is there? Maybe you have had to consult a doctor for stitches? Maybe your child has had an injury when playing sports or in rare cases you may have had the misfortune of being involved in a more serious incident?

Serious head injuries
During each of these occasions a decision has to be made about the seriousness of the problem. The following signs are critical:

1. Is there a wound that requires medical attention?
2. Is the child conscious? (Responding to sounds? Aware of their surroundings?)
3. Is the child sleepy?
4. Is the child vomiting or feeling sick?

If any of the above symptoms are present then it is essential that the child is taken to the emergency room and seen by a specialist. This is critical with younger children and babies. With a serious injury to the head the medical team will need to also make an assessment of any injury to the brain.

Brain injuries
concussionThe brain sits within a strong bony chamber (the skull), which does a good job of keeping this vital organ safe from infection and injury. But, did you know that your brain is a soft jelly like blob, “floating” in this space? It is not carefully connected to the skull but linked via delicate fibrous tissues that allow it to move. Now imagine what happens when the head and skull takes a hit? You might want to think about what happens to a brain shaped jelly inside a jam jar? First it will move away from the site of the knock – often the head is hit on the forehead so the brain moves and bangs the back of the skull. Just like a bouncy ball it will then move forward and hit the front of the skull. Depending on the force and the angle of the blow to the head, the brain may bounce and twist and move within the skull.

In serious, traumatic accidents the brain can suffer tremendous damage. It can swell, bleed, sustain injury and essential functions such as language, learning, memory, and vision may be affected. Here medical teams may have to use complex surgical and life saving techniques to repair damage to the skull and try to limit brain damage.

Concussion
Concussion is a mild traumatic head injury where the brain has sustained a blow and the symptoms are usually benign but can vary in severity. The primary signs are:

1. Loss of consciousness for less than 15 minutes – occasionally there is no loss of consciousness but damage has occurred
2. Feeling sick and dizzy
3. Memory loss or confusion (sometimes known as post-traumatic amnesia)
4. Head ache and pain

If you think your child has experienced these symptoms following a head injury, please consult your paediatrician, family doctor or visit the emergency department. It is important that symptoms are carefully monitored and that further brain assessments can be completed. Symptoms are often rapid in onset, with some impairment in neurological function and often these resolve spontaneously. In some cases symptoms evolve slowly over time.

Post-Concussion Syndrome
There is an increasing awareness of the symptoms of concussion in children as there can be ongoing effects both in the short term and overtime. Many sports associations are now active in preventing, identifying and treating concussion.

There are three main types of difficulty, which can vary greatly between individuals and can appear at different times following the initial head injury. These problems can also last for a significant time post-injury.

Cognitive/Thinking
• Memory loss or poor memory – this can be a common after effect to a head injury which will often improve over time but occasionally results in problems that require assessment and new memory strategies
• Attention & Concentration – It can be hard to sustain attention over time or to concentrate on tasks or information. This can be especially important to consider with school age children.
• Planning & Organisation – These daily tasks can be affected, with children appearing to struggle with routines, plans and coordinating tasks.

Physical Symptoms
• Sleep
• Fatigue/tiredness
• Headache or pain
• Dizziness/balance and coordination problems
• Vision & Hearing changes
• Smell & Taste changes

Emotional & Mood
• Anger & Irritation
• Depression & Anxiety

CONCLUSIONS
Mild head injuries are very common and careful attention is needed to ensure that children are assessed medically and any ongoing problems are noted and understood. Support can be provided by an appropriately trained paediatrician, paediatric neurologist or neuropsychologist. Many organizations can provide help and advice – see www.headway.org.uk for details and read this fascinating article from the Children’s Hospital Association about why woodpeckers don’t get concussions and what it means for children’s health.

PLEASE DO REMEMBER:

• WEAR PROTECTION WHEN RIDING ANY BIKE OR SCOOTER
• TAKE PRECAUTIONS WHEN PLAYING SPORTS
• IF IN DOUBT DO NOT CONTINUE TO PLAY SPORTS
• SEEK MEDICAL ATTENTION AFTER A KNOCK TO THE HEAD – EVEN IF THERE IS NO LOSS OF CONSCIOUSNESS
• REMEMBER THAT THE EFFECTS OF A HEAD INJURY CAN LAST FOR A SIGNIFICANT PERIOD AFTER THE EVENT.

In most circumstances the problems with concussion resolve over time.


Clinician Profile: Dr. Sun Xiaomian, Developmental Behavioral Pediatrician, CMO

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Dr. Sun Xiaomian, DBP, Chief Medical Officer, LIH Olivia's Place Shenzhen

Dr. Sun Xiaomian, DBP, Chief Medical Officer, LIH Olivia’s Place Shenzhen

Sun Xiaomian, M.D.
Developmental Behavioral Pediatrician, Chief Medical Officer LIH Olivia’s Place Shenzhen

 

Dr. Sun holds a master’s degree in Developmental and Behavioral Pediatrics and doctorate in Brain Science of Biomedical Engineering from Xi’an Jiaotong University. She was previously Director of the Department of Pediatrics at First Affiliated Hospital of Xi’an Jiaotong University and Director of the Department of Pediatric Health Care at Shenzhen Futian Women & Children’s Health Institute. Dr. Sun has worked in pediatrics practice and health care for more than 30 years. She has extensive experience in diagnosing children with neurodevelopmental disorders (motor, and language/language, issues with social functioning, intellectual developmental delay), and social, emotional, learning, and behavioral disorders (ADHD, autism spectrum disorder, Tourette’s, obsessive-compulsive disorders, bed-wetting etc.), and nutritional problems (malnutrition, micronutrient deficiency, childhood obesity), and growth and development disorders (dwarfism, precocious puberty, etc.). She also has a strong background in intervention and research.

Dr. Sun is a member of the Developmental and Behavioral Pediatrics Group in the Early Childhood Development Society of the Chinese Maternal and Child Health Association. She is the Vice Chairman of the Developmental and Behavioral Pediatrics Society of the Guangdong Province Association for Improving Birth Outcome and Child Development, a member of the Standing Committee of Autism Rehabilitation in Guangdong Province, and a member of the Developmental and Behavioral Pediatrics Society of the Guangdong Academy of Pediatrics .In addition, she is the Vice Chairman of the Shenzhen Child Health Association, a member of the Children’s Rehabilitation Society of the Shenzhen Rehabilitation Medicine Association, and a member of the Shenzhen Pediatrics Society. She is an editorial board member of the Chinese Journal of Woman and Child Health Research. Language: Mandarin

 

Why did you choose your field?

Dr. Sun: My mentor returned from the United States in the early 1980s, bringing the field of developmental-behavioral pediatrics back to China. At the time there were no similar professions, and I had a strong interest in this area, so with my mentor’s advice, I chose developmental behavioral pediatrics as a research direction and as a lifelong career.

 

Why did you choose to work at LIH Olivia’s Place?

During my time as a researcher and as a clinician of developmental-behavioral pediatrics at large public hospitals such as the First Affiliated Hospital of Xi’an Jiaotong University and at Shenzhen Futian Women & Children’s Health Institute, the establishment of developmental behavioral pediatrics has been difficult for a variety of reasons. As a result children with developmental and behavioral issues could not get the support they needed, at a time when the need for such services was growing in China.

 

It has been my dream to establish developmental behavioral pediatrics into a more rigorous clinical medical discipline and to serve more families and children. On the cusp of retirement, I encountered LIH Olivia’s Place, and found that LIH’s international management philosophy, its advanced, multidisciplinary medical technology and team was very consistent with my ideas. I knew that with LIH Olivia’s Place I could achieve my professional dreams.

 

What are some of the most rewarding experiences you have had in your chosen profession?

As a doctor, the most rewarding experience is to see the patient gradually recover with my care and return to society.

 

What’s your favorite thing about Shenzhen?

Shenzhen is a young and emerging city, full of vitality. The city government is efficient, the residents of the city high quality, and the air quality is good. My favorite thing about Shenzhen is its spirit of innovation and its efficiency.

 

What’s your favorite thing about working at LIH Olivia’s Place?

The clinical team. We are united, support each other, have a strong sense of ownership over our work, and have all joined for the same dream, to dedicate ourselves to the cause of improving child’s medical rehabilitation. This gives me a strong sense of belonging.

 

What would you like to be doing in 5 years’ time?

In 5 years, LIH Olivia’s Place should be even more mature of a company By then, if physical health allows, I will continue to contribute my efforts at LIH Olivia’s Place Shenzhen Pediatric Clinic, to help more families and children.


My Experience at Children’s Specialized Hospital

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Dr. Amy Meng, Pediatrician, LIH Olivia's Place Beijing

Dr. Amy Meng, Pediatrician, LIH Olivia’s Place Beijing

Children’s Specialized Hospital in New Jersey, US, was established in 1891. It celebrated its 125th year in 2016 and continue to provide leading healthcare services in children’s rehabilitation. As part of the partnership between CSH and LIH Healthcare, Dr. Amy Meng, Developmental Behavioral Pediatrician at LIH Olivia’s Place Beijing, travelled to CSH to completed an “externship.”

 

 

 

 

Meeting CSH in front of the Maple Leaf

It is said that the maple leaf in the eastern United States enjoys great reputation. The Children’s Specialized Hospital (CSH) Mountainside campus is located among long and narrow two-story buildings. The buildings are on a slightly raised hillside and hidden among maple trees, quiet and peaceful. Walking in to CSH Mountainside for the first time, I could see doctors, front desk, and waiting areas. Everything was in good order. Staff who were busy working greeted me with warm smiles.

CSH Mountainside Campus

CSH Mountainside Campus

The first night I arrived at CSH, I had the honor to attend their quarterly commendation meeting. They shared new rehabilitation therapy methods and presented case studies to explain how to use those methods effectively. This made me feel the strong academic atmosphere of CSH.

Profound Education with Dr. Beckwith

The following days were mostly spent in the out-patient department of CSH Mountainside. This department includes the Behavioral Development Unit, Physiatry Department, Psychology Department, and Medical Department.

My first station was the Behavioral Development Unit, where I spent about 6 weeks. This unit mainly sees children with developmental disorders, learning disorders, social communication disorders, cognitive impairment, and attention deficit hyperactivity disorder.

Developmental behavioral pediatrics is an emerging discipline with only several decades of history even in foreign countries. In China, we just establish this discipline in 2016. There are few behavioral development physicians in China. And the knowledge of most domestic developmental behavioral physicians is limited to common disorders such as autism, developmental delay, cognitive impairment, and hyperactivity. Actually, this specialty includes these conditions but also any diagnosis associateed with intelligence, development, and behavior belongs to behavioral development, such as Angelman syndrome, Williams syndrome and Down syndrome. In China, children with these diseases often visit a Children’s Neurology Unit, Children’s Healthcare, or Children’s Psychology Unit. Physicians in top-level hospitals may have contact with and know about behavioral development, however, the vast majority of physicians in China are not familiar with behavioral development, let alone the best intervention methods, intervention effects, referral opportunities, and referral organizations. For parents of children with special needs, it is hard. They often feel conflicted, confused, and helpless. In the first-tier cities like Beijing, parents can visit some pediatric rehabilitation or behavioral development hospitals. However, compared with CSH, both physicians and therapists in China have great space for improvement.

Most of the time at CSH Mountainside, I followed Dr. Beckwith in an internship program. Dr. Beckwith is a promising young physician who is the Director of Behavioral Development. He has been rated as one the most popular physicians among parents. Ninety percent of patients here are children with autism and ADHD, but there there are also some rare conditions like Prader-Willi syndrome.

Patient-centered CSH

Physicians in China usually have time pressure because there are so many patients; however, It seems that CSH gives abundant time and space for physicians to communicate with children and families. Generally speaking, for a first-visit patient, physician would spend 60 to 90 minutes in the first consultation. Actually, in that “short 90 minutes” consultation, physicians need lots of information, such as ADHD symptoms, complications, learning ability testing, medication, and communication methods. They spend half of the time listening to parents’ concerns. Dr. Beckwith once said that abundant outpatient time is the important guarantee of patient satisfaction. Meanwhile, physicians show great respect to patients’ privacy. Before each of my observations, we requested permission from parents. Over the years, CSH has obtained consistent praise in a nationwide patient satisfaction evaluation (Press Ganey). This rare achievement is based on the 125 years of culture and history of this hospital.Meng 2

What is a Developmental Behavioral Physician?

Physicians who receive American Developmental Behavioral Physician Training (i.e., fellow) must have an American pediatrician background, receive three years of training, and pass a national board examination every year. CSH arranges learning schedules for fellows, for example, following home visits, attending classes and discussion meetings, medical records discussions, etc. As a fellow, they are required to have a good command of common diseases and medications, know the behavioral development characteristics of rare conditions and understand relevant specialties. For example, CSH fellows are required to receive training in the Physiatry Department for three and half months, learn relevant psychology knowledge, and also to participate in research programs.

I benefitted a lot from my experience in the CSH Physiatry Department. The main responsibilities of this department are addressing problems of various kinds of movement disorders, testing movement performance, adjusting appliances, and relieving muscle tension (Botox or surgery). It is beneficial for developmental behavioral physicians to experience all kinds of complex disorders over time. In an interdisciplinary setting, physicians need to be familiar with various complex conditions and symptoms in order to judge when to refer to physical therapy and what kinds of therapy skills should be referred.

In China, it is commonly accepted that the precondition to be a qualified developmental behavioral pediatrician is he/she has to be a pediatrician with general clinical experience. Besides knowing about children’s development and treatment for common developmental conditions, he/she also needs to master knowledge of genetic disorders, nervous system diseases, auditory problems, and movement disorders and other relevant problems, to have certain understanding on psychology, applied behavioral analysis, linguistics, occupational and physical therapy, and how to use common tools of behavioral development.

Summary

I am much honored to have this internship in behavioral development as a representative of LIH Healthcare. I was deeply moved by CSH and their physicians, by their high efficiency and patient-centered service model, professional ethics, modest attitudes, powerful knowledge base, and treatment outcomes. They are not only modest and knowledgeable, but also very warm-hearted. When they knew my eagerness to help children in China, they were very generous to explain knowledge and refer relevant books to me. I understand that I still have a long way to go to be a qualified developmental behavioral pediatrician. With their encouragement and support and hard work on my part, I hope in the near future I can contribute my own efforts in treating children in China.


Winter Nutrition and Maintaining a Healthy Weight

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Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia's Place

Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia’s Place

baked-potatoIn the winter months, there is a smaller selection of fresh foods, we more frequently eat foods which are cooked, and the food we choose in the winter tends to be higher in energy value (calories) than at other times of the year. Most of us also decrease our physical activity during the winter, which means that it is easy to gain weight. This leads to two questions: How does this extra weight affect our health? Is it normal to gain weight in the winter?

 

mhrf-cpmh-110691f10If during the whole winter a person gains one to two kilograms, it usually does not pose a health risk. However, complication arise when a person gains this amount of weight every winter and retains it over the year. Most often, weight gain is the result of poor nutritional habits, consuming large quantities of food, and reduced physical activity. A diet that is not varied, skipping meals, and alternating between over and under eating are sure ways to quickly gain weight.

 

How do we avoid a larger increase in body weight and prevent health risks that can arise because of this? First, do not give up on the recommended basic principles of proper nutrition, which are, let us remember: moderation, variety, and regular meals. These are important recommendations for all ages in every season.

 

1z-16789Some additional guidelines can help families to avoid weight gain in winter:
• Eat frequent, smaller meals
• Eat a variety of foods
• Avoid or decrease frying
• Cook meals with seasonal ingredients
• Chew each mouthful of food well
• Do not link your nutrition to emotional states (joy, sadness, happiness, boredom, anxiety, etc.

 

No less important is daily physical activity. Walking, light exercises at home, organized sport/recreation activities, and clearing snow or leaves are some other possibilities, but always keep your current level of fitness in mind.

Reference: Serbian Institute for Public Health


What is “Flatfoot” and How Does it Affect Children?

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Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia's Place

Ilija Dimitrovsk, Lead Physical Therapist, LIH Olivia’s Place

Pediatric flatfoot refers to a structural deformity that occurs in children, which involves the lack of a developed arch of the foot. This can further be classified as symptomatic or asymptomatic. In the latter, the child exhibits no symptoms. This condition is sometimes called “pronated foot” by doctors and therapists.

Symptomatic flatfoot in children is characterized by pain or tenderness in the foot or leg. There may be an alteration in the child’s walking patterns, with a valgus heel (rearfoot turned outward) and difficulty wearing shoes. The child may also tire easily, seeming to lack energy to participate in physical activities.

flatfoot 1It is important to note that all children start out with little to no arch when they first start walking. As they mature, the medial midfoot plantar fat pad in the foot starts decreasing, leading to the development of a clearly identifiable medial longitudinal arch.

flatfoot 2In some children, however, the force of certain movements (pathomechanical) acts on the foot to cause a host of compensatory movements which affect the child’s gait function. There is noted fatigue of the lower extremity and the child may constantly want to be carried.

One possible reason for abnormal functioning of feet in children is a genetic predisposition to develop the condition. Biomechanical factors can contribute to the progression of flatfeet in children, like torsional problems in the transverse plane such as an adduction of the metatarsus (forefoot pointed to medial line – inside) or femoral (thigh) and tibial (shin-low leg) rotation.

Excessive internal hip rotation, rearfoot and forefoot varus (inversion- inward turning), limitations of dorsiflexion, equinus (foot pointed down- ”horse’’ foot) or pseudo torsion (Rotation) at the knee can also lead to acquired deformities of the foot.

A careful musculoskeletal assessment is required to spot anatomical compensations that signal the presence of an abnormal foot position. The foot needs to be evaluated in both weight bearing and non-weight bearing positions. Apart from a thorough gait analysis, the physical examination must include a detailed inspection for tenderness, severity of the deformity, range of motion, muscle strength, and spasticity. Any family history of foot deformities and medical conditions such as neurological disorders also need to be taken into consideration.

flatfoot 4Based on the results of such a foot evaluation, an appropriate treatment modality can be constructed. Orthotics provide early arthrokinematic (joint motion) care to children to prevent latent disability in adulthood. If not looked into at a young age, the loss of posterior tibialis function can trigger the development of a host of foot conditions as the child grows up. By supporting the child’s foot in its optimal position, orthotics ensure that mechanical instabilities are treated at an early stage, while improving posture and balance.flatfoot 3 This also promotes proper growth and development. Compensatory motions are eliminated and full functionality is restored to the medial arch height while maintaining the optimal structural integrity of the foot. This encourages healthy supination (inversion-inward turn) and functional pronation (eversion-outward turn) of the foot throughout daily activities; orthotics provide for the constant postural adjustments and readjustments the body undertakes on different terrain during the day. There is also less expenditure of energy due to the optimal alignment of the muscles, tendons and ligaments; the child is able to engage in physical activities without the constant feeling of lethargy.

References:
Russell G. Volpe (2012) Pediatric Flatfoot: When Do You Treat It? Podiatry Today: January 2012, Vol. 25, No. 1.
Michelle L. Butterworth (2010) A Systematic Approach To Pediatric Flatfoot: What to Do and When to Do It. Retrieved from: http://www.podiatryinstitute.com


LIH Olivia’s Place Teams Training on Autism Assessment “Gold Standard”

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Beth Rutkowski, PsyD, Clinical Psychologist & Psychology Team Lead, Shanghai

Beth Rutkowski, PsyD, Clinical Psychologist & Psychology Team Lead, Shanghai

LIH Olivia’s Place has always worked to meet the needs of the families they serve. Recently, questions about autism spectrum disorders (ASD) have been among the most common. LIH Olivia’s Place has a strong team of clinicians with training and experience administering a range of assessment measures designed to diagnose ASD. This includes the tool widely considered the “gold standard” of autism diagnosis- the ADOS-2. LIH Olivia’s Place has consistently employed specialists trained in the ADOS-2 over the last six years. However, as demand increases for high quality autism assessment throughout China, LIH Olivia’s Place has responded by increasing the number of trained professionals and the depth of our training program, in turn increasing our ca-pacity to serve families by obtaining clinical information using a widely validated tool.

The Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), is a partially structured observation of children and adults referred for ASD concerns. These observations are “standardized,” or held to a universal quality established through an extensive range of testing and confirmation.

The ADOS-2 has five modules, only one of which is administered at a given time. The determination of which module is administered is based on two factors- the individual’s verbal level and his or her age. Verbal ability can range from no words to fluent speech. The test can be administered to children as young as 12 months through adulthood. Each ADOS-2 module consists of talking or play activities using the same standardized materials every time it is administered. The algorithms used to diagnose autism spectrum disorders through the ADOS-2 have been consistently demonstrated to accurately identify autism spectrum disorders in toddlers, children, teens, and adults.

The ADOS-2 is widely used around the world and is the best fit for our team as we provide diagnostic assessment for children from China as well as expatriate children. Therefore, both Chinese and English speaking clinicians are presently being trained to administer the ADOS-2. LIH Olivia’s Place is utilizing the training system established by WPS, the publisher who has developed and distributes the ADOS system. The training is extensive and includes studying the administration of the modules, practice with the tool, and experience with scoring video examples of cases.

In December 2016, training on the ADOS-2 began with our Shanghai team. It will continue in Beijing, Shenzhen, and Kunming during early 2017. As individual clinicians complete the training, they will administer the assessments and work together to ensure the most accurate and comprehensive diagnoses possible. The ADOS-2 will be utilized alongside a variety of other tools from an inter-disciplinary team including psychologists, behavioral specialists, speech therapists, occupa-tional therapists, and physical therapists. With our increasing levels of skill and expertise, our teams continue to set a high standard for diagnosis and treatment of developmental disorders.

Dr. Beth Rutkowski is the Lead Psychologist at LIH Olivia’s Place Shanghai. You are welcome to contact her directly at ber@lih-oliviasplace.com or the Shanghai LIH Olivia’s Place team at (8621) 5404-0058.


ASD Training for Parents and Teachers in the Community

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asd-1Getting into the community and understanding the real needs of parents, teachers, and caregivers is important work at LIH Olivia’s Place. From 3-5 November 2016, LIH Olivia’s Place and Shanghai Changning Special Education Guidance Center held a public training on interventions for children with autism. Almost 50 therapists, special education teachers, parents, and caregivers participated. Three experts from LIH Olivia’s Place were invited to teach on autism spectrum disorders (ASD) from aspects of behavioral intervention, speech-language intervention, and occupational intervention, which enriched the participants’ knowledge of ASD and provided a great forum for communication.

 

Jamie Fanelli, Learning & Behavior Support Lead, delivers her presentation

Jamie Fanelli, Learning & Behavior Support Lead, delivers her presentation

On 3 November, Jamie Fanelli, Learning & Behavior Support Lead, spoke on Understanding and Supporting Students with Autism Spectrum Disorder. On the basis of increasingly inclusive attitudes towards children with autism in the US, Jamie presented the main features of ASD as well specific behavioral intervention methods and shared her practical experience of behavior analysis. Two interactive games also added much interest to the lecture.

 

Yi Lien, Speech Language Therapist, interacts with participants

Yi Lien, Speech Language Therapist, interacts with participants

The lecturer of the second day was Yi Lien, Speech Language Therapist. Yi presented on Speech Therapy and Intervention for Children with Autism Spectrum Disorder. During her one-day training, Yi introduced speech-language features of children with ASD in detail and shared assessment and intervention strategies for speech-language. She also introduced a program called “Hanen: More than Words” to help the audience understand that there are different ways to communicate. The highlight of her speech was analysis of detailed intervention methods by using rich video cases, enabling participants to easily understand the principles and master skills.

 

Fengyi Kuo, an LIH Olivia’s Place Occupational Therapist who is also a Visiting Professor at Indiana University and Adjunct Lecturer at Shanghai University of TCM, presented Occupational Support and Transition for Children with Autism Spectrum Disorder on 5 November. Her introduction of the concept of occupational therapy, sensory integration assessment, and intervention methods was warmly received by an attentive audience. Fengyi also helped participants solve practical problems in their daily lives or work during the Q & A session.

Fengyi Kuo, Occupational Therapist, answers a parent's questions

Fengyi Kuo, Occupational Therapist, answers a parent’s questions

Through three-day comprehensive training, experts from LIH Olivia’s Place brought practical experience which greatly inspired the participants.


LIH Olivia’s Place: Supporting Schools

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supporting-schools-1Staff at LIH Olivia’s Place are always delighted to be asked to support partner schools. We were recently invited to speak to parents at Wellington Bilingual School as part of the events leading up to the Festival of Education in Shanghai.

Jamie Fanelli, Learning and Behavior Support Lead, spoke to parents on the topic of Understanding the Connection Between Learning, Child Behavior, and the Power of Positive Reinforcement. She introduced some learning principles that are essential to understanding a child’s behavior and strategies to promote positive behaviors.

ilija-wellington-bilingual

Our physical therapist, Ilija Dimitrovosk spoke with the parents on the importance of physical activity for children in the early years age group. He provided theory behind the growth and development of young children as well as encouraging parents to participate when giving some exercise examples.

 

During the Festival of Education, leading experts from across the globe came together to discuss alternative approaches to teaching, as well as share their insights in educational thinking. Parents and educators were invited to join two days of talks, workshops and panel discussions in such areas as wellbeing, the relationship between Chinese and British education, Early Years, and classroom practice. LIH Olivia’s Place has a long history of supporting children, families, and schools and were honored to be involved in this initiative through sponsorship and opportunities for dialogue with educators, parents, and community members.

 

Our psychology team has continued to work very closely with the community at Dulwich High School. We are supporting their “Parent Academy” initiative by speaking on topics such as executive functioning and building relationships with teenagers. We regularly support the school staff by supporting career and professional development events and via professional supervision.


Partnering with Sunshine Rehabilitation Center for Occupational Therapy Training

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A training program on occupational therapy for children, organized jointly by Shanghai Sunshine Rehabilitation Center and LIH Olivia’s Place, was held from 17 to 21 October 2016 at Shanghai Sunshine Rehabilitation Center. Trainees from Shanghai Sunshine Rehab Center, Shanghai First Hospital, Shanghai Children’s Hospital, Shenyang Children’s Hospital, Quanzhou Children’s Hospital participated. The main speaker was Anna Tan Pascual, an occupational therapist from LIH Olivia’s Place. Through presentation of theory, group discussion, and live demonstration, Anna and the trainees thoroughly explored occupational therapy for children.

changning-1

At present, there is still a big gap between China’s occupational therapy and international standards. In order to improve the overall level of occupational therapy in China, it is of great importance for occupational therapists in China to learn from their colleague and to promote professional development of occupational therapy in China. Given the background, occupational therapist from LIH Olivia’s Place shared assessment and therapy skills in occupational therapy on children with nationwide OT experts, in order to jointly promote the development of occupational therapy in China and to help more children in need.

changning-2-annaThe main trainer, Anna Tan Pascual, LIH Olivia’s Place, is a registered occupational therapist in the Philippines and Australia. She has a Bachelor of Science in Occupational Therapy and Master of Rehabilitation Sciences, both from the University of the Philippines. In her more than 20 year career, she has worked in a wide range of pediatric settings. Anna’s clinical interests include helping children meet school and classroom demands, especially handwriting, as well as working with children who are blind or have low vision.

In this 5-day training program, Anna not only gave presentations on sensory integration, fine motor skills, cognitive therapy, handwriting skills, visual habitation and visual perception, independence in self-care as well as helping at home, but also shared her own clinical experiences and vivid case studies to help trainees better understand the theories. LIH Olivia’s Place hopes that through this training program, more infants, children, and teenagers who have fine motor, visual perceptual, handwriting, self-care, and sensory processing difficulties can be helped and supported.

One of the highlights of this event was the on-site case studies in which four children were invited to the training site. Friendly and experienced Anna soon won the children’ s attention and cooperation, and she as well as the trainees assessed the children ‘s capabilities in sensory integration, work behavior, posture, bilateral coordination, muscle tone and muscle strength, and dexterity, by working with them and also by observing them play matching games, build with blocks, put on and take off clothes, draw shapes, and do other activities. Trainees were then divided into groups for discussion so that they could have a better understanding of the practical operations in occupational therapy.

changning-3

The mission of LIH Olivia’s Place drives our efforts to help and support all children and their families in China. In this training program, we were honored to share our clinical knowledge and experience with experts from across the country.


China Hosts APPCS 2016 in Shanghai in October

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The 6th Congress of the Asia-Pacific Pediatric Cardiac Society (APPCS 2016) was successfully held on 20-23 October, at Shanghai International Convention Center. The history of the Asia Pacific Pediatric Cardiac Society dates back to 2001, when APPCS literally was born from notes on a napkin during an animated airport conversation between Dr. Anthony Chang and Drs. Apichai Khongphatthanayothin and Pirapat Mokarapong at the conclusion of the Third World Congress of Pediatric Cardiology and Cardiac Surgery in Toronto, Canada. The discussion focused on the increasing need for a large-scale meeting on pediatric cardiology in Asia similar to other regional pediatric cardiology meetings, such as the Association of European Pediatric Cardiology, rather than for each Asian country to host its own pediatric cardiology meeting, usually with very limited resources. Over recent years, APPCS has provided a high-profile, international congress for research in the theory and practice of pediatric cardiology. The congress has been instrumental in the advancement of pediatric cardiology and surgery.

XinHua Hospital, one of the largest hospitals in Shanghai, was selected to be the main organizing institution for the 2016 Congress. “Forward to the future of Pediatric Cardiology” was set as the vision for the event and many cardiology professionals from around the world were invited. As one of the most important parts of this international conference, Dr. Du of Xinhua Hospital presented on cardiac rehabilitation over two days. LIH Olivia’s Place Shanghai has been working with Xinhua Hospital and Dr. Du’s team for almost five years, supporting Xinhua through various clinical pathways, including physical and occupational therapy, NICU rehabilitation, and diagnosis and Intervention for autism.

appcs-1Our invaluable partnership has enabled us to arrange opportunities for widely recognized clinicians to share their knowledge and experience through their research and work during APPCS 2016. Dr. FengYi Kuo from LIH Olivia’s Place was invited by Dr. Du to moderate the conference on 22 October. Dr. Kuo ensured that the 100 attendees were able to exchange questions and discussion with each presenter, providing clarification as needed to leap linguistic and cultural gaps. At the invitation of LIH Olivia’s Place, 4 exceptional clinicians from top tier institutions in the US, as well as two senior clinicians from LIH Olivia’s Place, presented at the Congress:
• Dr. Sandra L. Rogers, Professor of Occupational Therapy, Pacific University
• Chris Tapley, Physical Therapist, University of Michigan/Mott Women’s and Children’s Hospital (Ann Arbor, Michigan)
• Megan E. Rose, Registered Dietitian, Pediatric Cardiothoracic Intensive Care Unit, University of Michigan/ Mott Women’s and Children’s Hospital ( Ann Arbor, Michigan)
• Dr. Jennifer Fridgen, Physical Therapist, Seattle Children’s
• Dr. Fengui Kuo, Occupational Therapist, LIH Olivia’s Place
• Dr. Becci Dow, Clinical Psychologist and Clinical Manager, LIH Olivia’s Place Shanghai

appcs-2During the one and half day cardiac rehabilitation training, all six clinicians presented on different strategies, methods, and interventions for congenital health disease, high-risk infants, posture and positioning for disabled children, feeding, nutrition, swallowing, and early movement, and they also shared with the audience the test and intervention strategies for cardiopulmonary exercise. During the training, Dr. Rogers also gave a workshop on Newborn Baby Assessment and Feeding. Three additional clinicians from LIH Olivia’s Place Shanghai, Speech-language pathologists Sophia Guarracino and Chihui Yong, and Occupational therapist Elle Millward, also attended the conference.

LIH Olivia’s Place, an affiliate of LIH Healthcare, is working with national medical groups to bring international knowledge and research to China. We are working within our communities and in partnership with local hospitals to advance medical development in China and help more children access quality resources and services to reach their potential.


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