Noheli's New Moves

Through comprehensive rehabilitation following an acquired brain injury, Noheli got her movement back.

Noheli is a six-year-old who never stops moving. In July, her father, Nelson, brought her to the emergency room when it appeared that she was unable to move the left side of her body. She was transferred to Cohen's Children's Medical Center where she was diagnosed with and treated for Acute Disseminating Encephalomyelitis, or ADEM. ADEM is a rare neurological condition that affects only 1 in every 125,000 to 250,000 patients a year. The condition damaged Noheli's myelin - the sheath that provides a protective covering of the nerves - in both her brain and spinal cord. One month later, she was admitted to Blythedale Children's Hospital for comprehensive rehabilitation on the Traumatic Brain Injury Unit to improve her swallowing, speech, and the weakness on the left side of her body.

Pediatric Physiatrist Amy Lynn Tenaglia, MD began treating Noheli once she came to Blythedale. Noheli's condition required occupational, physical, speech and feeding therapies multiple times a week. As a physiatrist, Dr. Tenaglia works closely with each of the therapy services to develop and coordinate a treatment plan for patients like Noheli, incorporating both her medical diagnosis as well as her rehabilitation needs.

"I get to work really closely with the therapists and the team members here to guide these kids through the rehabilitation process," said Tenaglia.

Noheli is bilingual and her therapists incorporate both English and Spanish in her sessions. However, for Noheli, her first language is play. When Dr. Tenaglia visits her room, they often have a thumb war, which helps strengthen the left side of Noheli's body. 

"A lot of times kids, especially the younger ones, you don't communicate with them in a traditional sense anyway, so I think we're very good at being creative at working with them no matter their background, no matter what language they speak, and just help them get stronger," said Tenaglia. 

In her other therapies, her therapists focus on bilateral movements and increasing Noheli's ability with all movement. Her father recalls when Noheli arrived at Blythedale she was unable to walk but now is able to unassisted. 

Child and dad


Noheli has continued to make progress at Blythedale, attending Mount Pleasant Blythedale Union Free School District as a first grader, with hopes of discharging soon to attend The Robert Stone Day Hospital at Blythedale. There she will continue to receive therapies and attend school, but will also be able to return home at the end of each day. Nelson is excited to bring Noheli home but will miss the care they have received at Blythedale. "I’ve really liked this place," he said. "I know that the people who work here are good and passionate about their job, and that’s very important for us, as relatives, and also for the patients, because it motivates us and lifts our spirits."