Dr. Ayyangar developed and directs several Pediatric Rehabilitation programs at the University of Michigan including the Pediatric Rehabilitation Medicine Fellowship Program, and the intrathecal baclofen program. She was also instrumental in developing the injection under sedation program for botulinum toxin and phenol injections and initiating the use of US guidance for injections in the pediatric population. She has a particular affinity for the management of children with complex needs and is currently actively involved in the Pediatric Palliative Care Service, and is board certified in Hospice and Palliative Medicine (as well as pediatrics, PM&R, and pediatric rehabilitation medicine.) She has served on the AAPM&R Board of Governors as well as several academy committees. She was Vice Chair and Chair of the Council for Pediatric Rehabilitation/Developmental Disabilities and received the 2015 AAPM&R Outstanding Council Service Award. Dr. Ayyanagar has made national and international presentations on topics related to spasticity management and cerebral palsy and has received several honors including recognition as one of the Best Doctors in America as a pediatric specialist in 2013, 2014 and 2015 by US News and World Report.