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Early detection and intervention in Mexico

The Association in Favor of People with Cerebral Palsy (APAC) I.A.P. works tirelessly in the area of detection and early intervention for children with a high neurological risk of triggering a disability due to birth conditions. For their work in the Medical-Therapeutic field, APAC has been awarded a 2018 World Cerebral Palsy Day Merit Award.

The project

APAC was founded in 1970 with the purpose of providing specialised care and services to people with cerebral palsy and other disabilities. Their services include rehabilitation, psychological care, medical assistance, education, job training and support for social inclusion.

Since 2007, APAC have also been running a detection and early intervention program. This program is targeted at children aged 0-6 years old with high neurological risk of triggering a disability due to birth conditions.

The interventions aim to:

  • reduce or prevent long-term physical damage
  • make a timely diagnosis
  • initiate rehabilitation treatment.

The required level of care and intervention is determined by number of factors such as age and diagnosis. These intervention levels are then broken into groups.

APAC’s intervention protocol is as follows:

  • evaluation, diagnosis and allocation of level of care (group)
  • registration/admission to APAC
  • group integration and medical evaluations, including physical therapy, neurodevelopment, nutrition, dentistry, communication and language, functional assessment and clinical history.
  • imaging studies
  • children receive health and physical therapy services
  • preschool students receive formal and alternative education
  • group psychotherapy for parents
  • end of year final assessment – next level of care identified or referral as required.

This protocol was developed in-house by the specialists who make up APAC’s medical and therapy services team, including neuropaediatricians, neuropsychologists, neurophysiologists, general practitioners and paediatricians. The team also includes social workers, dental surgeons, psychologists, speech therapists, nutritionists and educators.

APAC also offers significant subsidies to low-income families, to ensure the service is accessible.

Timely detection

To help parents identify warning signs of neurological damage in their babies, APAC worked in collaboration with DIF – the National System for Comprehensive Development of the Family in Mexico – to develop Timely Detection Tests.

The Timely Detection Tests are questionnaires for parents to complete which focus on children 0-4 years old.  This test aligns with the internationally recognised General Movement Assessment (GMA).

“The influence of the General Movement Assessment in our intervention protocol can be found during the initial assessment stage. We, of course, are familiar with this instrument and its accuracy, and use it in a qualitative manner, in the initial assessment of babies under 5 months old in corrected age. Unfortunately, our current conditions don’t allow us to utilize the GMA further, but we are in the process of getting certified,” explains Dr. Eva Ibañez Medina, Chief of Rehabilitation Services and specialist of Pediatric Rehabilitation.

Divided into 8 segments according to developmental milestones, each segment contains 5 warning signs. If the parent identifies more than 2 warning signs they are encouraged to attend APAC for a free assessment.

The promotion of these tests is important as the lack of awareness is a major issue.

“In Mexico, there is no culture of prevention when it comes to timely care for children with risk factors and warning signs of neurological damage.” – Isis Lemus, APAC’s Corporate and Socially Responsible Investments Liaison Officer

“With this in mind, APAC, in collaboration with a local advertising agency, is in the process of launching a public awareness campaign on early detection, so parents – and the general public – around the country know about the program and its importance, and, in turn, we can serve more babies,” explains Isis.

APAC have also developed a workshop called Care and Inclusion of Children with Disabilities from 0 to 6 years old with the purpose of providing basic information, as well as theoretical and practical guidance to staff at daycare centres operated by the Mexican social development departments.

“The goal is to provide them with adequate tools to work with children with motor, hearing, visual and mental delays, so they can be included into work groups,” says Isis.

Brighter futures

To date, APAC have provided individualised treatment to over 1000 children through their detection and early intervention program. Currently only operating in Mexico City, APAC would like to replicate the program throughout the country.

Their work to detect, diagnose and initiate rehabilitation as early as possible gives children with CP and other neurological conditions the best start to life.

“From the first week, I saw huge improvements in my baby. He was a boy who slept all the time. Now, having been to physical therapy at APAC, he is more awake, has stopped making fists, has started following objects with his eyes and is more receptive of noises. We’ve been coming for a year, and have been able to revert the bad diagnostics we had received. It’s very exciting for me to know that the work put in, here at APAC, and the therapies he receives are worth it. I’m so happy about that.” – Rocio del Pilar, mother of Mateo Reyes (2 years old).

Clearly, the work APAC is doing is making a huge difference in the lives of many children with CP, and their families.