UPupupupup! DOWNdowndowndowndown!

GERBER!!!!!!!!!!!!!!

That has nothing to do with this post, I just think the picture is funny.

Little had his physical evaluation today by a physical therapist who I will refer to as PtH since her name starts with an H and I don't like to use people's real names. She was so nice and so positive! Andrew warmed right up to her. She asked more in depth questions on the areas he scored low on from the first screening and then did her hands on portion that Andrew was none too pleased with.

PtH pressed on his feet, twisted his ankles, pushed and pulled his arms and legs, set him on his tummy, put things he wanted out of his reach, etc. She said his lowest area of muscle tone seems to be across his shoulders and neck (which I was expecting) but that he does have hypotonia all over. She said the "floppiness" seems to be confined to his upper half - which is GREAT news for future walking. But speaking of walking, PtH said he may end up with shoe inserts that help correct ankle rolling like a brace would. Here is a picture I took of him yesterday that better shows what I mean about that than the pictures I posted last time:

She had asked me questions about his birth and his motor development timeline and from those answers she said she believes he was probably just born with low muscle - that it wasn't bc of anything we did or did not do for him, it wasn't bc he's lazy or anything like that - it seems to just be that he was not born with Herculean strength (I. AM. SHOCKED.)
He initializes movement on his own, even though he fails to perform whatever skill it is he is trying to do, so that's a good sign. it shows that he is motivated but just doesn't understand what he has to do to get from point A to point B. For example, if he is laying on his back and he wants to be sitting up, he just kind of flails around and cries because he doesn't know that to get there, he needs to roll over to his side then push himself up. <------ homework assignment #1 PtH said that since he has not been standing and bending and pushing and pulling, that the pathways for those brain-muscle connections just haven't been formed yet. So we are going to form them for him through repeated exercises and encouragement.

Then she began the harder tests.................and Little turned from believing he had made a "fun new friend" to believing he was being attacked by evil minions of hell. It was torture to watch that sweet little face just melt down and scream and cry and look at me not understanding why I wasn't rescuing him. I had my own tears streaming down my face at that point. I should have worn waterproof mascara.....I'll know for next time. PtH promised that it would get easier on him as he gets used to the new positions and starts taking on some more of his own weight but that anger was surprisingly helpful at this stage.

As she did her tests, she kept pointing out positives to what he was doing - as in, "He may not be able to get on all fours, but he's got his weight distributed evenly!". She was just so nice and so upbeat. She even told him he'd have to try a lot harder if he wanted to show her a fit she'd never seen before. PtH said she was excited to get to work with a baby with so much potential - I can see how sometimes she would want a baby who progresses quickly when you have so many that have so much farther to go. She really seems to think he will pick up skills at a pretty steady pace. So hopefully we're on track to have those 1st steps before his 2nd birthday! I've decided that I will make his walking path down the hallway towards the bathroom so that as soon as he heads off on his own the potty training can begin. HA!

The whole time she was checking off boxes and filling in bubbles and scribbling notes in her Andrew File. Tonight she said she will input everything into her computer program and she will get back a score that tells her what program is best suited to help my little nugget (she believes he will qualify for fine motor as well as gross motor). From there, she will arrange another meeting with me and the Services Coordinator where we will discuss what steps need to be taken next. She gave me 2 more homework assignments (clapping and bending), a shopping list (step stool, yoga ball, and Pediasure) and said she'd call me this weekend to arrange that meeting for next week.
*This is taking FOR.EVER. The referall to start all this was put in on Jan 23*

So that's where we are today. Oh, she also said I should get him enrolled in EFMP on post - so OHO ladies with experience in this, could you PM or e-mail me? I don't know anything about it yet but I will definitely be googling it tomorrow.

So now on to a section I'd like to call PHOTOS TO SHOW HIS FUTURE GIRLFRIENDS (yes Maddie and Bella, that means you):

Duck, Duck, Juice

Andrew is gross motor delayed - at 13 months old, all he can do is balance in a seated position (that I put him in, he can't get there himself) and roll over. He's basically at a 7 month old level as far as the gross motor skill set goes. He has never attempted to get on all 4s or to a seated position or pull up on anything or step his legs or hold his own bottle. His pediatrician says he has low muscle tone (hypotonia), is "floppy", and that his feet roll under more than they should at this point. Here are a few pictures of his feet to show you what I mean:

Andrew's fine motor skills are great but he's completely immobile and it is causing him trouble in other areas - like pooping (yeah, I know you wanted to know that, lol) and growing (he's only grown about 7.5" since birth and the norm at 1 year is 10"-12"). The frustration he has from his cognitive ability exceeding his physical ability is causing some serious tantrums and attachment issues.

At his 12 month checkup, his pediatrician (Miss J) examined him and listened to our concerns about his development. She decided he should get a Gross Motor Evaluation from Kentucky First Steps (an early intervention center) and put him in for a neuro consult at Vanderbilt Pediatric Neurology. Apparently, all of his symptoms together *could* indicate a neurological issue. Our hope, however, is that Andrew is simply hypotonic and physical therapy will due the trick.

After almost 3 weeks of waiting, the neuro's office called and set up his 1st evaluation for June 08. Yeah, I know, but hopefully he will have had a few months of physical therapy by then and we will have a better idea of whether this is neurologic or just muscular. The next day I received a questionnaire in the mail from KY First Steps (K1st from now on) as a screening tool to see if he really needs early intervention or not. There were sections of Communication, Fine Motor, Gross Motor, Problem Solving, and a few others. As I read the section on gross motor, I just laughed. None of them applied to Andrew bc he isn't even performing the preliminary skills to get to the ones they were asking about! For example, one of the questions was "When supporting your child with one hand, will he take several steps forward?"................................uuuuuuum no. Pretty sure your child has to be able to stand first. "When your child is standing on the floor holding onto a coffee table, or the like - does he or she bend tot he floor to pick up a toy then return to standing?" Again - NOPE. We're not anywhere close to that one. A few days ago the Screener from K1st called and went over the Qs with me and scored him. Needless to say, Andrew scored a zero on gross motor. He did great on everything else! He plays peekaboo without being prompted, his speech is on track, he uses his fingers and thumb to pick up tiny objects, he understands how to get small items out of bigger ones, etc. He is really a smart little bugger, he just can't do for himself physically. Yesterday during lunch, he had a rubber duckie on his tray and a sippy full of juice (that he won't pick up or drink from) and in between bites, he'd grab the duck or touch the sippy. As he would do these things, I'd say "duck" or "juice"........then I realized we were playing duck, duck, juice.

So the Screener told me he passed (ok, failed) on to the next step. Today at 1:00 the Services Coordinator will be coming to the house to explain what will happen next and have us sign paperwork. I know that after today, the physical therapist will be coming to evaluate him. Screener told me that part takes about 2.5 hours and that Tot will not like it. That's going to be a lovely afternoon. From there, Phys Therapist will decide if he needs monitoring and a re-evaluation in a few months or if he needs weekly physical therapy sessions or something in between.

So that's where we are. Believe it or not, this was the short version. I'll update more tonight or tomorrow with what the Services Coordinator says.