Is rehabilitation the Cinderella of health, education and social services for children?

Abstract

In 2003, the editors of Pediatric Rehabilitation posed a challenge to the community of professionals involved in paediatric rehabilitation: to write an essay that discussed whether rehabilitation is the Cinderella of health, education and social services for children. According to Webster [1], the term ‘Cinderella’ can be defined in the following ways: (1) a heroine, (2) the tale itself, (3) a ballet, (4) a person or thing of merit, undeservedly neglected or forced into a wretched or obscure existence, or (5) a person who achieves unexpected or sudden success or recognition, especially after obscurity, neglect or misery. The editorial board of Pediatric Rehabilitation addressed this question on two occasions, adopting the fourth definition of the term Cinderella [2,3]. Both times, the adopted stance asserted that paediatric rehabilitation needed to undergo crucial changes, to prioritize a holistic view of the child in the medical, social, educational and financial support aspects, allied with available scientific resources. In this sense, the belief was that paediatric rehabilitation’s Cinderella image should be disspelled. It is understood that the intention is to rescue paediatric rehabilitation from the neglected role to which it has historically been submitted. In other words, paediatric rehabilitation needs to be ‘rehabilitated’. If rehabilitation is able to do more for children than has been expected and its results can bring positive recognition, then the view that it is inferior and less important than the other areas of medicine should be eradicated. Paediatric rehabilitation began with a misconceived pretext: that the child is a miniature adult [4]. The SARAH Network of Rehabilitation Hospitals never shared this viewpoint [5]. Dedicated to paediatric rehabilitation for over 40 years, SARAH could not pass up the challenge of debating the issue [3,6]. This essay aims to demonstrate, from the historical perspective up through present-day paradigms, that paediatric rehabilitation has come to play an important role in health care. A quantitative analysis of the relevant scientific literature in this area was reviewed. This review will present principles of evidence-based practice, charting a counterpoint to the scientific literature of paediatric rehabilitation. This specialty has, at present, an important critical mass from various centres. There is evidence of an expanding interest in rehabilitation, manifested by the increasing quality of scientific publications.