Hello Bill Since tummy sleeping has been ruled out because of crib death I've been concerned about some kids missing the stimulus to develop their shoulder girdles. Most kids who did not tummy sleep don't like tummy time but I've found that if Mom or someone neat is on her/his tummy face to face or side by side and there is interesting stuff to do it can get quite hilarious and the rolling may happen spontaneously. It's also a good way to experience what you are asking of the child. If you can't take another minute of that position maybe she's had enough as well. The other person should always roll over to get up to model the movement then assist rolling to get up until rolling is mastered. Getting off the tummy is the reward for rolling over. Good luck to her.
Joan Riches B.Sc.O.T., OT(C) Specialist in Cognitive Disability Riches Consulting High River, Alberta, Canada 403 652 7928 -----Original Message----- From: [email protected] [mailto:[email protected]] On Behalf Of Juan Turcios Sent: December 16, 2008 6:20 AM To: [email protected] Subject: Re: [OTlist] peds question Hello Bill how are you. Well I think that you need to have her do a lot of tummy time. It's one of the most important ways to improve overall strength (upper back and shoulder stability). Encourage reaching from this position ( on elbow and on hands (elbows extended)). This will improve neck strength, shoulder stability, and arch formation of hands. You should work in sitting balance using a theraball. Encourage reaching in this position (need 2 people). She does not have a hand preference at the time so she may be inclined to using one hand. Or she may be left handed. If you think that there is a problem with her right hand encourage reaching with this hand while on the ball. Massages to the hand with lotion and PROM exercises should increase awareness of extremity. Going back to tummy time, work on rolling (segmented and log rolling) to increase dissociation of upper to lower body. And encourage adaptive technique to transfer from laying down to sit. e.g. on belly,roll to side, use upper extremities to assist to sit up. this should get her going. Let us know how it goes. Juan On 12/15/08, Bill Maloney <[email protected]> wrote: > > My niece has a friend with a child who's scenario I have attached below. > She lives in AZ. She is particularly interested in knowing: what are > available resources for her (i.e. Easter Seals, early intervention > services, > etc.) and which clinical person she should pursue (PT or OT, *although my > personal input was to seek an OT with a peds certification*!). Also, if > any > readers with peds expertise would be so kind as to offer me any "home > program" type suggestions, I will share that with her in the meantime. Any > feedback is very graciously appreciated. Happy Holidays to all. > > Sincerely, > Bill Maloney, OTR > > > > *Birth date 21 Mar 08 > > Age: 8 months > > Weight: 16 pounds > > Diagnosed with : Benign myoclonic epilepsy > > Underlying reason: unknown > > Extra health info: elevated lactic acid readings (normal range 14-16 hers > was 21)- more blood work to follow > > > > Elizabeth can sit with assistance. She can sit on an inclined (her feet > below her body) surface unassisted for short periods of time. She will > "throw" herself backwards when assistance is taken away. She doesn't fall > over in any direction she propels herself back. She can stand and prefers > this she will grab fingers and stand up. When grabbing she shows no signs > of > weakness on her right side. But she will not willingly pick up things with > her right hand. She won't push up on her right arm, her right arm isn't > noticeably smaller than her left but measures about ΒΌ an inch smaller > (circumference). She can grab with little to no effort but will immediately > move the object to her left hand. Sometimes she will hold things in her > right hand but it is more like she forgets the object is there. She > hates tummy time but we do at least 10 mins a day, on weekends we do this > several times a day. She will raise her head up as far as she can and she > raises her feet up (so her back is arched). She can't/ won't roll over on > to > her back. When she is on her back she lifts her head off the ground like > she's trying to sit up but she can't come all the way up. > > She doesn't seem to have any mental delays. She babbles, tracks, mimics, > plays interactively with her others, she has learned compensation > techniques, etc...* > -- > Options? > www.otnow.com/mailman/options/otlist_otnow.com > > Archive? > www.mail-archive.com/[email protected] > -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected] No virus found in this incoming message. Checked by AVG - http://www.avg.com Version: 8.0.176 / Virus Database: 270.9.18/1849 - Release Date: 12/15/2008 5:04 PM -- Options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/[email protected]
