Ten-year-old Sarah thrives with help from CHKD’s comprehensive program
Each year in the United States, around three out of every 1,000 children are diagnosed with cerebral palsy (CP), a disorder of movement and coordination related to abnormal muscle tone. It can be caused by factors like premature birth, lack of oxygen during delivery, an insult to the developing brain before the age of 5, or even genetic factors. But with the right treatment and support, kids with CP can unlock their own potential.
At CHKD, a comprehensive cerebral palsy program is available for children with this diagnosis. Patients with CP can vary widely in functional abilities, says Dr. Katrina Lesher, longtime director of CHKD’s Physical Medicine and Rehabilitation Program. Symptoms may include muscle stiffness or weakness, difficulty walking, speech issues, and other complications. CHKD’s CP Program offers individualized care and support, connecting children and their families to the resources and therapies that will help them function to the best of their personal abilities.
Dr. Lesher sees over 500 patients with cerebral palsy each year. She focuses on a multidisciplinary approach that includes fellow physical medicine and rehab physicians, orthopedic surgeons, neurosurgeons, therapists, and orthotists who provide casting and bracing, all with the common goal of improving function for this unique population.
“It’s an approach to the care of these patients that crosses numerous specialties, and we communicate very effectively, primarily through our electronic health record,” says Dr. Lesher. “We also help coordinate specialist visits and procedures to reduce the number of trips families make for appointments. Our team approach ensures that the patient has the best outcome.”
And, for CP patients who have experienced a prolonged illness, hospitalization, or surgery, CHKD operates the only inpatient rehabilitation unit in Virginia that’s just for kids. The eight-bed unit helps pediatric patients develop new skills or regain those that have been lost due to accidents, illnesses, or surgeries.
It’s an incredible resource for children diagnosed with cerebral palsy, like 10-year-old Sarah McDonald.
Born at 23 weeks, Sarah spent the first six months of her life in the CHKD Neonatal Intensive Care Unit, fighting her way through jaundice, a bowel perforation, retinopathy of prematurity, and periventricular leukomalacia. Sarah was eventually diagnosed with cerebral palsy and began working with the multidisciplinary CP team at CHKD. As she grew, her family worked with Dr. Lesher to improve her scissoring gait, which occurs when legs are too close together and cross over each other when walking.
By 2022, Sarah’s walking had become a concern. Then 7 years old and attending school, “she just wasn’t walking correctly,” says Sarah’s mom, Monica. “Her knees were kind of bending, and she wasn’t able to support herself.”
To improve her function, CHKD’s orthopedic surgery team performed a single event multi-level surgery to address Sarah’s issues with her lower limbs. For nearly a month after her surgery, Sarah recovered in CHKD’s Acute Inpatient Pediatric Rehabilitation Unit, receiving hours of therapies each day, including physical and occupational therapy, to optimize her post-op results.
“She loved her care team,” says Monica. Because of their work schedules, Sarah’s parents could only visit at night. The staff coordinated family check-ins during the day on Sarah’s tablet.
Today, Sarah still loves that tablet, as well as singing, coloring, and building with Legos. She’s able to walk well with the aid of a walker and ankle-foot orthoses (AFOs) and participates in therapies at school. “Sarah is a poster child for motivation,” says Dr. Lesher. “She’s out to conquer the world.”
At her last checkup in March, Sarah impressed her providers with how well she’s getting around and answered questions about her status on her own, without waiting for her father to answer.
“I like them a lot,” Sarah says of her team of caregivers. “They help me understand, too. I’m happy they give me the time to talk.”
Sarah’s come a long way from her pink hat days in the NICU (see picture above), and her resilience and fighting spirit continue to influence everyone she meets.
“With the way that Sarah is progressing and how people are saying that she inspires them, it almost makes us cry,” says Monica.
“Everyone who has worked with her loves having her as a patient,” says a proud Dr. Lesher. “She’s sassy, she’s motivated, and she’s remarkable.”
Published in CHKD's KidStuff Magazine, Summer 2025
Written by Jessica Davenport • Photograph by Ken Mountain
