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  • Avenue Chapelle aux Champs, 40 1200 Bruxelles Belgium
  • 02/776.84.70
  • Danielle WARLET

Accompanying children with multiple disabilities in CREB, Brussels, Belgium

  • Childhood
  • Europe : Belgium
  • Experience Index Card

From Danielle WARLET the Mar 22, 2012

Rehabilitation Center for Children Brussels offers care and medical education in a framework adapted to the needs of children and adolescents with multiple disabilities
  1. Context
CREB is located on the site of the Catholic University of Louvain (UCL) in Woluwe, in the commune of Brussels in Belgium, near the University Hospital Saint Luc. CREB has existed for 30 years and he settled in the buildings for architects and engineers at the construction site of the university and for demolition after construction.
The CREB hosts and hosts of children and young adolescents with multiple disabilities aged 0 to 16. The Day Centre "Awakening" welcomes 55 children during the day and shelter "L'Oiseau Bleu" takes over 27 of these 55 children in the evening and overnight.
Of the 55 children, mean age 8 years, only six or seven children can walk and no talk. Many of them, in addition to their motor disability, suffering from vision problems and / or hearing, which must be added problems related to epilepsy. The food often poses difficulties because many children have swallowing disorders. Their food is "ground" or their power through a gastrostomy tube.
The type of support these children is not due to their age but their needs and the groups were formed in this direction.
  1. Finality
Regarding the reception and educational support for children and adolescents with multiple disabilities, the needs were and still are huge now. That we welcome children have no access to school despite compulsory schooling in Belgium. It was therefore necessary to make an appropriate response to stimulation of children. Presence in everyday medical CREB can also meet the medical needs of children.
The family environment of children waiting for a specific treatment for their child by professionals because the family can not always meet, as a space emotionally, to the multiple needs of children. Opposite the professionals wanted to respond to this need for specific care and appropriate (physical therapy, speech therapy, occupational therapy, educational, medical).
  1. Implementation
Medical and educational institutes of CREB were established in 1982 by parents concerned by this issue. Their children finding no place in schools, it was important to create a place of their home and provide them with stimulation appropriate to their disability.
The objective of CREB since its creation is still the same but adapts over time to the school population. This is welcome children and adolescents with multiple disabilities to provide them with a stimulating living environment suited to their needs, including their medical needs. Today, children receive a lot more drugs than 30 years ago. Similarly, the probes were inserted gastrostomy in CREB only a few years ago.
Thus the operation and activities of CREB evolve along with scientific advances in terms of drugs or knowledge on methods and techniques related to the handicaps of foster children.
Each child has an individualized educational project that determines its needs and supported individual and group. So he, in his program, supported individual physiotherapy and psychomotor (or indoor pool), speech therapy. Occupational therapists are also very present in everything concerning the adaptation of the material. Meanwhile, educational activities are implemented by educators.
Regarding group activities, it is musical activities, discoveries of taste, visual stimulation, development of the movement, hippotherapy sessions, craft activities for those who can.
We also have a pool that allows us a different approach to the care of the child.
  1. Means
CREB has 110 employees, while employment confused (medical, paramedical, educational, technical and administrative) for 85 full-time equivalent positions and has no or few volunteers (2 or 3 people maximum).
We have established partnerships with the particular AP ³ (Association of parents and people with multiple disabilities), the Afrahm (Francophone Association for Assistance to persons with mental disabilities), the AIRHM (International Association of Scientific Research for Mental Disability ), universities in general and specifically the University of Liège Jean-Jacques Detraux.
We attend regular training quite as specific training BOBATH, stimulation of basal Frölich, Sherborne training, massage, etc. psychomotor water.
We are funded by the French-speaking Community Commission of Brussels and the National Lottery. For the rest, and for specific projects, we work with service clubs (Rotary, Lion's ...) and some sponsorships.
For day care center, we have 6 local "living space" in which are distributed the six groups of children. We also have a physiotherapy room, psychomotor, speech therapy, occupational therapy. Almost all living spaces feature a Snoezelen room. These spaces are divided into two parts: one for activities and another for the rest.
Accommodation is spread over three apartments each accommodating nine children. Children fall into the apartments every day at 16 am and join the day center at 9 am every morning.
The day care center and nursing home are located in the same place.
The financing structure is the largest source of fear for CREB Our NPO is funded almost in its entirety. However, always cover the costs of operation, maintenance, renovation, etc.. of our buildings and it consumes a large portion of our capital.
  1. Evaluation
The initial objective of CREB was injured as it was to provide a forum for stimulating and re-education specific to children who were condemned to stay at home and the center has been operating since 1982.
It is very satisfying to see that one meets a need of the population but also to see how children no matter how small it.
Developments, positive and negative, are nevertheless constant in the care of children including:
  • medication is not given over three times, but 5 or 6 times a day,
  • medical aspects are becoming heavier,
  • the professionalisation is increasingly pushing through continuing education,
  • proposed activities for children are highly oriented on the development of the senses: music, movement, smells, ...
  • orthopedic equipment is becoming more complex cars, forced standing, brace Total night ...
The main difficulties or limitations encountered in the CREB are those related to medical care. We are not a hospital and when the management or condition becomes serious, we are led to work with hospitals. It is usually short-term stays for the child to find a medical stability allowing it to re-enter the CREB
It takes a great opening in the medical management to continue to provide living space for these children with activities that give them pleasure. Educational teams should be aware of new practices such as probes gastrostomy or introduction of oxygen.
With adequate funding, good architects and trained personnel, it is quite possible to reproduce such structures elsewhere to provide children and their families a living environment and development tailored to their needs.

Translation project
Canonical language : French
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