From Acute Care Rehabilitation to Competitive Sports: TIRR Memorial Hermann’s Pediatric Program Includes a Full Range of Services

TIRR Memorial Hermann’s new eight-bed pediatric unit offers children age 6 months to 18 years the same quality of nationally ranked, customized care the hospital offers adults who have suffered a severe injury or illness and would benefit from inpatient rehabilitation. As with TIRR’s longstanding outpatient pediatric programs, therapists use the latest technology and remain child-focused to ensure that kids are comfortable while they progress through their therapy sessions. The new inpatient unit is locked, with a private, fully equipped, child-friendly therapy gym and an outdoor sports court to meet the needs of young patients.

“Because our pediatric rehabilitation team manages patients under 18 with all diagnoses, we have to be well-versed in the treatment of a variety of disorders, ranging from brain and spinal cord injury to spina bifida to developmental delay,” says Teresa Cramer, PT, DPT, board-certified clinical specialist in pediatric physical therapy and pediatric clinical coordinator at TIRR Memorial Hermann and the Memorial Hermann Rehabilitation Network. “We partner with parents and caregivers in a family-friendly environment to ensure the best outcomes possible while maximizing quality of life and facilitating return to their families, schools and communities. Our pediatric team is specially trained to meet the unique needs of our young patients and their families. We also utilize important safety measures to prevent the spread of COVID-19.”

TIRR closed its original inpatient pediatric unit in the early 2000s but continued to offer outpatient pediatric rehabilitation. “As we’ve opened our satellite locations around the city, we have included outpatient pediatric rehabilitation at each facility,” says Cramer, Memorial Hermann Rehabilitation Network pediatric program manager, who leads a core group that ensures standardization of best practices across all locations.

The move of Shriners Hospital for Children to Galveston left a need in Houston for inpatient pediatric rehabilitation care. Fellowship-trained affiliated pediatric rehabilitation specialist Stacey Hall, DO, an assistant professor of physical medicine and rehabilitation at McGovern Medical School at UTHealth Houston, is medical director of the new unit.

“We provide really intensive rehabilitation for our pediatric patients—3 to 5 hours of therapy daily during the week,” Dr. Hall says. “Therapy continues on the weekend, while also allowing break time for the patient and family. Intensive rehabilitation gives our kids a faster trajectory of recovery and improves overall outcomes, specifically in the brain injury population.”

Pediatric rehabilitation services are available for patients with traumatic and non-traumatic brain injury, spasticity, post-tumor brain and spine management needs, limb loss, traumatic spinal cord injury, stroke, encephalitis or infectious encephalitis, technology-dependent tracheostomy needs, polytrauma, spine surgery, selective dorsal rhizotomy and spina bifida. In addition to the full range of pediatric therapy care, TIRR team members work with other affiliated specialists when needed, including neurosurgeons, orthopedic surgeons, pediatricians, oncologists, neurologists and many others.

“We’re using patient and clinical feedback to make changes daily to create a better experience for our pediatric patients and their families,” says Rhonda Abbott, PT, FTPTA, MBA, senior vice president and CEO of TIRR Memorial Hermann and the Memorial Hermann Rehabilitation Network. “We’ve been returning patients to the community for more than 60 years. To apply the principles of rehabilitation again with refreshed lenses for the pediatric population has been exciting for our team and the community. I’m very passionate about serving pediatric patients, especially children with the most complex care needs. We now offer children the full range of rehabilitation from acute care through inpatient rehabilitation to outpatient to wellness and prevention programs, as well as competitive sports and recreational activities for kids.”

Following their inpatient stay at TIRR Memorial Hermann, pediatric patients can transition to the Memorial Hermann Rehabilitation Network’s outpatient program at four locations around Houston. Former inpatients can also follow up with a pediatric physiatrist at the TIRR Memorial Hermann Outpatient Medical Clinic.

Care for Kids at the Outpatient Clinic

Dr. Stacey Hall and newly recruited affiliated pediatric physiatrist Simra Javaid, DO, who joined the TIRR medical staff and the faculty at McGovern Medical School in September, see pediatric patients 3 days a week at the TIRR Memorial Hermann Outpatient Medical Clinic. The physician-based clinic meets the needs of adult and pediatric patients who require initial or continuing rehabilitation care with a physician, with services provided through a number of specialty clinics and programs staffed by a multidisciplinary team of health care professionals. The clinic is also open to people who are not former TIRR patients.

“Common pediatric referrals to the Outpatient Medical Clinic are for the management of cerebral palsy and spina bifida,” Dr. Hall says. “We also see kids with brain injury, spinal cord injury, muscular dystrophy, cancer, muscle and nerve disorders, and those who walk on their tiptoes as a result of cerebral palsy or neuropathy.”

To schedule an appointment, call (713) 797-5926.

Healthy Competition Through the Adapted Sports and Recreation Program

“Our mission is to provide and support meaningful opportunities for people living with physical disabilities and chronic health conditions to participate fully in their community in accessible sports, recreation, and fitness and wellness activities,” says Peggy Turner, CTRS, adapted sports and recreation program coordinator and athletic community liaison at TIRR Memorial Hermann. “We have programs for kids from high school age on down. Some of our program participants miss school due to surgeries, so we don’t have an upper-age limit for participation. Our core value is to support independence and inclusion and to help kids of all ages re-enter the community successfully. By staying fit, they reduce their risk of readmission to a health care facility.”

Studies have shown that children and adolescents who are active and social are more likely to do well in school and go to college. “We’re connected with 14 or 15 universities that sponsor wheelchair basketball teams for both girls and boys,” Turner says. “One of our kids, Kaitlyn Eaton, was selected for the U.S. Paralympic Women’s Wheelchair Basketball Team and went to Tokyo for the Paralympic Games. All of these successes show what a person can accomplish if given the opportunity. Kids are so resilient, and we like to help them maximize their potential.”

Turner fosters relationships with service providers, individuals and adapted sports partners, including the City of Houston’s Adapted Sports and Recreation Center on West Gray and the City of Pasadena’s Adapted and Inclusive Recreation Program. “I help patients transition from the hospital to the community, visiting inpatients and outpatients at TIRR facilities to make them aware of what’s possible after discharge,” she says.

TIRR Adapted Sports and Recreation offers youth and adults with physical disabilities an outlet to continue playing sports both competitively and recreationally through wheelchair basketball, wheelchair rugby, handcycling, wheelchair softball, wheelchair racing, seated throw/field events, powerlifting, recumbent cycling, fitness programs, tennis and more.

“If we don’t have a program at TIRR, we help kids find one that allows them to accomplish whatever they want to do,” Turner says. “At our Adapted Sports and Recreation Day we introduce them to adapted archery, table tennis, fencing and para-powerlifting for all age groups. If they like archery, for instance, we connect them to two or three different granting agencies to help them get access to equipment.”

For more information or to participate, call Turner at (832) 567-4832.

The Challenge Program and Returning to School

Living with a brain injury requires learning new skills. The Challenge Program at TIRR Memorial Hermann provides a comprehensive range of services to help brain injury and stroke survivors maximize their potential, celebrating milestones and successes through each step of recovery. Specialized services focus on community integration skills critical for the transition to independent living, school, work or volunteer activities following brain injury. The outpatient day treatment approach addresses physical abilities, memory strategies, interpersonal communication and problem-solving skills needed for long-term success.

“People in the program build strength, learn new skills and gain the confidence they need to continue daily activities despite the effects of brain injury,” says Julie Welch, PT, MS, director of rehabilitation. “We accept age 16 and above, but we can provide services for those younger than 16 on a case-by-case basis.”

The Challenge Program collects data on client progress from admission to discharge and beyond. “Our outcome studies show that, on average, 93% of those who complete the treatment program met their independence and personal safety goals, decreasing their need for supervision at home and in the community,” Welch says. “100% of adolescent clients who completed their treatment program met their independence and personal safety goals. 80% of adolescents who completed the program returned to school.”

Children with serious illnesses or injuries often require extended absences from school, which can negatively affect schoolwork and emotional adjustment. For many of these children, going back to school is a tough physical and emotional challenge. The Return-to-School Program at TIRR Memorial Hermann is open to kids of any school age, beginning with kindergarten, and is focused on building strength, increasing independence and regaining skills and confidence after serious illness or injury. The program is tailored to the child and family, with emphasis on interacting with peers, learning and remembering new information, negotiating the school environment, organizing school assignments, paying attention, physical fatigue, reading and writing, and social and emotional adjustment. Team members work with schools to provide assistance in determining the accommodations and assistance necessary for a smooth transition to the classroom.

To make a referral or schedule an appointment, call (800) 44-REHAB (7-3422).