Congenital Topics

The session will explore how a prosthetist and a pediatric-certified hand therapist collaborate across the full continuum of care for children who use upper limb prosthetics. Presenters will outline each discipline’s role in evaluating children for upper limb prosthetic options and describe how they partner with the child and family to identify devices that align with the family’s goals and priorities.

The session will also highlight effective, collaborative documentation strategies that support third party coverage for prosthetic devices. In addition, presenters will demonstrate how ongoing interdisciplinary coordination supports successful prosthetic training, reassessment, and long term care as children grow and their needs evolve.

Congenital pediatric diagnosis's such as syndactyly, thumb hypoplasia, duplicated thumb, camptodactyly, radial longitudinal deficiency, and trigger thumb/finger. This session focuses on prefabricated/custom orthotics and protocols for both conservative and post-operative treatment for each diagnosis. 

Rehabilitation for children with congenital upper limb differences requires a multidisciplinary approach, with occupational therapy and physical therapy interventions aimed at improving range of motion, preventing contractures, enhancing strength, managing pain, and promoting functional independence in self-care and play. Gaining early passive range of motion (PROM) in the upper extremities is often critical to be eligible for potential surgical interventions as the child matures. To achieve these goals, therapeutic interventions often combine a “therapeutic dance” between three primary interventions: manual stretching, orthoses, and serial casting. The efficacy of these methods is determined through shared decision making and is dependent on patient tolerance, family buy-in, and the integration of home programs into daily life. The application of these techniques will be demonstrated through three distinct case studies including arthrogryposis, radial longitudinal deficiency, and camptodactyly. By synthesizing clinical techniques with a family-centered care, therapists can significantly improve PROM and functional outcomes, ultimately preparing the child for future surgical and functional milestones.

Care for children with congenital hand differences involves a multidisciplinary approach to assessment and treatment of limb dysmorphology to optimize function. However, these children may experience mental health issues that influence participation and health-related quality of life. Yet, research shows that routine mental health screening is rare among pediatric upper limb specialists. As members of the multidisciplinary team, pediatric hand therapists play a critical role in identifying these concerns. However, interviews with families have shown that youth and parents may not expect to receive mental health or psychosocial support in these specialized hand and upper limb clinics because of the way health services are currently structured. Systems-level factors play a role in how mental health concerns are expressed, identified, and managed. This presentation will provide an overview of practice approaches used to screen for mental health concerns and psychosocial interventions provided for children with congenital hand differences. Evidence from the literature alongside findings from multi-methods research (surveys, qualitative interviews) will examine how healthcare terminology influences how mental health needs are shared. The importance of a collaborative approach with caregivers and children to elucidate, identify, and address mental health needs will be discussed.