Orthotics- LJ has outgrown these. Since his foot has grown, his arch has changed and his gait has improved he is no longer benefiting from the original DAFO's from two years ago. We had the orthotist cast and mold LJ's feet last week. Nate came along for the fun and he helped Noodles pick out some snazzy, new velcro straps and patterned foot pads. Hopefully the customized orthotics will be ready in three weeks. The new ones should also help improve LJ's balance and gait. Next up, shoe shopping to fit said new DAFOs :)
DMO Suit-Its working. Though LJ resists having it put on each day, once it is on, it is subtly changing his posture. He sits up strong and beautiful in his chair and his new It is remarkable how well he does immediately once it is taken off. He can hold an independent, tripod, seated position for a couple minutes. Prior to the suit, he was only able to hold himself up for a minute or less. One downside is the zippers can pinch the skin, especially in the groin area. As a consequence, diaper changes become apprehensive for LJ. The other downer is that the Gtube button keeps getting caught on the suit. It's tight and you have to be very careful when putting on and taking it off. Last week, his button accidentally got yanked out when taking the suit off. Balloon fully inflated got pulled through the hole in his tummy. He was not a happy camper to say the least. Nate was instrumental in helping distract LJ as it was re-inserted.
DMO Glove- The glove is not gonna work. We're bummed. LJ is still involuntarily fisting his right hand all the time- including when the glove is worn. It's never in a relaxed state. We thought we might be able to have the orthotist adjust the glove so that the fingers could be reinforced. The other idea we tossed around was tightening up the material of the glove to get a 30 degree wrist extension. Theoretically this might abduct his thumb which in turn would help allow his fingers to extend. In the end, the therapist and the clinical director agreed that the manner in which the glove's technology works was inciting LJ's palmar grasp- similar to when babies have a palmar hand grasp on a finger. The panel of material on the palm can't be removed so no matter what way the glove was manipulated it was not going to help LJ's palmar grasp. We have a follow up appointment with the therapist next week to see if we can get LJ a new splint casted and molded. This splint will not be functional (he won't be able to do anything fine motor when its worn) but rather will be worn at resting times sporadically throughout the day.
Verbal Behavior Therapy- Here was the latest chart from our manding sessions in October.
The good news is that we're happy to see the item requests and MO prompts increasing steadily throughout the month. The bad news is that LJ hasn't mastered some of the targeted signs we wanted him to learn. So we are keeping them on this months list of targeted signs. We're also changing this month's data collection. We are continuing the target mands daily but it will be less time intensive. Instead of tracking all his signs we are only collecting data on the 10 signs we are targeting this month. If we can track when Lewis does a mand/request using the proper sign 5 consecutive times he has mastered that sign and we can move on to a new sign.
The sun is shining this morning. My brain is spinning but I'm not complaining. We've got quite a lot planned for this week as well. I've got a plan and I'm looking forward to making ground on some fronts this week.
7pm announcement: LJ just transitioned from his knees and belly to side sit to a propped, tripod seated position all by himself!!! He did it 3 times in a row if not more!!! As I cried tears of joy, Nate ran and got him his own soccer medal from last year and awarded it to LJ. Melt. And lastly, Nate gave him a kit kat bar from the trick or treat bag. I'm blissed out.
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