I wanted to start with this great picture, Never Give Up. Working with children with special needs has taught me to never give up. Just recently I met a young man that has been struggling with his tone as well as moving forward on his skills. This is a common challenge I have seen as the children grow. Their skills plateau and then become stuck on how to continue to move forward. Habit plays a big role in their inability to move forward. We are creatures of habit, where our vision becomes blurred and we lose the ability and sense of how to get out of a continuous cycle. One side of us wants us to have a change and the other side of us becomes scared to make the change. We then end up liking the comfort that habit gives us.
I met Derek for the first time when he came to me with his family. He was sitting on a reclined chair with a strong flexed position of his body, almost like a fetal baby position. His family told me that several years before he was sitting by himself while at the table and would feed himself. His favorite drink was the Cranberry Juice and what they loved must be to see him sitting on the porch with the family having his drink on his own. After a while he became depressed, stopped moving as much, and started taking several psychiatric medications that helped him relaxed, he then stopped feeding himself, would not hold a cup on his hands, and became tighter and tighter loosing than the ability to sit on his own.
We quickly set a plan to start towards his progress. The main focus of the plan was to break the habits and get him back to sitting and enjoying a nice family meal at the table. We did this by introducing activities that posed just enough and the right challenges through all movements he did during the day. He attended a day facility during the day, therefore getting the day program involved in the daily activities was essential for success. His routine was simple, including mobility components throughout most of his day.
The first and biggest step was to stay focused on the end goal. We knew this was going to be hard work as making changes is not just hard on the children but on the caregivers.
His routine included the following components:
1-Relaxing time while sitting on a Tumble Form Seat in a semi-upright position listening to Mozart three times a day.
2-Slowly increasing his tolerance to sitting upright.
3- Leaving the wheelchair at the door at the day facility and moving to an adapted activity chair for table activities or feeding, moving through the day to a regular chair with armrest, sitting on a therapy bench with help behind for support, and sitting at the edge of a mat with minimal support. The different sitting positions allowed for practice and repetition of simple but effective activities.
3-At home practice holding the cup with two hands.
4-Practice bringing the cup to the mouth with two hands while having his drink.
I have seen great relaxation come through with music, its effect can be wonderful. After eight months he was a new man. Derek saw his physician and many of his psychiatric medications were able to be reduced. He was now relaxed, happy, and did not depend on the music to maintain a relaxed state.
After eight months I was able to see Derek sit on a regular chair while enjoying a TV show and sit at the table while grabbing a cup and have his favorite drink with no help to hold the cup and bring it to his mouth. The family stayed focus on their goal from the beginning to the end and they truly made every minute count. The new changes were intense but the result was just simply amazing.
Share your success story with us. The stories will help other parents and children have more ideas on how to change routine and breakthrough strong habits, that do not let your child continue to move forward.
"Providing Options for Movement and Independence"
Karen Crilly PT, DPT, MAPT, CBIS
https://karencrillyphysio.setmore.com/
https://www.facebook.com/KarenCrillyPhysio
https://www.linkedin.com/in/drkcrilly/
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