Medical and rehabilitation issues in the care of children with spinal cord injury.

Rehabilitation of the child with SCI involves setting and changing goals appropriate to the child's age, development, and family expectations. Unlike adults with SCI, who may be very close to expected levels of independence at discharge from inpatient rehabilitation, children often require years of outpatient therapy to achieve optimal outcomes. Children with SCI also are at risk for unique complications, which can alter their function. The rehabilitation community extends beyond the usual hospital based practice to include school and transitional services. The focus of rehabilitation changes across stages of development to initially enhance independence in mobility and self-care skills, and later to promote academic achievement, independent living, and employment.