***Here is my mandatory disclaimer stating that I am not a physician or physical therapist and am in NO WAY qualified to diagnose or recommend treatment options for anyone's child! I am simply putting out there what we have used and how it has helped Little for you to use as a reference or inspiration or completely ignore or to use however you see fit.***
1. Hip Helpers: spandex shorts with a sewn up seam in the center to tighten up hypotonic hip joints. He wore these for a few months when he was just about a year old, at the suggestion of his physical therapist. Andrew sat wide legged, with his legs out in a v and these helped to bring his legs together closer to regular hip distance. They can also help with w sitting and hip rotation in babies with hip abduction. I did not go through insurance for these, as they were only $16 per pair. In this picture, Little is wearing them in a size C. I still have them, if anyone needs a pair in that size. Click the link above to make sure your baby needs a C and check with his/her pediatrician or physical therapist to see if these are a good fit for your child and let me know via e-mail (LittleFeedback@hotmail.com) or facebook (link on the right) or by leaving a comment below.
2. Cascade 3.5 D.A.F.O: He got fitted for these when he was about 13 or 14 months old. We were able to get them through our insurance via primary care physician's referral to a pediatric orthopedist. Cascade makes many different dafos and the 3.5 is the model that both his PT and his Ortho agreed was best for him due to his hypotonia and supination. Vocabulary lesson time (HOORAY!);
hypotonia hy·po·to·ni·a (hī'pō-tō'nē-ə)
A condition in which there is diminution or loss of muscular tonicity, resulting in stretching of the muscles beyond their normal limits.
supination su·pi·na·tion/ˌsupəˈneɪʃən/ Show Spell[soo-puh-ney-shuhn]
1. rotation of the hand or forearm so that the palmar surface is facing upward (opposed to pronation ).
2. a comparable motion of the foot, consisting of abduction followed by inversion.
3. the position assumed as the result of this rotation.
He began wearing them every time we wanted to try to get him to walk and once or twice per day for an hour to stretch. He no longer walks in them, but we are still using the 3.5s (in a larger size, of course) at home to stretch his calves and feet when they are particularly tight.
Unfortunately, they don't stop wee ones from tipping over.
Finding shoes to fit over these suckers can be difficult and expensive. I think Little was in a size 4 shoe in these pictures but those New Balance were a size 6 double wide. I got them at Sears. You could also go the route of the Hatchback Shoe, which is a special order shoe that has a hinge in the middle. The shoe bends open in the center so you can slide your AFO or DAFO in then pop the backside of the shoe up over it. Pro - easy to get on over the orthotic. Con: ugly and expensive. Unless of course, Hatchback wants to send me a pair for free to try out and review - then they're stylish and affordable! ;)
3. Potty Rail:
Built for him by his Pappy. I wanted a seat he could sit down on and raise himself off of without help and without falling. This rail has been the perfect solution for him. If your child has weak thighs or balance issues and is unable to use the adaptive potty seats that fit over a regular toilet (Little is unable to walk up the ladder type steps and then turn himself around on the skinny platform on the medical potty seats available), you might consider something like this. Inexpensive and easy to make! His school even had one made just like it to accommodate him in the bathroom located in his classroom.
4. Tiger Helmet: to show off fierceness
Kidding, of course.
5. Baby Bjorn: because they are an AMAZING company with an equally amazing product. You can read about how we got our grubbies on this one by checking out the post I wrote at the time - ERGOmaniac
When Little outgrows it, I will be passing it along to another family in need. I haven't decided how I'll choose - but I'm thinking some kind of contest.
6. Handcuffs: because, well, toddlers are jerks.
Again, kidding. Don't call CPS.
7. Special Tomato Height Right Chair: This is a chair we use in the cafeteria at school. It took the place of old ratty booster seat that was tethered to a scoop back chair. The Tomato allows Little to sit at the lunch table with the rest of his class and not feel like he is in a "baby seat" or high chair. The padding all comes off if I need to wash it and the foot plate and seat are adjustable. I was able to get this 100% paid for by my insurance through a referral from his PCM. The referrals necessary to his insurance company were to a medical supply company (Pennyrile Home Medical in our case) who came out to the house and took his measurements, recommended products, and wrote their own referral paperwork. That paperwork and a second referral from our PCM written out for this specific chair were sent into our insurance company who then approved the order. After word of the approval, the medical store then places the order for the chair. It only took about two weeks for it to arrive.
8. Ottobock Kiwi Pediatric Mobility Stroller: This was procured the exact same way the Special Tomato Height Right Chair was. Keep in mind that the sun canopy and under carriage storage bag are both considered unnecessary and optional, so many times insurance will not cover them.
It is super smooth to push; even Andrew has no trouble with it. I think my favorite feature is the directional push bar - I can push him in the usual forward facing direction, or if I get backed into a corner or he falls asleep, with one quick push of a button, I can flip the handle bar over the seat to push him in the opposite direction (seat facing me). That will definitely come in handy exiting crowded elevators where there is no room to turn the stroller around! Plus if he is asleep, I can pull down the sun canopy to block people out and keep him facing me for privacy.
The front wheels swivel or I can lock them for going over gravel/cobblestone. There is a zippered pouch on the back plus an undercarriage bag. The only thing it is missing is a cup holder (which I've already added) and unfortunately it takes up my entire trunk some have to remember to leave it at home when I grocery shop. Anything requiring the stroller and luggage or purchases or anything else will mean I'll have to use my husband's car, which means switching over the car seat.
But I am so SO grateful and excited to have it!!!
9. Cascade 4.0 D.A.F.O.: this is the one we'll be getting shortly (as in the very next time we go to his PCM). Andrew's rotation has switched from supination to pronation as his ankle muscles weaken.
pro·na·tion/proʊˈneɪʃən/ Show proh-ney-shuhn
1. rotation of the hand or forearm so that the surface of the palm is facing downward or toward the back (opposed to supination ).
2. a comparable motion of the foot consisting of abduction followed by eversion.
3. the position assumed as the result of this rotation.
4. any similar motion of the limbs or feet of animals.
10. Physical Therapy and Occupational Therapy: really, I should have listed these first since he's been doing them since he was 13 months old. We started off with our states free birth to three, early intervention program called Kentucky 1st Steps. His PCM put in a referral and KY 1st did the rest. They came out to my home for every evaluation and session from the time he was 13 months to 3 years old. At 3, 1st Steps turns you over to the school system for services. Andrew has been in preschool since Jan 2013, a few days after his third birthday. He receives 30 minutes of PT and 15 minutes of OT each month. That is not enough for him, but it is all the state can provide. Because of that, our incredible therapists kept him on as a private client (again, try your insurance - the worst they can do is deny you. You'll never know unless you submit a referral). He now receives PT twice per week for 45 min each time and OT once per week for an hour on top of what the school can do for him. All four of his therapists are on the same page - I even brought his private PT to his IEP meeting at the school last month. The referrals constantly have to be renewed, and evaluations resubmitted, but every bit of paperwork and waiting room time is worth it to have the services he needs.
And that's it so far! I think we're incredibly fortunate in that we haven't needed a whole lot yet and that we've been able to get everything we have needed pretty easily. I know how blessed we are to have this amazing insurance plan through the Army and I also know that we will not have it forever. In fact, it may be coming to an end pretty soon, but that's a blog post for another time. I hope I've helped some of you out a little bit, or given you a bit of insight for what services and equipment you might consider for your son or daughter in the future. I am always on the lookout for new products to make Little's life a bit easier ( I choose to be proactive) and as I come across them, I will continue to pass the info on to you.
I hope you all had a wonderful holiday season and I wish you a year full of blessings! Put your faith in Him and God WILL provide! Proverbs 3:5- "Trust in the LORD with all thy heart, and lean not on your own understanding: in all your ways acknowledge Him, and He shall direct your paths."
*thank you, Pintrest for the sweet tree/car idea*