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Dr. Raymond Tervo Named Chief DBP of LIH Healthcare

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Dr. Raymond  Tervo

Dr. Raymond Tervo

Dr Raymond Tervo , Developmental Behavioral Pediatrician, most recently with the Mayo Clinic, Minnesota, has joined LIH Healthcare, commencing in November.

Dr Tervo brings with him extensive experience gained in both clinical and academic settings in the care of children with neurodevelopmental disorders. His most recent appointment was as Senior Consultant at the Mayo Clinic Minnesota and he has served as Professor of Pediatrics at the University of Minnesota. Originally from Canada, Dr Tervo obtained his BS from University of Toronto and MD from McMaster University.

Throughout his career Dr Tervo has been a widely published and highly regarded researcher with strong academic interest and clinical expertise in a wide range of neurodevelopmental disorders, including autism, ADHD and developmental delays.

In his new role as LIH Healthcare Chief Developmental Behavioral Pediatrician, Dr Tervo brings this wealth of experience to China. Dr. Tervo will be providing clinical consultations, joining our multidisciplinary professional teams, as well as conducting training programs in Shanghai, Beijing, Shenzhen, and Kunming.


New Technology Helps with Decision Making for Surgery for Children with Cerebral Palsy

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Lis Ringrose, Physiotherapist, Chief Therapy Officer, LIH Olivia's Place

Lis Ringrose, Physiotherapist, Chief Therapy Officer, LIH Olivia’s Place

Due increased muscle spasticity, children with cerebral palsy (CP) often develop muscle contractures (shortening) and skeletal malalignment (where bones grow at a slightly abnormal angle or hip joints do not form properly). These can affect the functional abilities of a child. For example, because they are unable to straighten their knees fully they have difficulty balancing on one leg and kicking a ball. Or because their hips and knees are unable to straighten fully they can only walk slowly and with difficulty. Usually these challenges can be addressed by physical therapy through specific exercises and activities. However, it is sometimes decided that further intervention is needed if these contractures and malalignments are too significant to be treated just by physical therapy. The first step to consider is conservative treatment such as Botox. However, at times, surgery is necessary to help correct the muscles and/or bony structure.

Orthopedic surgery should not be decided upon lightly and is a decision best informed with the most amount of information possible. Firstly, the desired outcome of the surgery should be considered. Functional information should also be taken into account; what can’t the child do now that he/she wants to do and will surgery help? Are the child and the family willing to undertake the short-term discomfort of surgery and challenge of extra therapy for a long-term gain? Finally, detailed information about the child’s biomechanics (how they move) should be gathered to aid the decision of whether to proceed with surgery, but also, exactly what surgery to do. This information can be gathered by the child’s physical therapist – length of muscles, strength of muscles, and functional skills using compensatory movements. It can also be gathered through a formal gait (walking) analysis which looks in more detail at the action of walking. From this information, conclusions can be drawn that give more detail about how muscles are working and where the strengths and weaknesses are. Gait analysis is best done in a gait lab with specialist equipment; however, there are also now apps for rehabilitation professionals that can be used on iPads and tablets. Physical therapists (PT) are also trained to analyze movement by observation. Gait analysis both in a formal lab setting and through observation by the PT aims to gather information not just about what movements a child can do but how the child does those movements.

Regardless of the amount of information collected prior to surgery, the outcome of orthopedic surgery for children with cerebral palsy is still not always predictable. Some children respond very well and their function is greatly improved. Others can have little if any improvement which is disappointing for both the child and family given the effort that is put in for the surgery and recovery. Recently, a new piece of equipment has been developed to add even more detail to the information that can be collected and used during the decision making process. It is able to analyze the ‘how’ of movement in even more depth.

walk-dmc‘Walk-DMC’ (DMC meaning Dynamic Motor Control) uses electromyography (EMG). Electrodes are placed on the skin over the muscle groups that need to be analyzed and feedback detailed information not just about whether the muscles are working but also when and how much. Comparing the information collected to a ‘typical’ set of information, it can determine the level of muscle control. This can then inform what surgery would be beneficial and which would not. Through collecting data from over 400 children before and after orthopedic surgery, it has been found that those with better muscle control have better outcomes following surgery. With the information collected from Walk-DMC, a child’s team can have this information prior to surgery to help in the decision making process.

This technological development to help clinical decisions has much potential. Researchers plan to collect more information to help with more objective decision making for different types of orthopedic surgery for children differently affected by cerebral palsy. They also plan to monitor children who have less typical movement patterns to discover if corrective orthopedic surgery allows for change in movement patterns to become more ‘normal’ even at older ages. Other than monitoring the outcomes of surgery, the Walk-DMC could also be used to gather information on other treatment approaches that rehabilitation professionals, such as PTs and Occupational Therapists (OT), use in treating children with CP to discover which are most effective at leading to the best movement control.

Walk-DMC is a new development in the move towards providing more targeted, indivualized treatment for children with CP. It is currently not widely available but as it is using already common technology in a new way, the developers hope that is won’t be long until more people can be trained in its use and it can be more widely available.

Original article:
Schwartz MH, Rozumalski A and Steele K, Dynamic motor control is associated with treatment outcomes for children with cerebral palsy. Developmental Medicine & Child Neurology; Volume 58, Issue 11, pp 1139-1145. November 2016
Other sources:
Langston J, University of Washington Today, Walk- DMC Aims to Improve Surgery Outcomes for Children with Cerebral Palsy. 27 April 2016


Dr. Ming Li Visits LIH Healthcare’s US Partner, Children’s Specialized Hospital

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In October 2016, Doctor Ming Li from Peking University First Hospital made a 2-day visit at Children’s Specialized Hospital (CSH) in New Jersey, US. The visit included opportunities to meet with the management and clinical staff from CSH. As a well-established doctor and well-known scholar in the field of pediatrics, Dr. Ming Li was very satisfied with the experience and paid a high compliment to LIH Healthcare, the sponsor of the visit. “There’s nothing any better than coming and having a chance to do clinical rounds, patient observations, and exchange ideas with excellent developmental behavior pediatrics practitioners who face the same challenges. This is quite a fulfilling trip!” Dr. Li said. The visit was a first-time training collaboration between LIH Healthcare and Peking University First Hospital. Dr. Li is a Consultant Pediatric Neurologist and Associate Professor in the Department of Pediatrics at First Hospital of Peking University.


Leader in Taiwan’s Speech-Language Field Joins LIH Healthcare Consultant Advisory Board

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Wang Nan Mai, Speech-Language Pathologist, LIH Healthcare Consultant Advisory Board

Wang Nan Mai, Speech-Language Pathologist, LIH Healthcare Consultant Advisory Board

Wang Nan Mai, SLP (Dept. of Speech Language Pathology and Audiology, Chung Shan Medical University, Taiwan) became a member of the LIH Healthcare Consultant Advisory Board in October. She will routinely consult with speech-language teams throughout LIH Healthcare.

As a speech-language consultant on the Consultant Advisory Board, Wang Nan Mai will support development of clinical training programs and best practice service models for inpatient and outpatient settings. In addition, she will support LIH Healthcare’s efforts to identify and recruit highly-qualified speech-language therapists to provide leadership in this field.

Wang Nan Mai’s expertise makes her an excellent fit to facilitate teaching and research activities throughout LIH Healthcare, as well as to support collaborative research projects with strategic partners.

Nan Mai’s unique background in speech-language therapy combines professional degrees from Soochow University in Taiwan, Minnesota State University in the United States, and 30 years of extensive clinical and teaching experience as one of the few researchers in the early development of speech development assessment models in Taiwan. In the early years, she led the initiative to construct teaching curriculum and labs for the Department of Speech Language Pathology and Audiology.

Nan Mai has served in many leadership roles. Aside from being the director of the Department of Audiology and Speech at Chung Shan Medical University for 6 years, she is the Chairman of the Asia Pacific Society of Speech, Language and Hearing (APSSLH), and a committee member of the International Society for Augmentative and Alternative Communication.


Lazy or “Demand Avoidant”?: Motivating Children with ADHD

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Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia's Place Shanghai

Dr. Sophie Westwood, Clinical Psychologist, LIH Olivia’s Place Shanghai

An article that recently caught my eye, on ADHD and motivation, was written by a guest blogger, Sherry Cramer, an Educational Therapist, and posted on Anne-Marie Morey’s ‘Bay Tree Blog’. Anne-Marie is also a North American educational specialist. She has a great blog and often posts interesting and useful articles and resources. I strongly recommend educators and parents to take a look at her ‘Bay Tree Blog’, http://www.baytreelearning.com/blog/

Difficulties regarding motivation and children and young people are common but there are some specific ways of thinking about this issue and tips and strategies for children with ADHD that can be helpful. Here is the link to the blog to read for yourself http://www.baytreelearning.com/blog/2016/09/06/motivation/
I am going to outline some of the main points and a few other things that I think are important on this topic below. All of the research references can be found in Sherry’s blog post.

Sherry begins by explaining that researchers have found two major circuits of connections in the brain that are implicated in motivational behaviour: the reward and executive circuit. Both, or at least one of these circuits, function differently in the brains of children and young people with ADHD. The reward circuit doesn’t receive enough dopamine to keep children with ADHD focused on their goals and thus they become distracted by their own desires and things around them. A smaller, and less active and mature executive circuit in children with ADHD means that they struggle with ‘executive-function’ based tasks that enable us to plan, organise, pay attention and manage our time. Sherry goes on to describe a variety of tools that help to set up the right environment, details some of the benefits and controversies surrounding medications, and suggests reading for behaviour modification strategies, self-management and building executive functioning skills.

With these difficulties in mind, it makes it easier to see why children with ADHD often find it harder to complete the tasks required of them. In addition to these underlying brain-based skill deficits, other factors such as level of interest (we all like certain things over others), complicated ‘hidden’ social rules, the consequences or rewards of doing something, and the fact that repeated failure of a task can raise anxiety and/or lower self-esteem, commonly influence motivation. Taking these and other factors into account can help to shift the perspective of ‘laziness’ to think about why the child or young person is avoiding the demands of the task. Take for example Jack (a fictional character with realistic difficulties). Jack is an 11-year-old boy living with his parents and sister at home in Shanghai. He has a diagnosis of ADHD and takes medication when he goes to school. Jack’s parents are concerned because he has always loved soccer and plays in a team with his friends at weekends. Lately though, Jack has been playing videogames more and says he ‘can’t be bothered’ to play soccer. When his parents do manage to get him out the door and on the way to soccer practice he moans about going and doesn’t put much effort into the game. Jack’s parents have been sensitive to his needs as a young person with ADHD but are unsure whether this behaviour is laziness or more related to the issues described above. What factors might be contributing to Jacks ‘demand-avoidance’? How do you think Jack’s parents could approach this situation? Is there anything Jack can do to help himself?

The last section of Sherry’s blog posts focuses on how parents and educators can plant the seeds for personal motivation to thrive, and the skills that they might need for nurturing this growth. I echo Sherry’s advice and encourage those that are interested to read the books that she has recommended: they are often books that I recommend in my clinical practice.

References:
http://www.baytreelearning.com/blog/ http://www.baytreelearning.com/blog/2016/09/06/motivation/


Clinician Profile: Cristina Sakthivel, Speech-Language Pathologist

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Cristina Sakthivel, Speech Language Pathologist, LIH Olivia's Place Shanghai

Cristina Sakthivel, Speech Language Pathologist, LIH Olivia’s Place Shanghai

Cristina Sakthivel, MS CCC-SLP
Cristina is an ASHA-certified speech-language pathologist from California, US. She holds a B.S. and M.S. in Speech-Language Pathology from California State University Sacramento, and has completed training in PECS and PROMPT methods. Cristina has treated adults and children with speech and language needs for the past 6 years in a variety of settings, including medical/skilled nursing, public schools, and as a private practitioner. Cristina specializes in working with individuals with complex communication needs and multiple impairments. She served as an Augmentative & Alternative Communication Specialist in the San Francisco School District for four years. During this time, she provided direct therapy to students and consulted with other speech-language pathologists, teachers, and classroom staff to support the language needs of children using aided language methods. Language: English

 

How long have you been in China?
I packed up my husband and two geriatric “wiener” dogs and hopped a flight to Shanghai 2 years ago.

Why did you choose to work at LIH Olivia’s Place?
LIH-OP’s mission and vision are something I really believe in- improving access to therapeutic services for children in China.

Why did you choose your field?
I’ve always loved anatomy and language; speech-language pathology is the perfect blend of both. I find it wonderful that in the course of a day I can facilitate language growth by popping bubbles with a toddler, work on speech sounds with a second grader, and help a high school student craft theses statements and target social pragmatic skills.

What are some of the most rewarding experiences you have had in your chosen profession?
My true passion is working with children with complex communication needs (i.e., children who are nonverbal with multiple impairments) and providing them a means to communicate through pictures/icons, light-tech, or high-tech communication devices. I’ve never heard anything sweeter than the first time a child is able to say “no!” or “go away!” via aided means. It brings a tear to your eye!

What’s your favorite thing about living in China and/or working at LIH Olivia’s Place?
I love living in Shanghai- I think it’s a vibrant place, with so many wonderful and exciting things to do. I love that I still get lost when I go on a jog! And I love Family Mart.

What would you like to be doing in 5 years’ time?
I hope 5 years finds me continuing to travel as much as possible, enjoying a healthy life/work balance, and providing high quality therapeutic services to those in need.


Staff Profile: Akshata Kamath, Learning Support Specialist

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Akshata Kamath, Learning Support Specialist, Shanghai

Akshata Kamath, Learning Support Specialist, Shanghai

Akshata Kamath,MA, PGDM,PGD
Learning Support Specialist
Akshata is a versatile child advocate with a solid focus on the individual needs of special education students. She designs and implements inspiring hands on lessons, wide ranging manipulatives, and Individualized Learning Programs to enhance student achievement. She is skilled in addressing her student’s needs, ensuring children will thrive and develop in an adaptable educational atmosphere. She has a Masters in History and Post Graduate Diploma in Education Management from Mumbai University. She also has a Post Graduate Diploma in Clinical Psychology and is pursuing a Masters in Education from Karnataka University. She has worked in India as a classroom teacher for over 5 years and at SHINE Academy, Shanghai for 3 years as a Learning Facilitator for children with autism, ADHD, learning difficulties, cognitive impairment, and Down Syndrome. Her core teaching areas include mathematics, language, and science. She also has a strong background in creating Individualized Learning Plans (ILPs), behavior management, and social skills.

 

Hi!!! I have been living in Shanghai for close to 6 years now. I worked in the field of Education for 6 years before arriving to Shanghai with my family. For me education has always meant a process of facilitating learning and acquiring knowledge, skills, values, beliefs, and habits.

LIH Olivia’s Place strongly believes in providing world class therapy to differently abled children and offering every child the best opportunities to reach their excellence. The therapists here work with compassion, sincerity, and dedication, which inspires me to contribute my talent and knowledge toward our mission and vision.

LIH Olivia’s Place continues to explore and grow in a positive way, involving experienced people from around the globe, bringing together new technology and ideas, and improving services for both expatriate and Chinese families. Together we have created resources that can be accessed by all families.

The work culture at LIH Olivia’s Place is amazing. We have a great team of experienced therapists who willingly share their knowledge to attain excellence in children. My ideology of learning and giving back to society is what I see in the mission of LIH Olivia’s Place. This learning and giving back to society kind of environment makes me happy. LIH Olivia’s Place is where I continue to learn and enhance my knowledge in every way. The happiness of a child’s parents when they are informed about their child’s success gives true meaning for imparting knowledge and education in community.

As my family will someday leave China, I would like to establish an LIH Olivia’s Place in my home country to expand the learning and share new techniques and ways of supporting children with difficult needs. There is more happiness and fulfillment in sharing.


More than Words – The Hanen Program for Parents of Children with Autism Spectrum Disorder

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This month, LIH Olivia’s Place Shanghai will begin offering a parent training program called “Hanen : More Than Words” for Mandarin Chinese-speaking parents of preschoolers who are on the autism spectrum or have social pragmatic deficits. The More Than Words program was developed by speech therapists who are experts in the field of communication disorders and is backed by extensive research. The program will be delivered by Yi Lien & Chihui Yong, speech therapists who are trained and certified in the More Than Words program.

More Than Words empowers you to help your child reach the following three goals:

1 Improved social communication and back-and-forth interactions

2 Improved play skills

3 Improved imitation skills

Here are some of the valuable things you’ll learn when you attend the More Than Words Program:

• What motivates your child to communicate

• How to use your knowledge about your child to set appropriate and realistic goals

• How to make interactions with your child last longer

• Tips for using pictures and print to help your child’s understanding

• Strategies for how to talk so that your child understands you

• Strategies for developing your child’s play skills

• Ways to help your child make friends

Program Components

The More Than Words parent program includes:

• 8 training sessions in small, personalized groups

• A Hanen Certified speech-language pathologist leading the program

• A pre-program consultation for you and your child with your speech-language pathologist

• Three individual sessions for you and your child with your speech-language pathologist in which you are videotaped while practicing with your child. Then you and your speech-language pathologist watch the videotaped interaction to “see” what’s helping and what you can modify to help even more

Program Details

Fee: RMB 9000

Sessions will be held on Saturdays, 2.30 -4.30pm, beginning 22nd October 2016.

Please see flyer (in Mandarin Chinese) for program content and schedule: Hanen More Than Words

For information on the Hanen Centre and Hanen More Than Words

For additional program details or to register, please call LIH Olivia’s Place at 86-21-5405-0058/59 or e-mail us.


LIH Olivia’s Place Shanghai Collaborates with the Gladney Center

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Beth Rutkowski, Clinical Psychologist, works with a child at the Gladney Center.

Beth Rutkowski, Clinical Psychologist, works with a child at the Gladney Center.

In partnership with Gladney Center for Adoption, Dr. Mai Xiong and seven members of the LIH Olivia’s Place Shanghai team visited and re-assessed a group of children who are hoping to find a “forever home.” The clinical team had an intensive day of updating clinical files for twenty-five children and were rewarded with smiles, laugher, and curiosity all round.

All staff at LIH Olivia’s Place are committed to providing access to high quality therapy for all children in China and we were delighted to partner with Dr. Mai and Gladney to provide much needed support for these young people. The Gladney Center for Adoption was founded in 1994 and since then has matched almost 1000 children with families in the United States.

To learn more about the project, and the children, see the following websites:
http://superkidscharity.blogspot.jp/search/label/FSL%20Project

http://adoptionsbygladney.com/blog/august-3-2016-%E2%80%93-update-cccwa-shared-list-project

 

Beth Rutkowski, Clinical Psychologist; Elle Millward, OT; Ilija Dimitrovski, PT; Dr. Susan Cadzow, DBP; Sophia Guarracino, SLP; Shirley Zhou, ST

Beth Rutkowski, Clinical Psychologist; Elle Millward, OT; Ilija Dimitrovski, PT; Dr. Susan Cadzow, DBP; Sophia Guarracino, SLP; Shirley Zhou, ST


SCMC Conference Focuses on Clinical Skills & Advances in Care

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Developmental behavioral pediatrics is a rapidly evolving field. However, in China it is still an emerging field with insufficient professionals and establishment of relevant programs. Both pediatricians and educators are confronted with serious challenges in diagnosis and treatment. In order to improve diagnosis of pediatric disorders and treatment quality, “Developmental Behavioral Pediatrics Conference,” a national continuing medical education program, was held in Shanghai from 22nd to 26th June 2016. This conference was held by Shanghai Children’s Medical Center, affiliated with the School of Medicine at Shanghai Jiaotong University, attracting more than 100 healthcare providers devoted to developmental behavioral pediatrics. LIH HealthCare played a key role during the conference through the participation of several of our experienced clinicians.

The conference focused on clinical practical skills including standard treatment of pediatric disorders and differential diagnosis. Lecturers explained complex theories clearly and concisely. From basic introduction to clinical treatment, the content was well organized with prominent themes and a high-level of precision. All participants showed strong enthusiasm and took part in discussions. The conference was well received and questions put forward by participants were satisfactorily answered. In addition, the conference summarized new advances in developmental behavioral pediatrics in China to encourage healthcare providers to promote best practices.

img_2910A few experts were invited for this conference: Dr. Mark Simms, Director of Developmental Behavioral Pediatrics at Children’s Hospital of Wisconsin, who has helped to establish and advance developmental behavioral pediatrics in China over the past ten years; Professor Jin Xingming, leader of the National Developmental Behavioral Pediatrics Group; and Professor Zhang Yiwen, Director of Developmental Behavioral Pediatrics at Shanghai Children’s Medical Center. Meanwhile, Nelson Chow, CEO of LIH Healthcare, gave a keynote address at the conference, highlighting the mission of LIH Healthcare to support to support the field of developmental behavioral pediatrics in China.

Also, Dr. Susan Cadzow, Director of Developmental Behavioral Pediatrics at LIH Healthcare, presented on Infant Mental Health. Dr. Cadzow is a Behavioral/Developmental and General Pediatrician from Australia, and has worked in China for more than five years, she has extensive clinical and teaching experience in the areas of developmental and behavioral pediatrics, general pediatric medicine, and neuro-disability. In addition, Dr. Cadzow undertook further training and research in child protection and infant mental health.

Clinical psychology in China is not as well developed as in the USA or Europe. When it comes to infant mental health, there are very few resources and research on this area here. Very few people are aware that babies may have mental problems and can benefit from mental health support as adults do. During Dr. Cadzow’s presentation, she introduced “What is Infant Mental Health?,” and “What is Attachment Theory” to an audience which included pediatricians, therapists, and other pediatric clinicians. Through case sharing, Dr. Cadzow explained the risk factors and effects of early adverse experiences. She also helped the audience to understand how to identify infant mental health problems and how to promote good infant mental health. With the data analysis, case sharing and demonstration, and theoretical explanation provided by Dr. Cadzow, the audience gained a better understanding what pediatricians and other clinicians who treat babies should know about infant mental health and where to find resources.

After the conference, Professor Mark Simms was invited by LIH HealthCare CEO Nelson Chow to visit LIH Olivia’s Place Shanghai. During the visit, Professor Simms was impressed by LIH HealthCare’s efforts to support the development of rehabilitation services in China. During the meeting, Professor Simms and Nelson had a great discussion on how to further Development Behavioral Pediatrics in China, how to support rehabilitative care, and how to work together to bring recent advances in theory and practice to China.

LIH Healthcare is dedicated to supporting the advancement of developmental behavioral pediatrics and will always contribute to the field of pediatric rehabilitation. We believe that pioneers in this field will apply what they have learned to clinical practice and attract more healthcare providers to improving children’s quality of life in China.


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