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Contact Ginny

If you have any questions or inquiries, please feel free to contact Ginny:

420 Hilmoore Drive
Silver Spring, Maryland 20901
Phone:  (301) 452-4656


Paleg Modules

September 2019

Ginny Paleg is one of the few pediatric presenters capable of filtering the work of many scientific publications through her extensive clinical experience and to boil down complicated evidence to real life application.  Her case stories demonstrate the application of diligent academic research in an accessible way.  This course is like a long walk with a friend who has had a few too many cups of coffee.  You’ll emerge at the end of the day full of laughter and hope and a certainness that you have done well and can now do even better.  You will have new tools and evidence in your clinical bag and a renewed drive to help children be active and participate with all of their strengths and abilities.

Topic Description Objectives
1. Hypotonia Hypotonia is a symptom of many genetic, metabolic, anatomical and other causes of lifelong sensory and motor impairment.  Therapists often assess and treat infants and children with hypotionia of known and unknow causes.  This session will begin with a definition of central hypotonia, a way to define hypotonia as minimal/moderate/severe.  We will then follow the new AACPDM Carepathway which follows a recently published systematic review of PT and OT interventions for hypotonia (the presenter is an author of both sources).  Specific evidence-based interventions will be discussed through case studies and group discussion.
2. Early Intervention: using equipment to enhance coaching New research has shown new evidence-based ways to improve all domains of the ICF-CY.  This session will highlight active coaching of child-directed, care-giver delivered interventions to promoted activity and participation with natural routines.  Case stories will be discussed that highlight how equipment for sitting, standing, stepping and lying can be incorporated into early intervention in natural environments.
3. School based standing and stepping programs Same as Basic Standing but directed to school-aged children
4. What Happened to the Children? Basics of Common Diagnoses Thru Case Stories This session is for novice therapsist who would like to now more about the root causes of common diagnoses, expected prognosis, and evidence-based interventions incl. cerebral palsy, Down syndrome, and spinal muscular atrophy
5. Hip Health and Happiness This session will explore how to read hip x-rays and what to do to improve hip health.  We will focus on the evidence behind postural management and interventions that might be helpful.
6. Basic Standing This course will focus on the use of standers. The material will focus on standing as part of a comprehensive postural management and hip health program. We will review hip surveillance programs and how to interpret relevant x-ray findings.  We will discuss assessments to aid with these interventions. 1.                Able to list three evidence-based outcomes of a standing program

2.                Able to use the Posture and Postural Ability Scale (PPAS)

3.                Know the schedule for hip surveillance

4.                Be able to assess and prescribe abduction appriately

7. Basic Supported Walking This course will focus on the use of a upright mobility devices (including gait trainers).  We will discuss how self-initiated efficient mobility influences development of vision, language, math, socialization, cognition, socialization etc.  Thru case studies we will see that early and continued access to mobility devices improve activity and participation.
8. Advanced Standing This course should be combined with the basic course and goes into details of equipment selection and complex cases.
9. Advanced Supported Walking This course should be combined with the basic course and goes into details of equipment selection and complex cases. If focuses on how lack of early movement influences the brain, bone ad muscle
10. Early Detection and Intervention for Children with CP The term “cerebral palsy” can be applied to all children with lifelong sensory and motor impairments that are central (brain) in origin and non-progressive.  This diagnosis includes many causes including genetic, metabolic, anatomical, and injury (stroke, bleed, trauma, etc.).   The incidence of children who will receive these diagnoses is commensurate with those who will receive a diagnosis of autism spectrum disorder (ASD), meaning the population of children with these two diagnoses are the same.  Yet, many more resources and research are offered for children with ASD.  One way to better serve the children and families that fall under the CP umbrella, is to find them sooner, diagnose them earlier and offer evidence based CP-specific interventions (much like we do for ASD).

All early interventionists should be knowledgeable about General Movements and the Hammersmith Infant Neurological Exam (HINE).  When used as screening tools by trained professionals, we could identify 80-98% f the children who will go on to receive a CP diagnosis.  This will enable us to recommend families see specialists earlier, as well as offer appropriate interventions.

1.      Understand General Movement Assessment

2.      Be able to use the HINE as a careening tool

3.      List 3 reasons why early detection is important

4.      List two evidence-based interventions for CP

11.  GMFCS and GMFM This course is for therapists who knows about but who seldom uses the Gross Motor Function Classification System (extended and revised) in its entirety and rarely does a GMFM-66 or 88..  Through case stories, we will explore the levels at different age bands.  We will also review and  discuss the GMFM and percentiles.  You will seethe power of this tool when used with finesse and gain a deeper understanding of the cost of overestimating and what happens when you measure capacity vs performance.  Realistic measurement grounded in valid and reliable testing methodology will allow you to make better choices and help children reach  their full potential for activity and participation.