Physical Medicine & Rehabilitation (Rehabilitation Medicine)

therapist with child using a walker

If your child’s functional ability and communication skills have been affected by disease or traumatic injury, look to the Nemours experts in pediatric rehabilitation medicine (also known as pediatric physical medicine and rehabilitation or PM&R). Our pediatric rehabilitation program for children up to age 17 is designed to help your child improve the abilities to move and communicate, and to function as independently as possible in the home, school and community environments.

 
A Team Approach for Successful Pediatric Rehabilitation Medicine

To accomplish this, we use a true team approach to include related areas of expertise and coordinate care. Your child will benefit from the knowledge and skill of our board-certified physicians in physical medicine — also called rehab physicians or pediatric physiatrists (pronounced fi-zee-a'-trists) — neuropsychologists, physical therapists, speech therapists, occupational therapists, social workers and rehabilitation nurses, among others. One of our pediatric rehab physicians will lead your child’s care team. These physicians have completed residencies in physical medicine and rehabilitation and either one year of practice as licensed physiatrists or one year of physical medicine and rehabilitation fellowships following the completion of their residencies.

We’ll use a coordinated, integrated approach to evaluate your child, develop a treatment plan, and provide all of the necessary therapeutic services. And we’ll give you both the education and training you’ll need to continue your child’s progress at home.

 
Conditions That Pediatric Physical Medicine and Rehabilitation Addresses

We offer pediatric rehabilitation medicine services for a wide range of conditions, including:

  • traumatic brain injury (including concussion)
  • acquired brain injury (such as a stroke, brain tumor or loss of oxygen to the brain)
  • pediatric spinal cord dysfunction (including those resulting in ventilator dependency)
  • amputation
  • congenital and acquired neuromuscular disorders (including cerebral palsy, spina bifida, muscular dystrophy and juvenile rheumatoid arthritis)
  • burns
  • encephalitis
  • meningitis
  • post-surgery for orthopedic conditions and injuries
  • multiple trauma
  • chronic musculoskeletal (orthopedic) pain including myofascial pain syndromes (chronic pain on sensitive points in your muscles in seemingly unrelated parts of your body) and reflex sympathetic dystrophy/chronic regional pain syndrome (RSD/CRPS), a chronic disease characterized by severe pain, swelling and changes in the skin
  • cancer
  • developmental disabilities

Nemours/Alfred I. duPont Hospital for Children, Wilmington


1600 Rockland Road
Wilmington, DE 19803
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For Appointments: (302) 651-4200

 
What to Bring
  • photo ID
  • medical and pharmacy insurance cards
  • preferred pharmacy name and phone number
  • names and dosage of all medications, including over-the-counter medication, your child is currently taking
  • guardianship and custody papers, if a legal guardian rather than a parent accompanies your child
New Patients

Bring these forms for your first appointment:

Returning Patients
 
Forms & Resources
New Patient Forms
Returning Patient Forms
Resources for Patients & Families

Our experts in pediatric rehabilitation medicine (also known as pediatric physical medicine and rehabilitation or PM&R) at Nemours/Alfred I. duPont Hospital for Children provide intensive medical and rehabilitation services for children through age 17. If your child’s mobility and/or communication skills have been affected by disease or traumatic injury, you can be sure that we’ll help your child regain as much ability and function as possible.

 
Areas of Expertise in Pediatric Rehabilitation Medicine
Our pediatric physical medicine and rehabilitation specialists can make a real difference for children in a number of specific areas:
  • traumatic brain injuries (including post-concussive syndrome and closed-head injuries)
  • congenital and acquired neuromuscular disorders (including cerebral palsy, spina bifida, muscular dystrophy and juvenile idiopathic arthritis or JIA, formerly called juvenile rheumatoid arthritis or JRA)
  • burns
  • acute (short-term) and chronic (ongoing) musculoskeletal pain (pain of the muscles and bones, such as myofascial pain syndromes and reflex sympathetic dystrophy/chronic regional pain syndrome or RSD/CRPS)
  • spasticity (stiff or rigid muscles) management (including Botox® and intrathecal baclofen pumps)
  • prescription/management of assistive devices, bracing/splinting, wheelchairs, seating, adaptive equipment and prosthetics/orthotics
  • cancer
  • orthopedic rehabilitation post-surgery
  • spinal cord dysfunction and spinal cord injury
  • respiratory issues (including mechanical ventilation)
  • cerebrovascular (relating to the blood vessels in the brain) accident/stroke
  • toe walking, in-toeing and out-toeing
  • newborn/high-risk follow-up and conditions relating to prematurity
  • gross motor and/or fine motor delay
  • congenital nerve diseases
  • brachial plexopathies (when the nerves of the body don’t work properly, such as Erb/Klumpke)
  • lymphedema, both congenital and acquired (lymphedema is arm leg swelling caused by a build-up of lymph fluid due to a blockage in the lymphatic system)
  • rehabilitation of any condition or injury affecting function, gait (how a person walks) and/or speech
  • electromyography (or EMG, a technique for evaluating and recording the electrical activity produced by skeletal muscles)
 
Pediatric Physical Medicine and Rehabilitation Inpatient Care

The inpatient pediatric physical medicine and rehabilitation program at Nemours/Alfred I. duPont Hospital for Children is designed to provide the best rehabilitation plan for your child during a hospital stay. Geared toward children who have severe functional limitations from their illness, disease or injury, our program includes coordinated, integrated therapy to evaluate and treat your child, and provides education and training for your child and family. The program’s goal is to improve children’s functional abilities and to return them to their home environment. Therapy takes place in a variety of settings, including at your child’s bedside and in the inpatient rehabilitation therapy gym. We also offer a pediatric therapy pool — the largest of its kind in the tri-state area.

 
Pediatric Physical Medicine and Rehabilitation Outpatient Care

The Comprehensive Outpatient Rehabilitation Program (CORP) at Nemours/Alfred I. duPont Hospital for Children is designed for children and adolescents who require the intensity of an inpatient pediatric physical medicine and rehabilitation program, but who are medically able to live at home with their families and make progress toward specific functional rehabilitation goals.

After discharge from an inpatient program, the rehabilitation team can continue caring for your child through outpatient visits and team conferences (discussions of your child’s care by all team members). During these visits, our team evaluates your child’s progress and revises the individualized rehabilitation plan to meet your child’s changing needs. Your family (and your child, when appropriate) is encouraged to participate in the team conferences.

 
Your Child's Pediatric Rehabilitation Medicine Therapy Plan

You can count on us to be with you every step of the way, from initial evaluations to discharge planning and follow-up.

Depending on your child’s needs, we offer all of the following:
  • occupational therapy (evaluation and treatment for children who have difficulty performing everyday activities — the goal is to develop or recover essential daily skills)
  • physical therapy (therapy designed to help kids maximize their physical abilities, independence, fitness and quality of life)
  • speech/language therapy (therapy to help children with speech and language disorders, or feeding and swallowing concerns)
  • cognitive remediation (therapy designed to help kids with brain impairments improve thinking abilities such as attention, working memory, flexibility of reasoning and planning)
  • neuropsychology (the study of how the brain affects children’s actions and thoughts)
  • school re-entry (assessing your child’s educational needs and helping to develop a return to school plan)

The therapy plan is individualized to your child's needs. For example, to start we might provide services at the bedside and then, as your child’s exercise abilities increase, we might move to the therapeutic gym area.

Parents, guardians and siblings are encouraged to observe and take part in each child's treatment program. You also can participate in education and support groups, counseling sessions and family/team conferences.

 
Pediatric Rehabilitation Psychology

The Pediatric Rehabilitation Psychology and Neuropsychology programs provide psychological assessment and treatment for children who have experienced a catastrophic illness or injury or were born with a physical challenge.

A team of highly trained child psychologists will help children learn to cope with the extra demands of their medical conditions, while having a normal childhood. Our psychologists will also encourage your child and your family to recognize your child’s achievements within the framework of your unique circumstances.

Our pediatric rehabilitation psychology services include:
  • psychological and neuropsychological evaluations
  • individual and family therapy for children with traumatic injury, catastrophic illness and disabilities
  • group therapy
  • evaluation of medication effects impacting attention span and thinking
  • parent and school consultations
 
Our Team of Pediatric Rehabilitation Medicine Professionals

During pediatric rehabilitation medicine, your child will be cared for by an interdisciplinary team that works closely together to address your child’s needs. Our pediatric rehabilitation medicine professionals have expertise in pediatrics and rehabilitation for children of all ages.

Your child’s pediatric rehabilitation team may include:

Pediatric Rehabilitation Medicine Physician: Also called rehab physician or physiatrist (pronounced fi-zee-a'-trist), this board-certified physician specializes in pediatric physical medicine and rehabilitation. Our rehabilitation physicians help to coordinate your child’s care while participating in our rehabilitation program. Our rehab physicians are trained to care for the physical and cognitive needs of your child. They direct and work with the team to maximize therapeutic interventions.

Advanced practice nurse/rehabilitation specialty nurse: This nurse works in conjunction with the pediatric rehabilitation medicine physician to oversee the clinical management of your child in the rehabilitation program, conducting ongoing assessments and evaluations of your child’s progress.

Rehabilitation nurse: This nurse monitors daily progress, develops 24-hour care plans, provides family teaching, and coordinates children’s rehabilitation program during the inpatient (overnight hospital) stay. The nurse also encourages kids’ independence and self-care through teaching.

Occupational therapist (OT): This team member works to increase your child’s independence in activities of daily living as well as to improve arm function, fine motor skills, visual motor skills and functional cognitive skills. The OT also will address the need for upper extremity splints, casts, adaptive equipment and home modifications.

Physical therapist (PT): The physical therapist works to enhance your child’s strength, gross motor skills, coordination, balance and endurance. The therapist also will assess the need for any special positioning equipment, lower extremity casts, braces and mobility aids.

Speech-language pathologist (also called a speech-language therapist or speech and language therapist): This team member provides diagnostic assessment and treatment for speech, language, auditory and cognitive disorders, as well as evaluates your child’s oral motor skills for eating and swallowing, and addresses the need for augmentative communication devices.

Neuropsychologist: The neuropsychologist evaluates the cognitive (thinking) and emotional status of your child with specialized evaluations that target aspects of memory, attention, language and abstract thought. Our neuropsychologist also evaluates and treats emotional and behavioral issues. In addition, teen support groups and individual therapies promote awareness and help kids cope with the challenges of rehabilitation.

Teacher: The teacher develops an individualized program based on your child’s specific needs, working with your child’s school and teachers as appropriate.

Social worker: The social worker supports your family throughout the entire rehabilitation process and helps to access community resources and facilitate communication.

Child Life specialist: This team member helps your child cope with the social and emotional impact of hospitalization through therapeutic play, social, recreational and group activities.

Respiratory therapist: This therapist provides evaluation and treatment services for all types of breathing complications.

Rehabilitation engineer: This team member uses innovative wheelchair adaptive devices, custom-designed aids and electronics to enhance the seating, positioning and specific mobility needs of your child.

Registered dietitian: The dietitian assesses the nutritional needs of your child to determine appropriate foods and caloric intake. The dietitian also teaches your child and family about nutritional matters after discharge.

Pharmacist: The pharmacist reviews all medications for drug interactions, appropriateness for medical issues and dosing, as well as ensures accurate and safe preparation of all products. The pharmacist meets regularly with the physiatrists and is available for questions about medication.

Internal case coordinator: This is a nurse who is responsible for accepting referrals and communicating with insurance companies. The internal case coordinator also facilitates discharge planning with your family and the rehab team.