When Carrie Babylon, director of the Arc of Montgomery Family Infant Child Care Center (FICCC), Rockville, Md, talks about some of the children who have come through her doors, her voice takes on a whole new, rounder, more tender tone than the one she uses to normally describe the clinic’s day-to-day dealings. She calls one of the children by his initials, “FT,” and tells the tale of a premature baby born after only 23 weeks of gestation.

“When he came to our center, he was about 14 or 15 months old,” she says. “And he was so stiff that he was literally like a board. We actually had a fire drill, and I was trying to get him to sit, and his legs were so stiff that he couldn’t bend them to sit. So he could only just extend every muscle in his body. The prognosis for him was that he was never going to crawl, much less walk. And after months of therapy, he now runs.

“I will never forget the first time he started taking baby steps. We told his mom we had a surprise for her, and she came into the room, and we told her to call his name. She called him, and he ran to her. We all just broke down into tears, because it was one of those groundbreaking moments they said would never happen. And he’s the happiest little boy, and he’s so quick!”

She pauses before she admits, “I’m probably gushing. But I just love the children and the therapists. It’s been my heart.”

Gushing, maybe. But after hearing the consistent stories of children blossoming after their time at the care center, it seems as though Babylon has every reason to be effusive. The care center was founded in 1991 with the help of State Sen Jennie Forehand (D-Md), who Babylon considers a “founding mother.”

“There was a need for children with medical conditions who couldn’t go to typical child care centers, so it was started out of that need for children with medical conditions to have a day care center they could go to that would be staffed by nurses and direct child care workers,” Babylon says. “This way, the parents could go to work and still avoid the children being institutionalized or hospitalized for long periods of time.”

Children enrolled in the center have medical conditions such as failure to thrive, gastroesophageal reflux, and other eating/feeding disorders, prematurity, borderline personality disorder, and various respiratory conditions. For these children, physical therapy has been a tremendous help.

Successful Treatments
As supervising PT, Ginny Paleg, MPT, attends the center about three times per week to help with the equipment and attend to therapy sessions. Typical sessions for Paleg begin with gentle massages and stretching before developmental manual guidance for skills like sitting, transitions, standing, and crawling. “Most of the kids are not walking at an age-appropriate level, so we get on the treadmill and use a body-weight support system for gait training,” she says. The children watch videos on equipment donated by the staff while the PTs do simple manual guidance (facilitation) of gait or electrical stimulation-assisted walking. Afterward, they return to the classroom for natural-environment training with a gait trainer, walker, or other assistive device.

“This situation is unique, because the nurses and teachers are so interested in helping the kids acquire new skills and can assist the children all day,” Paleg says. “During outside play time, it’s typical to see three or four kids in their gait trainers or mobile prone standers.”

Paleg says that positioning, helping the teachers and parents to help the kids all day and every day, is the main role of the PTs at the care center. “We stress the coaching model,” she says.

So far, the care center staff has encountered tremendous success with its methods. “The treadmill and harness system has been a real boost,” Paleg says. “Almost all of the children with Level 5 (most severe) cerebral palsy leave at age 3 taking steps.” One of the best outcomes in the clinic’s recent history has been a child with Level 4 to 5 spinal bifida who gained full sensation and some motor after 6 weeks of treadmill training with electrical stimulation. Additionally, the care center has worked with John McDonald, MD—best known as the physician to Christopher Reeve—and Karen Good, PT, at the Kennedy Kriger Institute to learn protocol. Eventually, Paleg and her colleagues hope to publish the case study.

This tight-knit group at the FICCC also has a distinction of being a center-based care. “For these kids, there is a distinct advantage in that the caregivers are experienced in feeding, sign language, positioning, and all the things that they do to help these kids gain functional skills,” Paleg says. “Because we have the equipment there, these kids have earlier access to standing, walking, and seating systems.”

For Babylon, it’s all about the success stories. “We really just have a great setup,” she says. “The children have progressed far beyond their neurologists’ and orthopedists’ expectations. It’s just wonderful to see the children walk for the first time or even just move a foot when their parents have been told they’d never walk. It’s really amazing.”

Yet, even the tightest ship needs help from the outside every once in a while. Babylon urges anyone with an interest to make donations, if possible. “We’d like to build another building where we can extend our services and offer before-and after-school programming,” Babylon says. “Right now, we go from 5 weeks to 6 years, and there’s a real shortage of places for people to send their children who are either developmentally delayed or have medical needs before or after school. So we’re trying to expand that program. So if anybody’s interested in helping out there, they can call us!”

She also adds that interested parties in other areas of the country who would like to develop this kind of program should contact them. For more information, contact the Arc of Montgomery County Family Infant Child Care Center, (301) 279-2165; www.arcmontmd.org .