Neurocognitive rehabilitation in the pediatric age is dedicated to children affected by congenital neurological disorders of the central nervous system, such as cerebral palsy, or acquired conditions (such as hemiplegia following ischemic events, hemorrhages, or brain tumors), peripheral neurological disorders (such as obstetric brachial plexus palsy or other peripheral nerve lesions), or those with psychomotor delay, for example, some premature infants or genetic syndromes. This method can also treat musculoskeletal or orthopedic disorders and motor coordination difficulties related to alterations in gesture planning (dyspraxia, some learning disorders). In children, knowledge of the world comes from their experiences, which means that in the presence of pathological movements, there will be difficulty in sensory perception, consequently altering the interpretation of the world and awareness of their own body, reflecting in their ability to learn new movements. What is observed, especially in neurological disorders, is rigid, stereotyped, and poorly variable movement. This is because a spontaneous or inadequate recovery process brings out elementary and qualitatively poor motor patterns that do not allow reaching a satisfactory level of autonomy.

The exercises in the neurocognitive rehabilitation pathway

After an initial assessment that includes an introductory meeting with the child and parents, a first evaluation is conducted. Through direct behavioral observation and information provided by parents, a series of objectives are defined to improve the child’s daily quality of life. The treatment is then structured by proposing exercises specifically designed to achieve the established goals. Progress is periodically evaluated, and exercises are modified accordingly. The exercises are conceived as “cognitive problems,” designed based on the element or elements of the condition to be modified and overcome. The child is manually and verbally guided by the therapist to interact with specific “aids,” objects that allow the collection of certain information (tactile, kinesthetic, proprioceptive, pressure, visual), activating cognitive processes (perception, attention, memory, problem-solving) aimed at constructing new knowledge and processing more correct motor patterns. All this is done by focusing attention on the information that is lacking at any given time, so that the brain can interpret it more accurately and respond with movements more suitable for the environment, thus richer and more variable. For example, to effectively understand and decipher tactile information, tiles with different textures can be used; for pressure information, pillows with different consistencies; for kinesthetic information, body interaction can be guided with figurines placed in different positions each time.