Botox

Referral Criteria: Botox clinic evaluates children for the treatment of spasticity caused by cerebral palsy and similar disorders such as acquired brain or spinal injuries. Through the use of Botulinum A (Botox®) the goal of Botox® injections is to reduce spasticity and involuntary movements in certain muscle groups to:

• Promote more normal muscle growth to delay or avoid the need for surgery
• Improve range of motion to allow comfortable brace wear
• Improve the client’s functional abilities: walking, standing, sitting and use of upper extremities
• Improve caregiving activities such as bathing, diapering and dressing
• Reduce discomfort associated with increased tone 

Clients with late fixed contractures are not appropriate for the Botox clinic; a referral to the Orthopedic Surgeon is advised.

Who Can Refer: Pediatric Physician/Neurologist or Nurse Practitioner (Please include OHIP billing information and all relevant supporting documents)

Who is part of the team: Paediatrician, Registered Nurse, Physiotherapist and Therapy Assistant

What to expect during the visit: To minimize the discomfort a freezing spray will be used to numb the skin prior to injections. You can help distract your child during the procedure.

What to Bring to the Appointment:

• Your child’s Health Card. The Ministry of Health and Long Term Care requires us to validate your health card at every clinic visit.
• In order for the team to complete a full assessment, bring your child’s orthotics, wheelchair and walking aids. Older clients may be more comfortable in shorts during the assessment. 
• Your child’s favorite toy for comfort. 
• List of current medications and allergies.
• Any notes or questions that you may have. 
• Any other forms related to your child’s care, such as reports from previous assessments, letters, and x-rays.
• A list of goals that you and your child would like Botox to address this may include ease with dressing and toileting or wearing orthotics comfortably. 

How can I prepare my child prior to the visit:

Your child may be asked to complete a series of physical tasks in order to assess their mobility and general level of functioning. Your child’s range of motion will be assessed while lying down on the assessment bed. Your child’s gait will be assessed and a video recording will be obtained for comparison as required.

Sedation Option
At ErinoakKids, we do not offer sedation services. Sedation clinics are offered at Credit Valley Hospital for clients who receive multiple injections. You can speak with the ErinoakKids Physician if you are interested in this option.  

Payment
If you are using Assistance for Children with Severe Disabilities (ACSD), OHIP+ or Exceptional Access for your payment, the nurse will send your child’s health card number to the selected pharmacy for payment processing.  

If you are using private insurance, you will be asked to call the pharmacy and provide your insurance information and method of payment as needed. Most private insurance companies require pre-authorization for coverage for Botox. Please contact your insurance provider well in advance to obtain the coverage request forms. 

Location
The Botox Clinic is offered at the Brampton, Mississauga and Oakville sites. Please confirm the location of your appointment prior to the appointment day.

Contacting the Botox Clinic
If you have questions about Botox Clinic, please speak to your Physiotherapist or call your home site and ask to speak to the Pediatric Nurse.