Evaluation

Madalyn had her evaluation on Friday to compare her use of her left side before and after the ACQUIRE program.

As expected she initiated more of the activities with both hands and some with her left hand only. Her left hand was more fisted than it was during the cast, and more fisted than I wanted, but I can safely say one week post therapy it looks great, and has been more relaxed again. Tone is something that varies, so I really try to focus on function and strength when trying to evalulate her progress.

I am mostly happy that activities with her left hand just plain look easier for her:)

Update on cast off work

You may remember last year during the ACQUIRE program I described a possible phenomenon that is a result of the child either thinking about and/or actually moving their unaffected side while casted each time they practice a skill with their affected side. This can result in an association being created in their brain that becomes a habit.

If two activities happen simultaneously inside our brains, connections are basically "wired together".

Last year this did not happen to Madalyn. I hypothesized (or did I read it??, who knows) that it happens to "more affected" children. However, since it did happen this time, I'm guessing is possibly has something to do with her age. Or maybe last year she did not think about her unaffected side doing the activity during therapy and this time she did. I mostly ponder this because it is interesting to me, not that knowing "why" will make a difference in Madalyn's future.

This "habit" or "connection" should go away after a bit, and her bilateral use should not be affected. But for now, when she does a difficult activity that she practiced during ACQUIRE, her right hand inadvertently performs the the activity simultaneously...

Here's a video of her one week post ACQUIRE program:

Dressing skills

Madalyn has been working hard on dressing by herself. I am planning to talk to her Occupational Therapist back home about seeing Madalyn for one hour sessions rather than 30 minutes so they will have enough time to add dressing practice and weight bearing to their current program. Although it is my responsibility to practice and do the home program at home, it will help if she gets reinforcement and direction from her therapist as well.

Madalyn does not work nearly as hard for me as she does her therapists, so it helps if I have someone leading our home program, and supporting us since afterall, I am just "mommy".:)

Removing top from bubbles

Madalyn did a great job removing a lid with her left hand.

Cast off-bilateral work

Miss Katera removed Madalyn's cast on Wednesday. While taking her bath, Madalyn excitedly held up two hands and clapped. Then she showed me all the things she can do with two hands.

My sister and I took her to Alabama Adventure, a huge waterpark that I think costs more than Disney World to enter for 4 hours...but oh well.

We had a good time and left just before it started to rain.

Once the cast came off, her hand immediately became fisted. As expected her tone came back. The older she gets and the more experienced I become about hemiplegia, the clearer spasticity becomes to me. Although I always "knew" what to expect, it's different when the forever part starts becoming a reality. A long time ago I asked her neurologist if her brain compensated so well from the injury, why couldn't it go one step further and heal the motor deficits. Dr. Parker said, "that's just the nature of kids and Cerebral Palsy". I am really starting to understand that.

Like all new parents of kids with hemiplegia, you start off when they are a baby stimulating the affected hand, encouraging them to use it, and it really seems like that could make a difference, but it's just not enough.

So, although simply starting early and stimulating her hand isn't enough, the one thing that has made a difference so far is this program. She enjoyed it, worked hard, and we gave her the very best opportunity I know to gain function in her left arm and hand.

We are leaps ahead on supination. Her confidence and motivation to dress herself are increased. And I know the upcoming year of weekly therapy will be more productive because of the work she did in Birmingham.

Tomorrow before we head home, she will have an evaluation in the clinic to see exactly what skills and strength she has gained this time.

playing bubble and opening lid

Eating yogurt with left hand.

Desoto Caverns

We visited Desoto Caverns on Sunday.  It's about a 45 minute drive from Birmingham.  Madalyn and I took the tour through the caverns and watched the light show.  During the tour we got to experience total darkness which was neat.  Afterwards Madalyn jumped in a bounce house, panned for gem stones and sifted through sand in search for crystals!  All great therapy activities.

I wrapped Madalyn's cast in a plastic bag and we had a great time being squirted with water! You can hear her laughing in the video.   She thought it was very funny that I screamed when I got squirted.    

Mcwane Science Museum

Madalyn is having fun over the weekend at the Mcwane Science Museum.

In hand manipulation

This is a difficult task that Madalyn is practicing. She holds a bell in her fingers, and then lets it roll into the palm of her hand. It requires supination to keep the bell in the palm as it rolls.