Navigating Nathaniel's Needs

Nathaniel is like any other eight-year-old. He loves to watch cartoons, joke around and play on his iPad. The only difference is that Nathaniel not only uses this high-tech device for fun, but also to communicate and explore his world.

When Nathaniel was born, his doting parents brought him home to meet his older sister and begin their life together as a family in Manhattan. But soon after, his parents noticed Nathaniel wasn’t achieving some key developmental milestones and took him to be evaluated. Doctors diagnosed him with spastic quadriplegic cerebral palsy.

As Nathaniel grew, so did his medical complications—including challenges with the control, coordination and management of his muscles, from head to toe, and the development of a seizure disorder.

Despite physical limitations, Nathaniel was cognitively aware of his environment. So, determined to provide the best life for their son, Nathaniel’s parents enrolled him in Early Intervention services, and eventually, special education classes.

In addition to academics, Nathaniel attended therapeutic programs and received botox injections in his arms and legs in hopes of reducing muscle spasticity. Nathaniel’s parents continued to research and seek additional avenues to help the expanding needs of their son. 

In July 2017, as a way to continue his schooling during the summer months, Nathaniel was admitted and enrolled at Mt. Pleasant-Blythedale School, part of Blythedale’s Day Hospital program. With this move, Nathaniel would be able to receive medical and rehabilitative care—like intensive physical, speech and occupational therapies—while also attending class alongside his peers.

“Everyone at the school and hospital have so much heart and expertise,” said Dan Rosner, Nathaniel’s father. “It’s just tremendous and helps make managing his complex care a bit easier.”

As time passed, the hard work Nathaniel was putting in to both his schooling and therapies started to pay off with upper extremity motor control gains and an increased sense of self-expression.

“We’re working to help him become a more active, independent participant in his daily activities,” said Diana Ryan, Nathaniel’s occupational therapist at Blythedale. “Another focus for Nathaniel is assistive technology which includes alternate access methods, or switches, to help him play games with the touch of a finger or drive a power wheelchair with the turn of his head.”

Aided by an interdisciplinary team comprised of clinicians, assistive technology professionals, and seating and mobility specialists, an iPad was mounted to the lap tray of Nathaniel’s power wheelchair. Both state-of-the-art devices proved integral in Nathaniel’s development. A proximity head array (a specialized device used to drive the power wheelchair), helped improve Nathaniel’s head control, and the iPad aided in his ability to communicate… and that he did. Some of his favorite Blythedale pastimes include socializing in the hallways, exploring the hospital for a television to watch Paw Patrol or PJ Masks, gazing at the fish in the lobby’s aquarium and asking to go outside—all while accompanied by his beloved clinicians.

“Nathaniel is non-verbal, but understands everything that is going on around him, so it was important for him to be able to access a communication device,” said Stefanie Blanco, Nathaniel’s speech pathologist at Blythedale. “It’s an extension of his voice that allows him to push buttons for various vocabulary, convey his wants and needs, and use in school for academic and literacy type activities.”

Assistive technology has been crucial for Nathaniel in the instructional learning successes he’s experienced at Mt. Pleasant Blythedale School. Smartboards, laptops and various apps - all used in the classroom - help contribute to his increased participation in academic tasks, while also allowing him to ask and answer questions from his teachers and peers.

“It enables Nathaniel to really express and advocate for himself,” said Emily Hersh, superintendent of Mt. Pleasant-Blythedale School District. “Blythedale provides a sense of normalcy for children when life is not predictable or typical. When you see Nathaniel smile, you just know he feels happy, he has a sense of purpose and he has a place.”

With the start of a new school year, Nathaniel joins his new classmates in third grade with a rigorous therapeutic and educational calendar ahead. And, thanks to the critical collaboration between Blythedale Children’s Hospital, Mt. Pleasant-Blythedale School, and assistive technology, Nathaniel’s opportunities to empower his mind and body, are endless.

“The way all the staff works together to look at and meet the individualized needs of the whole child, whether it be communication, therapy, school or beyond, that’s the true Blythedale Difference,” said Stefanie Blanco.