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Paediatric Stroke Awareness and Rehabiliation at NAPA Centre

Apr 18th, 2024 | by Holly Knapp, PT, DPT

Holly Knapp, PT, DPT

April 18th, 2024

May is Paediatric Stroke Awareness Month

In honor of Paediatric Stroke Awareness Month, NAPA PT Holly is here to share vital information about paediatric stroke, including important signs to watch for. Additionally, Holly will explore how NAPA’s therapists utilise the principles of neuroplasticity along with a combination of physiotherapy, occupational therapy, and speech therapy techniques in paediatric stroke rehabilitation to maximse recovery outcomes for children.

“Paediatric stroke is a rare condition affecting one in every 4,000 newborns and an additional 2,000 older children each year.”

John Hopkins Medicine

What is a Stroke?

Stroke is a type of blood vessel disorder in the brain that happens when a blood vessel carrying important nutrients and oxygen to the brain is either blocked or bursts. This causes injury to the surrounding tissues. Strokes can be classified as hemorrhagic or ischemic. Hemorrhagic strokes are caused by bleeding into the surrounding brain tissues, whereas ischemic strokes are caused by insufficient blood flow to an area of the brain.

What is a Paediatric Stroke?

Strokes can occur at any age, including in the womb during pregnancy. There are a few classifications for strokes that occur in children. Neonatal stroke (or perinatal stroke) occurs between 28 weeks gestation to 28 days of life. Stroke occurring in children between 28 days old and 18 years old is generally classified as childhood stroke.

Paediatric Stroke Symptoms

According to the American Stroke Association, the following can be warning signs of stroke in children:

  • One-sided facial drooping or numbness
  • Sudden weakness or numbness on one side of the body – can be in the face, arm, or leg
  • Sudden onset of severe headache with or without sleepiness and vomiting
  • Sudden confusion, difficulty speaking, or difficulty understanding others
  • One-sided visual changes
  • Difficulty walking, balancing, or sudden changes in coordination
  • New onset of seizures or drastic increase in seizures, usually on one side of the body

It is important to recognise that stroke can happen to anyone and prompt treatment can maximise outcomes. If you suspect your child is having a stroke – call 911 immediately!

Outcomes Following Paediatric Stroke

Immediate medical attention will be focused on restoring necessary blood flow to the brain. Once your child is stabilised and ready to be discharged, it is important to work with your team to discuss your child’s function and create a plan for follow-up care. Outcomes following paediatric stroke can vary depending on where in the brain the stroke occurred and how long the brain was without oxygen. Some common impairments include difficulty with gross motor skills, trouble speaking, visual changes, and difficulty regulating emotions. Effects of childhood stroke usually impact one side of the body more than the other.

Paediatric Stroke Rehabilitation and Treatment Options

Overall, children have a greater potential for recovery following stroke compared to adults, especially with timely intervention. Treatment after paediatric stroke often includes physiotherapy, occupational therapy, and speech therapy.

Physiotherapy, Occupational Therapy and Speech Therapy After a Stroke

Utilising Principles of Neuroplasticity to Maximise Recovery Potential

At NAPA Center, our therapies will utilise principles of neuroplasticity to maximise recovery potential. Neuroplasticity is defined as the neural networks in the brain’s ability to adapt and reorganise. The following are ways to incorporate neuroplastic principles in therapies to aid in the brain’s recovery from paediatric stroke:

  • Repetition — It takes thousands of repetitions to achieve long-term changes in the brain. Daily practice helps build and retain new neural connections!
  • Intensity — The brain requires sufficient intensity to elicit changes. This means activities in therapy should be challenging!
  • Specificity — Practicing the specific skill you wish to acquire builds the strongest connections!
  • Use it or lose it — Neural connections not actively engaged in a task will degrade over time. This is why it’s important for us to practice skills along the developmental sequence, even if they may not seem like they directly apply to your child’s goals.
  • Transference — Plasticity in one circuit of the brain can transfer to plasticity in another neural circuit, this is why working on trunk control in standing can transfer to better sitting and transitions!
  • Interference — The brain’s neural connections don’t know the difference between compensations and optimal performance. It’s important to focus on alignment and optimal movement patterns in therapies to build positive neural connections for the movements we want to see.

About the Author

Holly is a paediatric physiotherapist at NAPA Centre Denver. She has always had a passion for paediatrics and working with children of all abilities. During her time in physiotherapy school, Holly directed her passion towards founding a wheelchair seating and mobility clinic in Masindi, Uganda and participating in paediatric research through the South Carolina LEND (Leadership Education in Neurodevelopmental Disabilities) program.

About NAPA Centre

At NAPA, we are committed to helping children lead their happiest, healthiest lives by providing the best and most innovative paediatric therapy methods from around the world all under one roof. Let your child’s journey begin today by contacting us to learn more.



  • Stroke in children. www.stroke.org. (n.d.). https://www.stroke.org/en/about-stroke/stroke-in-children
  • Pediatric stroke. Johns Hopkins Medicine. (2019, November 21). https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/pediatric-stroke
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