Today we had our visit with the physical therapist and the cognitive therapist. I'm really glad we had them come out. I learned some things!
Clara was a little tired, as she hadn't napped this morning. So she was a little wary and a little less playful than she otherwise might have been, but she did just fine.
Three ladies came out. One is our family coordinator- sort of a liason between the us and the organization and the therapists. She explained the organization, the insurance stuff, what to expect etc. Then the two therapists came, about 15 minutes later (so they were all here at the same time). They were all very pleasant and professional and clearly knowledgeable. The two therapists sat with Clara on the floor and tried to engage her in a variety of play activities, while asking me questions about specific things.
They also wanted her in just her onesie- I presume so they could really see how her body was moving, and maybe to make sure her clothes weren't getting in the way. Here's a picture of Clara signing "more". I forgot to tell them she could do that! Shoot! That's okay...they were very impressed with her cognitive development and her fine motor skills.
So, their determination is that she is eligible for physical therapy once a week. To be eligible a child needs to have at least a 30% delay. They determined that she's at about a 7 month level in her gross motor ability. They said it's basically that she is a little weak in her trunk- her stomach and hip area. This is why when she tries to support herself on her legs it looks like her feet are turning out a little. They noted that she's clearly developed some adaptations- scooting etc. but they would like the goal to be for her to crawl. I strongly agreed. I definitely want her not to skip crawling. I've always known that crawling is an important step for strength etc., and have heard that it can be important cognitively too, but they helped me understand that a little more. They said that without crawling she won't be exercising and strengthening her upper body and her hands and fingers, which apparently often leads to problems down the road with hand-eye coordination, handwriting, and all sorts of things like that.
Another interesting thing that they pointed out, which I hadn't noticed- because I didn't know to look for it, but I certainly see it now- is that when Clara wants something she scoots to it and turns her whole body so that she's facing it directly. What they would prefer to see, and what would indicate more trunk strength- is if she were to twist her body toward the toy or reach out to the side for it.
Finally, the thing that made me especially glad we did this, was that they said while she is very strong in her social and cognitive functions right now, often gross motor delays can cause delays in those other areas. It wouldn't necessarily happen, but because a child is more inhibited or delayed in "exploring their world" they can fall behind in social and cognitive development.
So what happens now is that we take care of a little paperwork stuff and then we start scheduling weekly 1-hour sessions with a physical therapist. The coordinator says there are two therapists available in our area right now, so we don't have to wait- which is excellent. They will develop a 6 month goal- even if they think it won't take that much time to reach the goal. For Clara the goal is to crawl and to walk. If we feel that we don't want to continue, or she reaches her goal sooner, she can quit at any time- it's entirely up to us. The therapist will come to our house and we are encouraged to partcipate, so we know how to work with her on the other days. We are not to treat the hour like babysitting time! So- I'm excited! I was kind of hoping that they would determine she was eligible, rather than being on the cusp and leaving all of the responsibility to us! I'll try to make another post as soon as we get started!
She likes to watch her mobile and is very good about just going to sleep on her own. I had to turn on the manual focus because it was dark and the camera only wanted to focus on the mobile.
So then, of course, Clara got all excited about the flash and the excitement since I didn't just leave. So she decided to get up and play. Then it took me an extra 40 minutes or so to put her back to sleep.
Then this morning I forgot to turn the auto focus back on, so these shots are a little blurry. This is Clara muscling her way up with the wagon.
Here she is taking some tentative steps. She does a really great job. Still very wobbly-legged and slow, but she'll be walking soon.
Ah, now I think I got the focus back...
Here's one more picture from this morning. I realized that we have a bajillion egg cartons. We save them for painting or to give to Mom to take for fresh eggs. This morning I decided they would be fun to build with...they're good for stacking and easy for Clara to manipulate.
So right now Clara is working with BethAnn. They're stacking the cloth blocks on the couch. Clara's getting more comfortable with her. I think part of the issue is the time of morning. Clara's only taking one nap at home now (I think she still does an AM nap at Leslie's) and so she gets a little tired and needy in the morning, which makes it a little harder to feel comfortable and cooperative. BethAnn sees that she's making huge amounts of progress though. She just said something about what she thought Clara was doing with her knees-I'll have to ask her about that later. I try to just sit quietly most of the time. If I talk, it just reminds Clara that I'm over here. Now she looks like she's trying to get her to do some torso twisting and some stretching while she's in a standing position. Oh...and now it's "mama mama...".
