Wednesday, November 24, 2010

Children's Development Team

After the hospital Physio's made their referral to the Children's Development Team (CDT) I got a phone call from them.  They asked me to bring him in for them to do their own assessment to see whether or not their service was appropriate for him.  Basically, you need to have a problem of some kind to be accepted, but if you are too severe (delayed in more than three areas) then they refer to you the Carpentaria Disability Services Early Intervention Team.  So I brought him in and we were seen by one of the CDT physiotherapists.  She did a developmental screening using the Ages and Stages Questionnaire (ASQ).  He was 5 and a half months old, and she used the 6 month old screening.  The results were that he has no developmental delays at this time.  He was borderline for his gross motor though, due to his high muscle tone.  Basically there is a potential there for delay if he is not able to overcome the problems being caused by his muscle tone.  The biggest problem is that he is not taking weight on his arms.  On extended arms I should say.  He props himself on his elbows and gets up on his hands a bit, but his arms are still very bent.  He is getting up onto his knees and trying to move around, but he is not using his arms as a baby usually does when crawling.  This results in him moving on his legs and his head.  The usual strategy for trying to help with this is to prop the baby up with their chest on something like a rolled up towel, to encourage them to place their hands down onto the floor and bare some weight.  Joshua just kicks himself right over the top!  So she said they would have to be creative in thinking about some ways to encourage him to take his weight on his arms.  This was also impacting on his ability to sit, because most babies will begin to sit by using their arms to help with balance, in a tripod position.  He wouldn't/couldn't do that.
So he was accepted into the CDT, for physiotherapy and I was also invited to bring him along to Baby Group.  Baby group is basically group therapy for babies.  It is set up like a playgroup with lots of activities and it is run by Occupational Therapists.  There are about six babies that go each Monday with their mothers/carers and the Therapists go around and help work with each individual baby and help to give strategies to use at home to help with the issues being faced by each one.  There is also story and singing time and parachute play.  It is quite enjoyable, and we've only been for three weeks so far but I feel like it had been beneficial for him.  On our second week there, the OT was working with him on sitting.  When you tried to place him in a sitting position he would pretty much fall right away and wouldn't use his hands to try and support himself.  They were considering a corner chair for him (personally, I think this is a bit over the top at his age, because many babies are not yet sitting, he wasn't even 6 months old) but she decided that he was trying to do it himself and that the best thing would be to let him try.  After working with him on the Monday, the next day, he could sit.  Not perfectly, he slumps forward, but he was doing it MUCH better than he was previously.

Sitting up and reaching for toys
He can keep himself up on his own now, and they were really impressed with how much better he is sitting this week than he was last week.  It is still a work in progress, but a great improvement.

Other things I have noticed is that if he is laying on his back and drops a toy, if it falls to his left he will reach out with his left hand and try to pick it up.  If it falls to his right, he will roll to his side so that he can use his left hand to try and pick it up.  If you make him use his right hand, he can do it, but he is strongly favouring his left hand.  He will also pull his left foot up with his left hand but not his right.  If I give him the foot he will hold it but he is not doing it on his own.  Tahnee the physio had a look and she thinks the tone is mainly a problem in his arm rather than the leg (though I think the right leg is a little tighter than the left, it is no where near as bad as the arms)

So things are fairly good with Josh, but we do have some challenges that we need to work on with Physical and Occupational Therapy.

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