It is their resilience and capacity to overcome obstacles at such a young age that some people never have to face in their lifetimes. Maryam, a 1-year-old patient with cerebral palsy from Dubai, proves that grit and determination can start at any age.
Cerebral palsy (CP) is a general term applied to many conditions that can result from a disturbance to the developing brain. CP affects muscle tone, movement and coordination. This can make it difficult for a child to control their body. Common activities like walking, standing, sitting, eating or swallowing can be challenging. Some children may have associated health conditions related to cognition, speech, vision, hearing and breathing.
Elizabeth, Maryam’s mother, realized that Maryam was not developmentally progressing at the same pace as her older siblings when Maryam was unable to sit up by herself at 6 months old. At 10 months, Maryam had an MRI performed at a hospital in Dubai. This MRI confirmed the doctor’s suspicions that she had cerebral palsy. The MRI scan showed the top portion of Maryam’s brain was affected due to a traumatic birth incident. Maryam began physical and hydro therapies five days a week, but they unfortunately did not help with mobility. After researching specialized care, Elizabeth found Shriners Children’s and traveled to Philadelphia.
Maryam sees Richard Goldberg, D.O., a physical medicine and rehabilitation physician at Shriners Children’s Philadelphia. She also attends physical, occupational and speech therapies multiple times per week. She practices walking in physical therapy (PT) with Tate Dawson, DPT, grasping in occupational therapy (OT) with Jessica Zawrotny, OT/RL, and communicating in speech therapy with Erin O’Donnell, SLP.
Dr. Goldberg checks Maryam’s progress from PT and OT to see if surgery is the appropriate next step in her orthopedic care journey. Dr. Goldberg said, “Elizabeth had explained to me that, unfortunately, services for her daughter were not available in Dubai. She returned to the States to improve her child’s chances of significant improvement through therapy and possible surgical intervention if needed. It is Shriners Children’s mission to treat children from any part of the world who require orthopedic and rehabilitation intervention, no matter their financial ability to pay.”
Maryam’s care has been a 10/10!
At Shriners Children’s Philadelphia, we are equipped to satisfy all areas of a patient’s orthopedic care, including making prosthetic and orthotic devices. Maryam’s OT team made her ankle-foot orthoses, which support her walking. The right side of her body is affected more by CP than her left, so her right foot drags while she walks. In PT, she is gaining the strength to walk independently without assistance from others or a walker. Every session she goes farther and gains speed. She loves walking with Tate to play basketball in the Central Activity. While she is still practicing to walk independently, she hops like a bunny when she wants to get somewhere faster.
Unfortunately, one side effect of cerebral palsy is spasticity, or spasms in the muscles. Maryam endures these spasms in her legs while she’s sleeping, causing her pain and waking her up. The most comfortable position for her is usually a half-moon shape, as this is the position where her muscles are most relaxed.
In occupational therapy, Maryam works on gaining grip strength and grasping objects with both hands. Using fun toys that require squeeze motions, like squeezable bubbles, keeps Maryam entertained during her therapy sessions. She also practices writing with her non-dominant hand, her left, as her right is weaker. She additionally works on feeding herself with an adaptive spoon to gain independence.
In speech therapy, Maryam is consistently learning new words and growing her vocabulary. In addition to that learning, she has practiced with an augmentative and alternative communication device to assist in her communication; however, she is successfully building her communication independently and does not require the use of that device in therapy anymore. Less than 2 years old, she is engaged and willing to learn, and her therapists always ensure she is having fun at the same time
This summer, Maryam is partaking in a 6-week Therastride program to continue working towards unassisted walking. Therastride is a body-weight-supported manual treadmill training designed to give our patients more opportunities for movement. This program helps Maryam gain core strength, ultimately supporting walking.
Maryam is a strong, determined little girl with so many possibilities ahead of her. As she gains strength in her movement and speech, she will be able to play more with her brother and sister, and eat her favorite food, avocado, with a spoon. She will also be able to walk around the aquarium and see all her fish friends whom she loves dearly. Elizabeth said that “Maryam’s care has been a 10/10!” The Shriners Children’s Philadelphia team always smiles when Maryam is around, as she can turn someone’s bad day around. We are all cheering her on and know she has it in her to succeed at all her goals.
