Aysha S Jamall, Faizan Masood.
A multidisciplinary approach to medically fragile children.
Pak J Rehabil Jan ;4(1):12-4.

Progress is determined by motivation and motivation is determined by confidence. In managing children with multiple deficits, it is necessary to extract underlying obstacles in order to make therapy most effective. The client, a ten year old girl presents with significant fear of movement. She presents with multiple fractures secondary to distal renal tubular acidosis and osteopenia. After confining herself to bed, post orthopedic surgery, she was referred to the Director of Programmes of Circle of Care, a center catering to children with special needs and promoting inclusion. Individual and parental counseling along with movement and art instruction yielded mobility and improved management of activities of daily life with moderate support from equipment and family members. As a result of collaborative work and systemic awareness, client was able to exit her state of immobility and become independent in problem-solving. A multimodal approach accounts for the physical impairments as well as the social limitations presented in a child. Multidisciplinary approach with importance on counseling makes therapy effective and progress visible particularly in children who present with multiple or frail disorders/diseases.

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