Dr. Ryan Van Matre and health care workers in Poland Editor's note: The following was sent by former Delphi resident Dr. Ryan Van Matre, director of Indy Spine and Rehab with offices in Delphi and Carmel. Van Matre spent time in Prague, Czech Republic, each of the past five years learning advanced rehabilitation treatments from worldrenowned physicians. After a recent month-long sabbatical to Krakow, Poland, he sent the following letter to the Comet to help spread the word about what he learned.

I have been studying in Prague, Czech Republic for the last five years at Charles University's Motol Hospital. The Prague school is worldrenowned for their expertise and teaching of cutting-edge rehabilitation.

It was there that I first learned of reflex-locomotion and of Dr.Vaclav Vojta, one of the great Czech neurologists. Dr. Vojta was a visionary who discovered that at-risk children with developmental delays (cerebral palsy, Down's syndrome, meningocele, autism, hydrocephalus, etc) were far better able to overcome their disabilities when given appropriate therapy as soon as the delays were noticed, particularly before the age of six months. After that time the plasticity of the child's brain becomes "hardwired" and therapeutic change is less remarkable.

The problem in most westernized health care systems (including the United States) is they have no adequate way to screen children early on for developmental problems.

Often pediatricians suggest watchful waiting, thus being reactive to the developing delay. Typically after the age of 12 to 18 months the parents of the child complain that something is wrong, an MRI and extensive neurological exams are performed, a diagnosis is made and therapy is prescribed (usually the federally funded First Steps program). All of this occurs well after the critical window of assessment has lapsed and poor motor patterns have "hardwired" into the child's brain.

According to Vladimir Janda, consultant on rehabilitation to the World Health Organization, as many as 30 percent of all children suffer from developmental delays.

There are varying degrees of severity including severe CP which may be noticed at birth, mild-to-moderate CP and children with central coordination disorder(CCD). Children with CCD are the toe-walkers, bottom scooters, and those who fail to crawl before walking. These children suffer abnormal development but are not identified with traditional screening methods. Children with CCD are prone to chronic back pain, scoliosis, and other musculoskeletal disorders later in life.

Children and adults who suffer CCD may adapt with therapy, but they will never experience permanent changes had the therapy been administered at the earlier six-month mark.

A child with severe CP who does not undergo early therapy may be forever confined to a wheel chair, while the same child who undergoes early screening and therapy may be able to walk and become considerably independent as an adult. Thus the long-term savings for caregiver administration are quite substantial.

Vojta left the former Czechoslovakia and settled in Germany after he renounced Communism. It was there he was found by Prof. Theodor Hellbrugge, eminent pediatrician and founder of the Child Center in Munich.

Hellbrugge was the physician who organized Vojta therapy and outlined a method to quickly and systemically screen infants for developmental delays.

Typically at age three to four months a child is screened, and if delays are prominent therapy is prescribed. The examination takes about fifteen minutes. Parental input is critical as they have the most information on the child's condition.

If therapy is required, it is "taught" to the parents by the therapists. Thus the therapy is family-centered, where the parents, grandparents or foster caregivers take the role as the primary therapist.

Therapy sessions typically last five to 10 minutes, three or four times a day, thus making this manner of therapy extremely cost-effective. And the results are simply astonishing.

I have been studying Vojta therapy in Prague for the last five years, though it has been difficult to learn. I was referred to Prof. Maria Drewniak in Krakow, Poland as being the best in the world to teach such therapy.

Prof. Drewniak is the director of the Child's Center in Krakow and is a specialist in pediatrics and rehabilitation. Her facility is amazing. There are two full-time pediatricians, a part-time child neurologist, a children's dentist, a child psychologist, seven physical therapists, a Montessori school and a Special Needs school.

The assessment and therapy as outlined by Hellbrugge is far different than the classical methods of rehabilitation most healthcare professionals are familiar with, being proactive rather than reactive. By maximizing a child's functional and social development we better enable them to become independent later in life. In the field of epidemiology (the study of disease) this is called "tertiary prevention" (or minimizing the effects of a disorder through early treatment).

I find this approach a higher calling, being able to forever impact a child's life. Sadly, few here in the states know of this efficient and cost-effective technique. I hope to change that.