Options for When Your Child Won't Wear a Scoliosis Brace

Bracing is a commonly given scoliosis treatment.
Bracing is a commonly given scoliosis treatment. Gala-az

When it comes right down to it, the only way to reduce a scoliosis curve (or at least stop it from progressing) without resorting to surgery is bracing. And as you can imagine, the key to success with this is for your child is to actually wear the brace—according to the doctor's instructions, that is. For many teens, this equates to living in a plastic cast for 23 hours per day.

Such a lifestyle would be challenging for pretty much anyone, let alone a tweener who is likely experiencing for the first time social pressures to fit in with peers, hormonal changes and more.

Not only that, but your child's natural proclivity towards self-expression and movement are bound to lead to at least some resistance to brace wearing—especially when brace wearing is necessary for up to 20-23 hours of the day for a period of years in order to get the desired results.

Actually wearing the brace for the required amount of time is one of those things you can't say you did, but didn't actuality do, and expect the treatment to work. You can't fool the doctor nor anyone else endowed with the powers of observation. No, compliance with instructions from your prescribing health provider is the only way to truly benefit from scoliosis bracing treatment.

Even so, many children and their parents do try to fool their doctor as to how many hours per day and how many days per week the brace was worn. But those who are honest about it, the Scoliosis Research Society reports, tend to reduce or stop the progression of their curves less than those who wear the brace as directed.

So what do you do if or when your child refuses to wear a brace? Here are five strategies that may make the difference.

Know the Program

It's critical that your child is aware of just how important adhering to the brace regiment is. But getting this to happen is no easy task, especially if you don't understand all the aspects yourself.

Along with learning on how to put on and take off the brace, and to are for it, be sure to ask your child's doctor any and all questions about the scoliosis curve(s) that will be braced. Don't stop until you have a complete picture. Things you might ask include:

  • Is the curve single (called a "C" curve) or double (called an "S" curve.)
  • Where is the curve located exactly?
  • What is the Cobb angle of the curve?
  • What is the Risser sign for the curve? (A Risser sign is a number - like a Grade - that gives the degree of skeletal maturity in a scoliosis patient.)
  • How snugly should the brace fit?
  • How does the growth period affect curve progression and/or correction?
  • What to do if your child is uncomfortable or in pain while wearing the brace.
  • How long is the initial break-in period and are there special instructions you should follow?
  • How many hours per day should my child wear the brace?
  • What Are there positions or postures that should be avoided or encouraged?

Another thing for you, as a parent to understand and discuss thoroughly with the doctor, is that successful curve correction is limited by a window of time.

Once your child reaches the age of 18, wearing a brace may no longer be an effective treatment. Depending on the degree of the curve (the Cobb number,) the only other option at that point may be surgery.

And finally, know that wearing a brace may well cause your child some discomfort. She may experience chaffing and/or restricted breathing, for example. Your doctor is your best resource for information on how to relieve these.

Make It a Family Affair

In this 21st century of ours, we're all busy—kids and families alike. Schedules are a must, and it's no different when it comes to consistent brace wearing. Along with a meeting to work out how the initial break-in period will go, consider holding a family pow-wow once a week, or even once per day for that matter, to plan, track and/or troubleshoot the regime.

You might engage your child by actively asking them about the brace—what they like, what they don't like and what would make sticking with the schedule easier for them. And by the way, the more you, as a parent, understand the program (see the item above) the smoother these meetings will likely go.

Another possibility is to throw a family or social event where you and your child apply art to the brace. (Ask your doctor first to be sure this won't interrupt the treatment aspect of the brace.)

Go Social

As most of us know, the tween and teen years are filled with important issues like who's hanging out with who, am I popular, how do I look, and what's the latest trend in make up? Trying to stay current with your friends and schoolmates is doubly hard when you're also trying to hide a brace or hump under your shirt. No one wants to be ostracized, and many kids worry about what others will say or think if a classmate spots their brace.

The good news is many kids outgrow their unwillingness to let their brace be seen by peers. Some feel it's too uncomfortable during the summer, while others, over time, simply get past the sensitivity.

Plus, these days there are organizations, web sites and peer to peer resources that help teens with scoliosis decrease the amount of isolation they may feel because of their brace. Some are designed for connection, sharing and friendship, for example Curvy Girls. Others strictly offer fashion advice (and of course, sell their wares.) Many of the YouTube channels and websites on the topic of scoliosis fashion have been created by the teens themselves. Curvy Girls lists a large number of support groups all around the country and beyond, and they also hold a Curvy Girl convention. Curvy Girls was started by a 13 year old girl who was diagnosed with scoliosis; it has grown into perhaps the most well-regarded support resource on the web. (And remember, you can use the site to find an in-person group, as well.)

Another great peer resource is Scoliosis Stories. If you think your teen would more positively respond to encouragement and information offered by a real live (female) scoliosis patient, this site may be right for you. Hannah, who is now a biomedical engineering student intending on specializing in scoliosis, was diagnosed at age 12. The website offers teens tips as well tough love. You can submit your story or questions for publication.

Use a Timer

Although not widely used as of November 2016, timers are available that can be inserted into the brace. The timers use a pressure sensor to keep track of the hours and minutes the brace is supposedly worn. I say "supposedly" because some studies show problems with pressure going too low for the sensor to accurately pick up. (Therefore, kids who wore the brace but may have moved in a certain way, were recorded as not having worn the brace.)

Brace timers maybe on their way in, though. Researchers are already finding the devices are useful in the study of compliance and adherence. Researchers who in 2015 studied a timer called the "Cricket" also suggest it may make a good tool for parents who monitor their kids.

The time in brace as recorded by the Cricket and other timers are then divided by the number of days your child reportedly wore the brace, to give the average hours per day.

Get Fashionable

Brace wearing has spawned a number of fashion businesses, as well as creativity in brace design on the part of manufacturers.

For example, according to the website OandP.com, the Boston Brace company, a well respected, long-time maker of spinal bracing options offers an array of colors and patterns in the form of transfers that can be applied to the brace. (Or, perhaps make your own.)

Hope's Closet offers an online shopping experience for girls with scoliosis. They specialize in tops, with camis, tanks and cap sleeve varieties available.

Another e-commerce site specifically for fashion conscious girls with scoliosis is EmBraced in Comfort. This site offers items for both top and bottom that are designed for different types of braces. For example, they sell a pair of brace shorts meant to be worn with either the Spinecor bracing system. They have many fewer items for sale than Hope's Closet. But one thing they do offer that Hope's Closet does not is a tailoring service (as long as you're a customer.)

So if your child's scoliosis treatment is the cause of discipline issues in your home, take heart. You now have five strategies that may help you gain compliance.

Source:

Hacquebord, J. M.D., Leopold, S., M.D. In Brief: The Risser Classification: A Classic Tool for the Clinician Treating Adolescent Idiopathic Scoliosis Clin Orthop Relat Res. Aug 2012. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3392381/ 

Rahman, T., Sample, W., Yorgova, P., Neiss, G., Rogers, K., Shah, S., Gaobs, P., Kritzer, D., Bowen, J. R. Electronic monitoring of orthopedic brace compliance. J Child Orthop. October 2015. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619370/

Scoliosis Research Society. SRS Bracing Manual. SRS website.  http://www.srs.org/professionals/online-education-and-resources/srs-bracing-manual

Tariq Rahman, T., Borkhuu, B., Littleton, A., Sample, W., Moran, E., Campbell, S., Rogers, K., Bowen, J. R. Electronic monitoring of scoliosis brace wear compliance. J Child Orthop. August 2010. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4619370/

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