Amazing outcomes thanks to early intervention

Physiotherapist Nicki Stuart delights in Anika Facer’s zest for life and said she is a great example of the benefits of early intervention and neuroplasticity.

“I met Anika when she was six weeks old,” said Nicki, who works out of the Cerebral Palsy Alliance (CPA) East Maitland centre.

Anika’s parents, Kylie and Kris Facer, were referred to CPA when a day after she was born Anika suffered a severe seizure. She was speedily transferred to the Neonatal Intensive Care Unit at John Hunter Hospital, in Newcastle.

Kylie and Kris were soon told that Anika had suffered a massive stroke, throwing the family into a world of pain, fear and confusion. “We were heart broken and terrified,” Kylie said. “They warned us not to expect too much from Anika, that she may not be able to see, drink or eat, let alone master any of the other skills people need to function.”

The couple were allowed to take their baby home and a few weeks later they were referred to Cerebral Palsy Alliance and Nicki became Anika’s physiotherapist.

“This was one of the greatest things that could have happened to Anika,” Kylie declared. “Our CPA team are now part of our family and we are so grateful to them for the work they to do.”

Anika achieved major milestones

Kylie said the seizure was a blessing in disguise. It alerted them to the stroke, which meant Anika had the benefit of early intervention and therapy based on neuroplasticity.

“People have a tendency to look at a glass as either half full or half empty, but those people are missing the point when it comes to neuroplasticity — in a lot of cases the glass can be refilled. Anika is a shining example of refilling that glass!”

Nicki agreed. “The stroke had affected Anika’s right side so we focused on making sure she used her right side. I saw her every two weeks and Kylie and Kris followed through with the therapy at home.”

Kylie and Kris were over the moon when Anika hit all her major milestones — eating at almost five months, rolling at seven months, crawling at 10 months and walking at 17 months.

Anika is now 20 months old and a recent assessment by a CPA occupational therapist revealed she only has a mild difference in the use of her right hand and a slight limp.

Doctors are impressed

“We will never know whether Anika would have the same degree of mobility in her right hand and leg if she hadn’t undergone intensive physiotherapy,” said Nicki. “However, I believe the positive outcome for Anika is definitely an example of the benefits of early intervention and it could be an excellent example of neuroplasticity in action.

“Usually we don’t see babies who have had a stroke until they are four or five months old. By then they have already learnt to neglect their affected hand, and often only use their non-affected hand to play. Because they have already figured out how to play one-handed, we then have to spend time changing those unhelpful habits. With Anika we created positive habits from the earliest opportunity.”

Kylie said, “Initially, the doctors were so pessimistic they frightened us. Now they all look at Anika’s scans and say they can’t equate the child they see before them with the scans they see on their files.”

This has given Kylie and Kris permission to be optimistic. “Anika’s comprehension is good. She is intelligent and good at problem solving, and dare I say it, manipulating us. The sky’s the limit. If one day she said, ‘Mummy, I want to be a brain surgeon or an astronaut,’ I’d say, go do it.”

The experience also motivated Kylie to join forces with Dee Banks, who she met via the Stroke Foundation’s Facebook page. Dee is mother to Emma who had a stroke in-utero that wasn’t diagnosed until she was one year old.

Stroke Foundation award win

These young mums had navigated the same maze of confusion and wanted to make the journey easier for other families so they started the Little Stroke Warriors community. They presented to the Stroke Foundation to seek a campaign for more awareness around paediatric and childhood stroke and on 3 May they were awarded the foundation’s Improving Life After Stroke award.

“Every year in Australia one in some 2500 births are affected by stroke,” Kylie explained. “Little Stroke Warriors started in May 2017 and now we have a tightknit community of 170 families and it keeps growing.”

The families are located around Australia and some live in remote areas, which means that their access to services is very limited. One family had a baby similar in age to Anika, and also with right-side hemiplegia. “They were located quite a distance from Alice Springs and only able to see a physio every couple of months. I had plenty of exercises and notes from Nicki so I emailed them to the family so they had some extra ideas.”

Kylie and Dee want to increase awareness about children having strokes and ensure that parents have access to information and support. They also want families to be given links to service providers such as CPA as soon as their child is diagnosed.

“Having Anika’s therapies start at such a young age can only have helped her situation. Every child should have the right to access these services and it should be a connection that is made at the time the brain injury is identified.”

For information on Little Stroke Warriors, go to this Facebook page.

For information about specialised Early Childhood Intervention programs for children with stroke, click here.