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Sunday, July 29, 2012

Physical therapy update!

I know I've mentioned the fact that both of the twins have been in physical therapy for awhile now.  I haven't written an update recently because, quite frankly, I've been too afraid to jinx anything.

But now that I can officially declare that both of my boys have "graduated" from physical therapy, I feel like I'm safe to shout it from the rooftops! 

They both started physical therapy back in January, after the pediatrician diagnosed them both with torticollis.  In the most basic terms possible, Beckett's muscles on the left side of his neck were tight, therefore causing his head to tilt and turn slightly left.  This was especially a problem when he was sleeping, which of course young infants do frequently, so the back left part of his head was starting to flatten.  Kiernan had the same problem, but on his right side instead of his left; and his head was more misshapen than Beckett's.  They were also quite weak and beginning to fall behind in gross motor development, which could have been related to the torticollis, but also to low muscle tone.  So the pediatrician recommended physical therapy.

Their amazing physical therapist, Miss L, has been coming to our house once per week since then, working with both boys and teaching me how to do exercises with them.  We did neck stretches with them after every diaper change for months and eventually the torticollis resolved.

The low muscle tone, however, continued.  The way Miss L explains it, if you have low muscle tone, you're always going to have it.  Adults who slouch a lot (me!) or lean on things while sitting (me again!) most likely have low muscle tone.  So it isn't necessarily detrimental to development or always indicative of developmental problems, but it can cause difficulties throughout childhood.  Therefore it's important to make appropriate interventions early in life.  At least that's how I interpreted what she said!

In the beginning, Kiernan's low muscle tone was more severe than Beckett's.  The speech therapist/lactation consultant we saw for nursing problems early on was actually the one who urged me to insist on physical therapy even if the pediatrician didn't agree. Initially, I was a bit worried that it might be more than just motor development, but that he might have a neurological or developmental problem as well.  But eventually he began to progress.  

{Nov 2011} In the beginning, Kiernan (L) could barely hold up his head when he was on his tummy.  Beckett (R) was much "stronger" at this point.

{Dec 2011} In the Bumbo, Kiernan (R) had a very hard time with head control.  Beckett (L) had a bit of difficulty at times too.

Over time, Kiernan progressed leaps and bounds and quickly improved.  Beckett also improved, but at a much slower pace.  In April, I began to get a bit concerned, because Beckett had really stalled on progress.  Miss L admitted that she was a bit concerned as well, but reassured me that he might just need a little more time.  Sure enough, in May, he kicked it into gear and started making some progress.  It took lots of exercises and significant chunks of my days were dedicated to deliberately working with the boys on their movements.  It was much more than just playing with them, although I tried to make it seem like play time as much as possible.  And every Monday, Miss L came over to work with each of the boys, to evaluate their progress, and to instruct me on how to adjust their daily exercises and other ways to help their progress.  She outlawed the Bumbo seats, the jumperoo, and allowed very minimal time in the exersaucer (only because I told her that it was sometimes the only way I could squeeze in a pumping session), calling them all a physical therapist's worst nightmare.  Instead, she showed us how to sit the boys in simple plastic crates (padded, of course) to help them learn to sit properly.  We had special shorts for the boys to wear in order to teach them to keep their legs from sliding apart when attempting to crawl.  It was a lot to handle, and sometimes it was exhausting, but every minute was worth it.

{Jan 2012} Kiernan (L) is doing much better with neck strength.  Beckett (R) hasn't made much progress.  

{Feb 2012} Learning how to sit independently.  Note Beckett's (L) significant "tripod" lean to the front, which is apparently fairly common in low tone kids.  

{Feb 2012} Having fun in their crates after the Bumbos were outlawed by Miss L!  (Beckett - L, Kiernan - R)

As spring turned into summer, Miss L began working a little less with Kiernan and dedicating a little more time to Beckett.  Finally, in late May, she considered Kiernan "all caught up" and he graduated from physical therapy.  She still kept a watchful eye on him when she came to work with Beckett, and always asked for updates on his progress and provided suggestions and guidance for his further motor development.

{March 2012} In early March, Kiernan started getting up on his hands and knees and rocking back and forth.  Eventually this progressed into scooting backward and he would often end up stuck in places.  

{April 2012} In early April, Kiernan started doing what Miss L dubbed "the inchworm".  After a few weeks of this, he progressed to real crawling on April 24.  He wasn't a very solid sitter until he learned to get from crawling to sitting and vice versa, then he sat by himself like a champ.  

{April 2012} Just days after he started crawling, Kiernan began pulling himself to his knees next to the couch.  Two days later, he learned to pull to a stand and has been pulling himself up on everything ever since!  In May he started cruising on furniture and is now the bane of his big brother's existence ;)

Beckett really started to make progress in June.  As we got closer to leaving for our vacation, we decided that she would see him when we got back and come up with a plan to evaluate whether or not he needed further therapy.  I'm proud to announce that she was very impressed with his progress upon our return to Florida and declared him "graduated" from physical therapy.

{April 2012} The same day that Kiernan pulled up to his knees, Beckett got up on his hands and knees for the first time.  I was so proud and excited and more than anything relieved!

{May 2012} It took Beckett another month to start creeping, but it only took a week after that to start crawling.  Shortly after he became pretty good at getting himself to and from the sitting position.  He is now a complete crazy man and can swiftly beat Kiernan in a crawling race.

{June 2012} In early June, Beckett started pulling himself to his knees.  Then, on June 18 I snapped this picture.  He didn't pull up again for another week, but since then pulls up on everything, including his brothers.  

As any parent knows, it's scary when you're told that something is "wrong" with your child.  Hearing it about 2 children simultaneously is even scarier.  Over the months I have put myself through the ringer with blame and questioning what I could have done to prevent it all.  But I'm almost grateful for that guilt, because it helped make me that much more determined to help them along in their progress.

Through all of this, I've become an advocate for early intervention.  If a kiddo is a little behind in something, I really see no harm in getting a little help in order to get them caught up.  If it turns out to be a more serious problem, then you have a head start in solving and/or treating it.  If it turns out to be nothing but a little delay, then at least you catch up early!  I think some parents hesitate because they're afraid of a label.  But really, what's more important is that your child gets the help that they need.

I really encourage every parent to seek help if you're concerned about your child's development.  I had countless people tell me stories about their children being "late bloomers" or that certain behaviors were normal when they aren't necessarily.  I'm so glad that I didn't listen and got the help that my boys needed. 

I'm so proud of my boys for all of their hard work.  And I'm so thankful for Miss L.  She is amazing at what she does.  I can't tell you how much I'm going to miss her visits on Mondays!  But we've grown close enough that we've promised to have "play dates" so that she can love on the boys ... and of course keep an eye on their motor development!

I leave you with this ADORABLE video of Miss L playing with bubbles with the boys.  She uses them as a motor exercise, but once we heard Beckett's belly laughs, she turned it into more of a game.  Seriously, it's so cute.  Hold on to your ovaries ladies.

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