Bobath Scotland officially opened 1st Dec 95 and we cannot believe how far we've come.
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Cerebral palsy is a permanent disorder of posture and movement resulting from brain damage occurring in the baby or young child before, during or after birth.
Children with cerebral palsy often experience additional difficulties affecting vision, speech, hearing and learning. They may also suffer from epilepsy. Due to impaired movement a child with cerebral palsy may find it difficult to explore their surroundings and learn basic life skills as quickly and in the same way as unaffected children. Aspects of digestion can be problematic causing swallowing difficulties, sickness and constipation. Each child is affected differently, both in the type of cerebral palsy and the severity.
There are three main classifications of cerebral palsy, all of which are likely to include additional difficulties such as those outlined above:-
Spastic cerebral palsy is when the muscles are stiff and weak. Children who have this condition tend to hold their bodies in certain characteristic ways and have limited movement.
Athetoid cerebral alsy causes the tone in the muscles to change quickly from floppy to stiff and makes arms, legs and body move excessively in a way that is hard for the child to control.
Ataxic cerebral palsy affects balance and causes unsteady movement.
There is no cure for cerebral palsy, and although the damage to the brain does not worsen, the effects of the condition can become more debilitating with age.
Bobath therapy can help children, adults and their families manage the problems that cerebral palsy presents. This can change the clinical presentation (symptoms) of the condition and increases a child’s independence and quality of life.
Cerebral palsy results from brain damage occurring before, during birth or in the first two years of life. The damage affects the messages being received by and sent from the brain, as well as the way in which the brain interprets the messages it receives.
Cerebral palsy is not terminal. Each child is affected differently, both in the type of cerebral palsy and the severity. Some children with cerebral palsy have other associated conditions, such as epilepsy and respiratory complications, which can lead to a shortened life expectancy (this is only in a minority of children).
Bobath therapy takes its name from Dr. Karel and Mrs. Berta Bobath who pioneered the treatment during the 1940’s. While treating a painter who had suffered a stroke, Berta Bobath discovered a new method of treating spasticity which over time has been developed as a unique problem solving approach to helping children with different types of cerebral palsy. The Bobath Concept has subsequently developed into a therapy approach that is still relevant today.
The main aim of Bobath therapy is to encourage and increase the child's ability to move and function in as normal a way as possible. More normal movements cannot be obtained if the child stays in a few positions and moves in a limited or disordered way. With the intervention of Bobath therapy we help the child to change their abnormal postures and movements so that they are able to comfortably adapt to the environment and develop a better quality of functional skills.
Bobath involves a trans-disciplinary approach that includes physiotherapy, occupational therapy, and speech and language therapy. The basis of the approach is to use specialised techniques to elicit responses that may derive from physical, aural or visual stimuli. These then create a repertoire of movement patterns that enable children to participate in daily activities. Bobath is a holistic approach involving the child’s family, local therapists and teachers who, by attending and participating in the therapy sessions, can continue good practice between treatment blocks.
Cerebral palsy affects approximately one in every five hundred children born. Despite developments in maternity and paediatric care, the number of children born with cerebral palsy is not decreasing. In fact due to improvements in health care more extremely premature babies are surviving and some of these babies have more complex needs.
Up to 135 children aged between 8 months to 18 years, from throughout Scotland, are helped by Bobath therapy each year. Bobath therapists, patients, carers, the child and their external support network all work together to help achieve defined goals for the child during their therapy block. A key element of Bobath therapy is to train the parents and family in therapy techniques that they can easily build into their everyday routine. As a result we are indirectly helping an estimated 400 parents and siblings each year.
In the past, we lacked the resources to help adults past the age of 18. However, we have always recognised that provision for adults elsewhere is very limited and that there is a clear need for continuing support among many of the service users who have turned 18. We are therefore extremely grateful to the Robertson Trust, who have generously provided funding to allow us to undertake a two-year pilot project treating adults with cerebral palsy, which started in April 2012. For more information, click here.
Children with cerebral palsy have a movement disorder due to abnormal muscle tone where muscles are either too stiff or too floppy. This hampers the natural development of skills such as walking, talking and writing. The Bobath concept recognises and provides a unique understanding of the many systems that influence abnormal tone, such as vision, hypersensitivity to touch, and ability to move through space. It examines how abnormal tone affects the building blocks necessary for movement, exploring ways of encouraging more natural movement patterns that can be integrated into everyday life.
With improvements to posture and movement a child may gain greater control of hand and eye movements. Even for the most severely impaired child this opens up a whole new world of possibilities.
Bobath treatment is a multidisciplinary hands-on therapy approach aimed at helping a child with cerebral palsy to move and function more normally and with greater independence by utilising handling techniques that positively influence the abnormal tone and postures. Parents are shown ways in which they can incorporate these handling techniques into the regular activities of a child’s daily life (e.g. dressing, eating, moving around the house, etc). The focus in Bobath therapy is to try and reduce unwanted abnormal postures and movements as much as possible and to encourage movements and postures that are more helpful and allow for better function.
Conductive Education originated in Hungary in the 40’s and is an educational approach involving only one person (a conductor) who directs children in groups to perform activities. The child’s learning within the group setting, is supported by “rhythmic intention” (e.g. using counting, songs, and rhythmical games) to provide the child with the basis of normal movement. Conductive Education involves no or limited physical handling and children are allowed to move in any way that is possible, i.e. the focus is not on quality of movement.
No, there are no tests.
Not necessarily. Many children with cerebral palsy attend mainstream school and go on to university or college.
Most children attend for intensive blocks of therapy lasting for up to six weeks, depending on individual need. Including the cost of evaluation and home reports/reference DVD, a block of therapy for each child costs up to £5,000. Each session lasts approximately 1 hour 15 minutes and while up to three therapists can be involved during sessions, more usually there are two involved.
Currently around £650,000 this year, 75% of which will come from voluntary sources.
If a child's NHS health Board does not cover the cost of the treatment block, we will aspire to allocate funding to each child through other sources. We apply for funds from a select group of charitable trusts; run our own established fundraising events; and encourage individuals, businesses, schools and community groups to fundraise on our behalf. We also encourage families to fundraise themselves with our assistance.
Our two-year adult therapy pilot project is generously funded by the Robertson Trust.
For more information about how you can help us fundraise, click here.
While some NHS Health Boards do offer a contribution towards therapy costs the majority of our income (75%) is derived from our own fundraising efforts.
Until recently, we received £6,500 annually from the Scottish Government - equivalent to around 1% of our income. This funding is currently being reviewed and we are also waiting to hear about the outcome of applications to other government funds, so the figure may change in future.