Brachial Plexus Birth Injury: The Toddler Years Through Early Childhood
Presented by Tymar Fields
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Between the ages of 1 and 6 years old, children rapidly grow and develop. A brachial plexus birth injury (BPBI) can dramatically impact the physical development of the upper quarter and the functional use of the arm. Clinicians must understand the critical timelines for interventions to optimize upper extremity function and participation in meaningful activities. Brachial plexus birth injuries are relatively uncommon, and most pediatric clinicians will infrequently provide care for this population. Many pediatric clinicians need additional resources to provide optimal interventions for this unique population. After completing this course, clinicians will be confident in evaluation, therapeutic interventions, and home programming for toddlers, preschoolers, and young children with a BPBI. Clinicians will understand critical timelines for therapy and surgical interventions to optimize development and upper extremity function. This course is an introductory course for occupational and physical therapists and early intervention providers.
Meet your instructor
Tymar Fields
Tymar is a pediatric occupational therapist and certified hand therapist. Professionally, she is inspired by new ideas and creative problem-solving and has a passion for learning. She began her occupational therapy career in 2008 at a nonprofit level 1 trauma hospital. In this role, she worked with children and adults in the…
Chapters & learning objectives
1. Brachial Plexus Birth Injury
Chapter 1 introduces anatomy of the brachial plexus and shoulder muscles and includes descriptions of typical clinical presentations. Special attention is given to the impact of weakness patterns on the development of the glenohumeral joint and resultant loss of function. This chapter also includes a review of the critical timelines that require a referral to a BPBI specialty clinic and/or provider.
2. Evaluating a Toddler and Young Child With a Brachial Plexus Birth Injury
Chapter 2 describes a comprehensive evaluation of a toddler and young child with a BPBI. This chapter includes specific instruction on therapeutic use of self and engaging with toddlers through play. This chapter also includes instruction on obtaining pertinent history and performing an occupational and developmental assessment, range of motion assessment, and sensory assessment. The use of the Active Movement Scale, modified Mallet scale, Assisting Hand Assessment, and goal attainment scaling are also discussed.
3. Interventions for Toddlers and Young Children With a Brachial Plexus Birth Injury
Chapter 3 is an instructional review of interventions to facilitate early childhood development and functional arm use. Interventions include range of motion, positioning for play and strengthening, facilitation techniques, bimanual skills, therapeutic taping, and using a motor learning approach for skill acquisition. Special attention is given to therapeutic use of self, parent coaching, and home program design.
4. Orthoses, Surgery, and Care of the Family
Chapter 4 reviews the most common surgical interventions for toddlers and young children with a BPBI, including postoperative care after nerve transfer, Botox injections, and shoulder tendon transfers. A comprehensive review of common orthoses used, including indications for use and basic design principles, is provided. This chapter concludes with special considerations and care for the family.
