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Old 02-27-2013, 09:43 PM   #6
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Re: Physical/Occupational Therapy Questions

Does she have physical delays or is she just at risk? If at risk I think I would get an eval and listen closely to the suggestions. For an at risk situation this might be enough until her motor skills start to lag.

If she is actually delayed I would be insistent on a physical therapist and even appeal if necessary. PT exercises use core strengthening exercises. Working on not just crawling but crawling correctly, sitting correctly, correct gait, pulling to stand and/or furniture cruising (depending upon the delay, obviously not all children will be on the same page of development) stretching muscles, evaluating which muscles were hypotonic vs hypertonic. DS's Pt at that age was also screening for possible structurally abnormalities and handing out better specialists recommendations then ds's ped (because lets face it most peds are only mediocre at handling children with advanced needs). Also she is at a key age where she needs to be transitioning over to standing therapy if she is not yet bearing weight.

DS's OT is not very good with equipment at all and if your daughter is going to need equipment (and this is the age where equipment needs start to accumulate) you will definitely need a PT. To put it in perspective at 12 months DS's PT had started working on finding a stander, at 15 months finally received stander and DS was also referred to Shriner's Hospital, at 18 months first wheelchair and first AFOs were ordered all equipment was received before his 2nd birthday. Now some kids with less delays skip the whole stander and wheelchair and go straight into either a gait trainer or walker.

Also the other issue I find alarming is if she does need stretches why isn't OT giving you homework and showing you the stretches? If she needs stretches once or twice a week stretching session isn't going to cut it. She should be showing you how to do it and inquiring how it went at the next session. Therapies primary purpose is for evaluation, help pushing the child to the next level and showing the parent what needs to be worked on so they don't regress and hopeful progress in between therapy sessions.

Also it may be a littler early but if her adaptive needs look like they are going to be long term it might be a good idea to start gathering recommendations for rehab doctors and finding out what the wait time is and what age they like to start seeing patients. I regret waiting as long as I did to get one lined up (we didn't use one until ds was 4yo). Evaluation of adaptive needs, procuring equipment and securing spaces in difficult to navigate programs is their specialty. The PT is kind of like the first person that you start the process with but the rehab doc and staff can take a turtle paced DME procurement process and rocket it through as quickly as possible. Seriously I have called for equipment needs per PT recommendations and had appointments either the same day or within a week's time because Rehab staff is just lightening quick with paperwork and cutting through all the impossible crap to get straight to where everything needs to go.

Last edited by mekat; 02-27-2013 at 09:48 PM.
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