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Assessing Neonatal Function BECAUSE OF THE high acuity nature of medical conditions managed in the NICU, multidisciplinary motor delay evaluations are not usually performed in this setting. In certain cases, however, neu - rologists with Gillette Children's Specialty Healthcare may perform neurological evaluations while infants are in the NICU. Indications for a NICU evaluation may include seizures, encephalopathy, abnor - mal neurological exams, perinatal asphyxia, prematurity, intracranial hemorrhage and fetal stroke, and congenital brain malformation. "Neurologists play an important role in identifying neurological symptoms, directing further diagnostic evaluations and implementing medical treatment of newborns in the NICU," says Nicole Williams Doonan, MD, pediatric neurologist at Gillette. "Because we are directly involved in patient care in the NICU and across the developmental spectrum, neurologists help support families at all points in a child's life and have an under - standing of both what parents and patients experienced early on, and what future issues may need to be addressed." and further improve development despite limitations, delays or neurological deficits. The orthopedic surgeons assess children's bone and joint health to rule out abnormalities, such as hip dysplasia, that might contribute to walking delays or an abnormal gait." The results from these analyses guide treatment decisions. The sooner children are evaluated and begin treatment, the better their long-term outcomes. "Early intervention helps put a child on the right path to achieve his or her greatest developmental potential and can potentially prevent future medical co-morbidities or complications," says Nicole Williams Doonan, MD, pediatric neurologist at Gillette. "The longer problems remain unaddressed, the harder it is for children to change course or catch up with their peers." Depending on the results of the evaluations, management strategies may include the use of orthotics and assistive devices, referrals to other specialists, and physical, occupational and speech therapy. Neurologists at Gillette also guide the medical management of epilepsy, autonomic dysfunction, movement disorders and headaches, as necessary. If children live outside the region or otherwise have to travel away from their communities to receive specialized care at Gillette, the Motor Delay Diagnosis and Treatment Clinic team works with physicians in patients' own communities to coordinate close-to-home services. ALL-INCLUSIVE CARE FOR PEDIATRIC SPASTICITY Roughly 80 percent of children with cerebral palsy have spastic cerebral palsy, according to the CDC. Children with this condition have increased muscle tone that contributes to rigidity and impaired movements. Gillette o™ers multidisciplinary, comprehensive evaluation of spastic cerebral palsy, as well as multiple conservative and surgical treatment modalities aimed at managing muscle tone and resolving any underlying orthopedic bone and joint deformities that may contribute to movement irregularities. For children identfied by their physicians as possibly having spasticity, the journey to evaluation and treatment begins at the James R. Gage Center for Gait and Motion Analysis, a center that has a worldwide reputation as a leader in assessing movement disorders. Here, Gait analysis uses data to drive healthcare decisions. A certified orthotist in Gillette Children's Specialty Healthcare's in-house lab customizes ankle foot orthoses for a patient. M D N E W S .C O M /// M D N E W S M I N N E S O TA ■ 2 017 0 7