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Research Updates

Recently, a study conducted in part by staff at Hattie Larlham was published in the Journal of Pediatrics. The study reveals new findings on growth and nutrition in people with cerebral palsy living in residential facilities.

The growth of children with cerebral palsy has been the subject of numerous research studies throughout the last several decades. These children are shorter and thinner than their typically developing peers and numerous factors appear to influence growth in individuals with cerebral palsy, including nutrition and the severity of cerebral palsy. Recent studies have demonstrated a significant relationship between health and nutrition in people with cerebral palsy, where better nourished children were found to be healthier.

Little research has focused on the growth and nutrition of children with cerebral palsy living in facilities. Dr. Richard Grossberg, Hattie Larlham medical director, with colleagues from major academic centers in the United States who study cerebral palsy, conducted a research study comparing growth and nutrition of children living in facilities to similar children with cerebral palsy living at home. The investigators expected to find that children in facilities were more severely impaired and subsequently had poorer growth and nutrition. Rather, the results of the study suggest that children living in facilities have better growth and nutrition than similar children living at home with cerebral palsy. The study demonstrated that living in a facility had a major impact on growth and nutrition with residential children having better growth and nutrition independent of age, severity of cerebral palsy or use of a feeding tube.

While the factors responsible for this difference are unclear, the level of care provided to these children by our committed staff of direct care workers, nurses, physicians, and allied therapists are likely influencing these findings. The study did not address health—other studies have demonstrated better health in children with cerebral palsy with better growth and nutrition. Future studies may look to examine the health of children with cerebral palsy in residential centers versus home.

Hattie Larlham is proud to have been a major part of this research with 87 of the 125 residential subjects living at the Center for Children with Disabilities in Mantua, Ohio. Read the full study.

We are proud of Dr. Grossberg's contribution to the field of disabilities research and are thankful to our staff for its willingness to participate in this study. Hattie Larlham will continue to be committed to improve the lives of those in our care through research.

Dr. Grossberg has also measured bone mineral density in many of our residents, as weakened bones is a significant medical issue in children with severe disabilities, causing frequent fractures. Dr. Grossberg and his colleagues look forward to publishing this data shortly.

Dr. Grossberg is working with the Hattie Larlham Research Institute on a study with Dr. Phil Toltzis from Rainbow Babies and Children’s Hospital to determine whether or not taking the antibiotic Cefepime makes bacteria in our bodies resistant to other antibiotics.

Studies are also being prepared to research intentionality in switch activation and interaction in communication. Both of these studies will focus on the use of assistive technology to engage in an activity. The switch study will take place primarily in the school setting and the communication study primarily in the residential areas of the facility.

Research Papers and Presentations

The Journal of Pediatrics; volume 151, issue 2; Henderson, R.¹, Grossberg, R.², Matuszewski, J.³, Menon, N.⁴, Johnson, J.⁵, Kecskemethy, H.⁶, Vogel, L.⁷, Ravas, R.⁸, Wyatt, M.⁹, Bachrach, S.¹⁰ and Stevenson, R.¹¹; Growth and Nutritional Status in Residential Center Versus Home-Living Children and Adolescents with Quadriplegic Cerebral Palsy; Copyright August, 2007, with permission from Elsevier Limited.

1. Richard C. Henderson, MD, Ph. D, the Department of Orthopaedics University of North Carolina, Chapel Hill, North Carolina
2. Richard I. Grossberg, MD, Hattie Larlham Center for Children with Disabilities, Mantua, Ohio
3. Jeanine Matuszewski, BS, the Department of Biostatistics University of North Carolina, Chapel Hill, North Carolina
4. Nitasha Menon, BA, the Department of Orthopaedics University of North Carolina, Chapel Hill, North Carolina
5. Julie Johnson, MD, Children’s Care Hospital and School, Sioux Falls, South Dakota
6. Heidi H. Kecskemethy, RD, CSP, Nemours Biomedical Research, A. I. duPont Hospital for Children, Wilmington, Delaware
7. Lois Vogel, MS, PT, PCS, Children’s Care Hospital and School, Sioux Falls, South Dakota
8. Rebecca Ravas, PT, MS, Hattie Larlham Center for Children with Disabilities, Mantua, Ohio
9. Megan Wyatt, MPT, Hattie Larlham Center for Children with Disabilities, Mantua, Ohio
10. Steven J. Bachrach, MD, HMS School for Children with Cerebral Palsy, Philadelphia, Pennsylvania
11. Richard D. Stevenson, MD, the Department of Pediatrics, University of Virginia, Charlottesville, Virginia

Mitchell, P., Ph. D., Hattie Larlham Research Institute and Kent State University (2007, January). Communication Supports in Ohio Residential Facilities. Poster session presented at the American Speech Language Hearing Association conference on Evidence-Based Practice in Augmentative and Alternative Communication in Atlanta, GA.

Goyal, M.¹, Grossberg, R.², and Allen, R.³, (2005, December). Nephrolithiasis with Topiramate in Nonambulatory Children and Young Adults in a Long-Term Care Facility. Poster session presented at the American Epilepsy Society in Washington DC.

1. Goyal, M., MD, Rainbow Babies and Children's Hospital, CASE University
2. Grossberg, R., MD, Hattie Larlham Center for Children with Disabilities
3. Allen, R., RN, Rainbow Babies and Children's Hospital, CASE University

Grossberg, R.¹, Harpaz, R.², Loparev, V. N.³ and Schmid, D. S.⁴, (2004). Documented Secondary Transmission of Varicella Vaccine Virus in a Long-Term Care Facility. 42^nd Annual Meeting of the IDSA.

1. Grossberg, R., MD, Hattie Larlham Center for Children with Disabilities
2. Harpaz, R., CDC, National Immunization Program, Division of Epidemiology and Surveillance, Viral Vaccine Preventable Diseases Branch, Herpesvirus Team
3. Loparev, V. N., CDC, National Center for Infectious Diseases, Division of Viral and Rickettsial Diseases, Respiratory and Enterovir Branch, Herpes-Measles Team
4. Schmid, D. S., CDC, National Center for Infectious Diseases, Division of Viral and Rickettsial Diseases, Respiratory and Enterovir Branch, Herpes-Measles Team