I was right. L has low muscle tone. It doesn’t mean he won’t be able to do things, but it might take him a little longer to get the hang of mastering them.
At the time of his early intervention assessment, L was walking with his ankles turned too much inward (pronating) and was walking at such a wide stance that he could only walk a few steps before falling.
Three ladies came to assess L: an early intervention coordinator, who we met a couple weeks prior for an initial intake; a speech therapist to assess L’s language capabilities; and an occupational therapist.
He was 16 months at the time of his assessment, and they determined he was mostly at a 15 month level. Since he was born a few weeks early, this didn’t bother me. I was surprised that they put him at a 6 month level for eating though. At the time he was stuffing and often choking/gagging on his food.
He kicked ass at fine motor skills, such as picking things up and putting pegs and shaped blocks into holes. The ladies seemed very impressed with him and I’ve wondered if that had anything to do with practicing baby led weaning with him.
They determined that L qualified for early intervention services because of the pronating ankles, food stuffing, and excessive drooling (also a sign of low-tone). They also determined that if insurance would not pay for services, we wouldn’t have to pay for them based on our tax return. This came as great news to me because we just can’t afford bi-weekly medical visits right now.
The ladies drew up a plan: physical therapy twice a week for six months before L would need to be re-evaluated. They listed several goals for him but the only one I can remember was walk across the room with flat feet to pick up a snack.
They gave L six months to accomplish his goals, but he’s met them already. Of course he was walking laps around the house by the time the physical therapist came to the house for L’s first appointment. (I love that they come to us!)
L’s PT, Ms. Mary, as I’m instructing G to call her, is awesome. Both boys adore her and they greet her like they do their grandparents when they show up at the house. Her visits aren’t very long — I am guessing because L seems to improve before each one so there’s not much work to be done. Each visit she gives me a new activity to try with L to strengthen his legs and ankles. Some of these things are:
- Jumping on the bed
- Jumping on the couch
- Walking across pillows
- Tickling the insides of L’s feet/ankles so he moves them inward
- Picking L up and helping him land on his feet (adjusting his feet so they are flat/straight if need be)
We have an over-sized chair in the play room I will let him bounce on, and we have a bunch of over-sized cushions my sister gave us that he can walk across. Nope, I’m not happy she suggested jumping on the bed and couch, but I understand the reasoning behind why doing so can strengthen his muscles and teach him better balance, so I only say no when the boys try jumping on the couches in the living room.
To strengthen L’s facial muscles and teach him to take bites instead of stuffing his face when he eats, Ms. Mary suggested:
- Drinking a milkshake through a straw (I’m trying to give him straws to drink through more often now)
- Taking a long piece of food (like a pretzel stick) and holding it for L to try and make him take bites
- Tickling his face before he eats
L met his physical therapy goals quickly, just as the ladies who assessed him predicted. This was good because our insurance let us know they’d only cover 3 months of early intervention services. However, L still pronates, so Ms. Mary has asked me to get a referral from L’s pediatrician for a pediatric orthopedist to determine whether or not he’ll need some sort of insert in his shoes to straighten his ankles. Naturally, the one she recommended is based in Richmond. We had a small chat about the lack of specialists in Fredericksburg and commutes and determined I was spoiled living in NOVA where I could drive 15 minutes and see any number of specialists 😉 This specialist comes to F’burg 1-2 times a month, so we may not have to take a trip. (I might be up for it though because I’d like to get this over with!)
Now that L’s walking and running, the next focus will be on speech. Ms. Mary and I set up a time later this month for L to be re-evaluated and we’ll discuss where to go from there.
Oh, yeah. He’s also turning into a climber!