When I told Ms Mary, L’s Early Intervention (EI) physical therapist, that the neurologist suggested physical therapy (PT) once a week to help with his low muscle tone (hypotonia), she rolled her eyes at the idea. We learned that if we supplement L’s PT with an outside provider, we wouldn’t be able to use the PT services EI provides. Even though she didn’t think L needed PT on a weekly basis, she said she’d be willing to do so if we felt he needed it.
At that same visit, Ms Mary noted that L’s response time when asked to perform certain tasks were delayed or it appeared he didn’t understand what she was asking him. I felt relief that someone else, someone outside our home, noticed what I have noticed for weeks. It didn’t help that G was jumping in to do everything for L either. She felt she had done all she could with L on speech and it was time to bring in a speech therapist.
Ms Mary told me that before her next visit I needed to figure out what we wanted her to do and if we wanted to start speech therapy.
I could see weekly physical therapy being a benefit, but I felt that if Ms Mary didn’t think it was necessary then we might not get the most out of her visits. Plus, it was getting harder to schedule visits with her since L’s nap schedule changed, she reduced her hours, and she was seeing additional patients while someone was out on maternity leave.
The idea of going to a physical therapist’s office was appealing; I could schedule those visits when G was in school. But I knew they wouldn’t do anything we couldn’t do at home. And for $60 a visit ($240 a month) that was NOT financially possible for us.
Then I thought, maybe I could enroll L in some sort of mommy-and-me class. Maybe gymnastics? Or soccer? I started researching what was available to us when G is in school. Some places required a $50 yearly membership fee, but even having to pay that, the cost of a session or monthly fee was less than $60, making it that an affordable alternative.
I laid everything out for Mr Boots, but lately he seems to think his opinion doesn’t count about these things. I’m the one who feels there’s a need for EI so apparently that means I have to make the decisions on where to go next. I told him my thoughts and he shrugged and basically told me I seemed to have it figured out, so why was I asking. Utterly unhelpful.
So, after a lot of agonizing, I decided on this: we would ask Ms Mary to come for a home visit once every month or two, because I wanted a fresh pair of eyes looking at L’s ankles since he is wearing the AFOs. I can’t tell if they’re making a difference, but I know she can. We’ll turn our focus from physical therapy to speech therapy, because I honestly can’t tell when L isn’t doing what we ask because he doesn’t feel like it or because he truly does not understand what we are asking. Finally, because I know children with low muscle tone need exercise to build muscle strength, I’d find a class for us to take, hopefully while G was in school.
At Ms Mary’s next visit, she surprised me by having our EI patient coordinator come with her. It worked out nicely because we had to rewrite L’s plan. Ms Mary was happy with what we (I) decided and even though she didn’t think she really needed to come back at all, she said she was more than happy to check out L’s ankles with fresh eyes. She is due to visit in December.
L will be seeing a speech therapist twice a month for the next three months, when we’ll reassess his progress. Scheduling those was a bit of a headache because of the holidays and the speech therapist is also covering patients for someone out on maternity leave. But luckily we were able to find dates that worked while G is in school. I’ve made it clear that G cannot be here for them as much as possible because he wants to be the center of attention and will do things for L. Plus, I’ve realized that L does a lot better when his environment is quiet and he can focus better. If it’s just us and the therapist we might see a lot of progress in the next couple of months.
I’m hoping to have a mommy-and-me class chosen by the end of the month. We tried one gymnastics class for walkers – 3 year olds. I didn’t think too much of the age gap until we were there. Plus, the coach was more interested in chatting with the regular moms than engaging with L. I thought that as a potential client she would have at least tried to engage with L more. The second half of the class went fine (open gym) but the first half, which was structured and had a LOT of off-limits stuff, did not. I was also surprised at how much tumbling there was. It was fine for the closer-to-three year olds but I wasn’t sure about L doing it (he had no interest anyway).
We’re supposed to try a gymnastics class at another facility tomorrow, this one for 16-24 month olds. I’m hoping that being in a class with children closer in age will go better. If this doesn’t work out then I’ll be enrolling him in soccer. He enjoyed himself when he was allowed on the field before the classes G took over the summer. And I don’t think they’ll care as much if he runs off from the circle.