Submitted by Michele Riak OTR/L
| Before | After |
|---|---|
| Unable to crawl | Began crawling reciprocally with fluidity |
| Parents were told child would never be able to crawl | Now walking |
| Unable to separate her upper and lower halves of her body | Can now move upper and lower extremities separately |
Gia is a 1.2 year old with microcephaly and resultant high tone globally.
Started with rhythmic movements [from the Brain and Sensory Foundations course]. When placed in supine she lifts head up. Had to gently bring legs up over head to reduce this reaction. Over the past week this has improved and she is now tolerating first rhythmic movement with knees up and singing. Very tight and LE are in a fixed pattern. Started to passively do cross walk with mom with arms and legs. Slowly. Ever so slowly tonal changes occurred.
Two weeks in. Gia is now loving first rhythmic movement and does not raise head for more than a brief moment when placed gently in supine. [Rhythmic] Wipers movement has gotten easier. Resultant movements when on mat…..amazing. Gia is rotating trunk! She is now weight bearing on bilateral upper extremities in side sit.
Four weeks in Gia is able to maintain quadruped and lift head up. Not full range but changes are evident. She is beginning to reach for a toy in this position. Tried working on TNR exercises but she is quite young. She will tolerate prone for longer periods and is getting more head righting which is very exciting. Working on rolling balls in this position and can do this for 3 tries at a time before fatiguing.
Six weeks in. Parents have consistently been doing rhythmic movements [from the Brain and Sensory Foundations course]! In addition, Gia is now able to transition from quad to side sit with residual lower extremity extension. Began working on hand and foot reflexes and instructed parents in their importance. Gia tends to self stim with her right hand and limits her grasp of objects to left. She will reach with right but her grasp bilaterally is primitive.
Eight - nine weeks in. Gia is able to maintain quadruped for long periods. She can turn her head bilaterally in this position and now can reach with extended arm (more on the left than the right ). She is reaching bilaterally in quadruped. She is not crawling. However, she is moving her arms reciprocally and will transition to prone or side sit from quad. Grasp has improved dramatically! Gia is now grasping with both hands. Showing grasp and voluntary release and much reduced self stimulatory oral movements with right hand to mouth. She is more vocal and is making more sounds. Mom reports she is now able to bring cup to mouth and can tilt head up!
12 weeks in. Started more hand and foot integration tasks with Gia. She is now maintaining half kneel bilaterally and with support can stand. Dad made parallel bars to use at home.. Have been having her pick up small pom poms with her feet bilaterally and doing hand and feet isometrics.
14 weeks in. Parents have admitted they have stopped doing rhythmic movements. Reviewed with parents and asked to continue. Started work on the Moro. Gia is now holding her head up in parachute swing. Something she was unable to do prior to beginning therapy. She would essentially tumble out. Worked with parents with Moro integration. First tested and she shows positive response for non integration. Working with roly poly and extension. Parents having difficulty with isometrics so going slowly and doing lower extremities only. Then upper extremities only. Gia is tolerant of this for only one or two reps.. She is more tolerant of roly poly and big star so we are actively doing this.
She is crawling reciprocally with more fluidity ( this was a child who was told she would never crawl).
Gia is now walking. She is getting in and out of squat with assistance and we were last working on the bear stance and walking in a bear stance. I wholeheartedly give credit to the information I learned in this course as the reason why she is now able to separate her upper and lower halves of her body, use bilateral hands and move with less restrictions.
[Edited for length and clarity, emphasis added]