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Class Helps
3-year-old Through Disability
by Cynthia T. Pegram, The News & Advance, January 2, 2003
For more articles visit
www.bridges4kids.org.
With five of his classmates, Christopher sits in a diminutive
chair at a low table eating a snack at Lynchburg City School's
Hutcherson Early Learning Center.
Christopher, the grandson of Pamela and Louis Gallaher of
Lynchburg, is enrolled in a program for children with
developmental delays.
On the back of Christopher's chair is his name in Braille. His
early childhood special education teacher, Ghana Ramey, or her
assistant, Janice Barbour, make sure that as he comes and goes
from the table, his tiny hand will feel the bumps that his
fingertips will some day read as his name.
Christopher has cortical blindness from damage to the visual
systems of the brain. At the time of his injury from shaken baby
syndrome, he had flame-shaped bleeding in the back of the eye in
the area of the retina.
He has a small patch of vision at the inner edge of one eye on
the side near his nose.
So when Heidi Fisher, his vision teacher, walks with him down
the hall, she teaches him trailing - how to run one hand against
the wall to help guide his way to where he wants to go.
And several days a week, Christopher works with colored forms
against a light board, to help capture and educate him to
understand the fragment of vision that remains.
She helps him understand that his fingertips can figure out
which button to push to get the music from the toy he uses - he
loves music. Or how to ask for what he wants by pushing the
right button on a device that has a tape-recorded request.
Christopher does not often speak.
This is a busy classroom - it's just about non-stop for the
adults trying to keep six or seven 3-year-olds on task despite
the disabilities that brought them.
While Christopher doesn't wriggle restlessly like some of his
classmates, he seems just as agile. As snacks are completed,
children are asked to return their bowls to the sink, which he
does, earning a "Thank you, Christopher."
Later, when they're reading together, Ghana Ramey uses his right
hand to run along the Braille words. Without adult attention,
when he is involved in a group activity, sometimes Christopher
will suddenly give a sweet smile, and begin to rock.
When the children have a period to do what they want, they seek
favorite toys. Christopher is curious about the full-length
mirror, tilting his head this way and that as he presses his
face close to the reflective surface.
On this morning they're all back near the low table when his
grandmother, Pamela Gallaher, slips in. She's about 20 feet from
Christopher, making no sound as she nears a chair. But
incredibly, he sees her immediately and goes over to her as she
pretends to hide. He laughs.
In September 2000, Christopher nearly died from the injury to
his brain. Yet he walks with only a small brace at his ankle. He
uses both hands and does not seem to have balance problems.
His grandfather, Louis Gallaher, says doctors tell him
Christopher's brain is rewiring.
Following injury, the brains of infants and children can develop
existing areas for new uses in ways that adults cannot.
"After eight or 10 years of age, the capacity to relocate is
considerably less," said Dr. Rob Rust, pediatric neurologist at
the University of Virginia.
An injury to both sides of the brain is more difficult to
recover from because there is no way for the brain to rewire,
Rust said.
Yet one of the problems in trying to accurately track the
outcomes is finding the precise cause of the injury - the
accused person won't admit to having done it, even when
convicted and in prison.
"So we don't know what kind of injury was done to produce what
kind of result," Rust said.
Some babies are only shaken, but others are swung and hit into a
wall. Others are shaken, then smothered or strangled, "and that
causes the greatest degree of injury."
The results can be low vision, hemorrhage in the eye, the chest
squeezed, bruises or brain injury. Some make a reasonably good
recovery, he said. "We've tried to figure out why - maybe it has
something to with the circumstances.
"No generality can explain the variation we see," Rust said.
Hemorrhages in the retinas (the nerve receptors at the back of
the eye that lead to the optic nerve) are symptoms of shaken
baby syndrome. That happens even though the retinas of children
are attached more tightly that those of adults, he said.
But very young children have the disadvantage of poor neck
control and developmental weakness.
"When they're being shaken and spun around, they can't protect
their heads, so they have that vulnerability," Rust said.
How can the brain be rewired?
"Most of what we do in every day life is very simple," he said.
"We make change and walk around. We're not called on to do
complex things - 95 percent of what we do is reasonably normal,
doesn't take a whole lot of space.
"We use that space more and more efficiently as time goes on,"
he said. And it gets pretty full.
"It's probable people who have injuries to the brain lose some
potential. We do know of situations where considerable degrees
of noticeable injury don't leave a clear hallmark," Rust said.
For example, surgery to cure epilepsy involves removing a
portion of the brain, but doesn't seem have too much other
effect.
Current research indicates shaken baby probably has occurred
more often than documented.
The first descriptions date back to the 1860s. The pathology has
been known since the 1940s. About 30 years ago, in 1972, a
pediatric radiologist discovered that certain kinds of injuries
went with certain things he saw on skull films.
CT scans have added to the knowledge base.
"Putting it all together as a syndrome is a post-1972
phenomenon," Rust said. "Since that time we've made the
diagnosis more frequently."
To some degree, he said, the child's capacity is diminished with
injury even in children with a good outcome. For example, if the
child was destined to play the violin he may lose that capacity.
"Others may lose the capacity for vision."
The more severe the injury, the less capacity over all.
"To estimate the prognosis is not easy," Rust said.
Many people know about Christopher and his successful fight for
life.
"We've fallen in love with Christopher," said Bobby Wood, pastor
of Sandusky Baptist Church which the Gallaher family attends.
"He's been on our prayer list, and part of our prayer ministry
ever since we learned about the situation," Wood said.
"We rejoice in the improvement he has made over these months."
Louis Gallaher said he believes Christopher will continue his
phenomenal improvement.
"I believe the Lord will take care of his eyesight," he said. He
cites Christopher's musical ability, and the very normalness of
his temperature, breathing and lack of seizures.
"Christopher is going to live a productive life which far
surpasses any prognosis," Gallaher said.
Contact Cynthia Pegram at
cpegram@newsadvance.com
or (434) 385-5541.
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