Shortly after he was born, Robert Ryan’s parents were told he might never walk or talk due to his cerebral palsy. Now age 6, with the help of specialists at The University of Texas Health Science Center at Houston (UTHealth），他喜欢在学校与家人和朋友进行对话。

Cerebral palsy is a group of disorders that affect a person’s ability to control their muscles and can affect everything from being able to walk and talk, to holding an object, chewing, and swallowing. Robert and his twin sister Claire were born four months premature after their mother Laura Ryan’s water broke when she was just 24 weeks pregnant. At just 1 pound, 5 ounces each, the blood vessels in their brains were extremely fragile, and both babies suffered brain hemorrhages, which led to cerebral palsy.

Claire died five weeks after birth, but Robert continued to get stronger. After spending five months in a neonatal intensive care unit he was able to come home.

Still medically fragile, Robert began to see specialists at the UT Physicians High Risk Children’s Clinic, which cares for children with all kinds of complex conditions and illnesses, including cerebral palsy.

自从他获释以来，罗伯特一直是诊所的病人，他的护理受到监督医学博士Supriya Ramanathan, pulmonary medicine staff physician. Along with his cerebral palsy, Robert is also treated for hydrocephalus, scoliosis, and a seizure disorder. As the clinical practice of McGovern Medical School at UTHealth, UT Physicians offers a wide range of specialists for Robert, including neurosurgeon Stephen Fletcher, DO; otolaryngologist Soham Roy, MD; neurologist Nivedita Thakur, MD; gastroenterologist Fernando Navarro, MD; and neurologist Michael Watkins, MD.

像罗伯特（Robert's）这样的复杂诊断是由麦戈文医学院肺医学副教授Ricardo Mosquera，医学博士Ricardo Mosquera创建的。在2004年发表的临床试验中JAMA，该计划降低了急诊室就诊，住院入院，小儿重症监护病房的入院和住院时间。该诊所提供了Care的协调，这是一支由提供者组成的多学科团队，24/7获得护理和远程医疗。

“蚊子博士开始这家诊所的原因，诊所所有提供者的目标是确保像罗伯特这样的患者保持尽可能健康，以便他们永远不必去急诊室。通过24/7电话线，我们的患者家人可以使用初级保健提供者，他们可以评估其需求并根据需要调整治疗计划，而无需在诊所中看到患者。” Ramanathan说。她补充说，如果这些患者最终到医院，那里的团队与诊所的医生紧密合作，他们可以在患者身上提供背景和病史，以全面描绘他们的关怀。

拉马纳森（Ramanathan）认为这是看到患者防止护理分裂的最佳方法。

她说：“这是最好的，因为我们从多学科的角度来处理事情。”“成为这支团队的一员令人兴奋，因为参与诊所的每个人都具有确保我们的患者取得最佳结果的相同目标。”

瑞安（Ryan）非常感谢罗伯特（Robert）在诊所接受的护理，支持和治疗。

“I really don’t know what we would have done without the high risk clinic, especially in that first year. It was so reassuring to know we would have a place to go that was going to be able to handle a complex case like his,” Ryan said.

罗伯特（Robert）看到的所有医生都从几种类型的疗法中受益。

While in the NICU, Robert took part in music therapy, where a media player with a custom playlist of music, as well as voice recordings of his mom, was placed under his pillow for him to listen to four times a day. “It was very reassuring for us knowing he was able to hear my voice even when I couldn’t be there physically with him,” Ryan said. “I also think that played a huge part in helping him begin to develop his verbal skills.”

Robert continues to take part in speech therapy two times a week and his verbal skills have continued to advance. He is now carrying on conversations and speaking in complex sentences. “His neurologist is blown away by his verbal progress,” Ryan said.

瑞安（Ryan）认为罗伯特（Robert）高级口头技能背后的另一个原因是，他只有2岁的时候就决定让他上学。罗伯特（Robert）就读于卡罗琳学校（Caroline School），这是一所专门针对多种残疾学生量身定制的学校。她说：“我认为与其他孩子在一起是他这么口头的另一个原因。”“这可能是我们做过的最好的决定之一。”

In addition to the social stimulation, the school also allows Robert a flexible schedule to work around his doctors’ appointments and therapy sessions. “With all that comes along with Robert’s complex needs, it’s great to know we have the flexibility to come to school late or leave early,” Ryan said.

He goes to physical therapy three times a week and occupational therapy two times a week to continue to develop his muscular strength, particularly his core muscles. He can now take steps with assistance using a gait trainer and can use his arms to push himself up into a sitting position while sitting on the couch.

Ryan continues to be impressed by her son and the hard work he puts in to get stronger every single day. “I have so much respect for him,” she said.

Ramanathan is also inspired by patients like Robert. “The fact that these kids are continuously learning new things despite the challenges they face every day continues to amaze me,” she said.

Ryan has done a lot of work with March of Dimes since Robert was born. “I’ve made speeches that have allowed me to speak about Claire and keep her memory alive, but I’ve also been able to continue to advocate for Robert and the challenges he continues to face,” Ryan said. “I just want people to know that he is a kid just like any other kid.”