FACILITATING DEVELOPMENT



We are four years into facilitating development following diagnosis of bilateral schiz, with the left side being a LARGE open cleft.

Our daughter does not seem to have any mental delays and is quite advanced. This ability has been a blessing since we require her to follow directions as much as is possible with her high muscle tone.

The first directions that she was required to follow was being told firmly to hold her head up. In the beginning it was just for about 15 seconds. Now after a gazillion verbal requirements and follow throughs, she has pretty good head control.

I also carried her on my hip as much as I could physically bear it (she weighed 25 pounds at 8 months of age). This forced her to use her trunk to support herself somewhat.

The movement that she felt as we walked also helped her brain to diffuse some of the high muscle tone and use more normalized muscle tone. (This is called vestibular stimulation).

We also did major (20,000 stretches in 3 months) oppositional stretching while holding her on our porch swing. She has made tremendous improvements and has just as far to go.

My thoughts in the beginning was to facilitate head control first, then trunk control, then work the muscles proximal (closest to the trunk) to distal (furtherest from the trunk), this being the order of development.

It meant segregating her movements, in the beginning, such as NOT asking her to hold her head up and use her arms at the same time. It meant only asking her to hold her up. As she became more able at this then we integrated some head control and arm use.

By explaining all this, I say it to illustrate, that improvements come, but it is for most of the families, an involved and slower than we would like process.

In most average healthy kids you see them trying to walk at a year of age and actually doing it within a three month period (without a lot of facilitation, I might add). It is exactly the opposite for us. It takes much facilitation and many times longer. I say this, not to be discouraging, but to engender the needed determination! Boy does it take determination (as well as tears).

Hang on, keep up the good work, and keep that youngun' (as we say in the South) working. You will get more.

Another thought that helped me, was if "sitting" isn't coming at this minute and you've begun to feel a little hopeless, pick another area and work on that. You may be surprised at something coming in, that you weren't expecting.

Our daughter READ and understood verbally spelled words at 19 months of age. She has a large empty hole where a speech motor should be, but she tells us when she is hungry (and that is often!), she says "mo-ure" when she wants more drink. She says "off" when the lights go off. She says "van" when she sees the van. She says "pizza", "pepsi", "pretty" and lots, lots, more.

We just had a funny little conversation this past week. I asked her if she was sleepy at 9 P.M. and she said "naahhh" (which is the usual answer) and I then thought I would take it a step further and as her if she was sure and she said "I'm sure". Those two words were an occasion for lots of laughter for us. I now ask her often, questions that end with "Are you sure?" and she answers "I'm sure".

She is four years old and reads signs to us when we are out running errands. I stopped at a local Salvation Army to dig around and as she emerged from the van (on my hip), she looked up and said softly "thrift store". That is what the sign said above the door to the Salvation Army. I cracked up! This is just to illustrate, that you may be surprised at the things your child "shouldn't" be able to do, but DOES.

Motivate, stimulate, facilitate, segregate, integrate. That is pretty much the story of our life.

One item that I would recommend and implore for children that are movement delayed, is a gait-trainer. I prefer them to standers. They can be used as a stander but gives the appropriate support to facilitate a child being able to take independent steps. Knowing how pleased we have been with ours, I would "run to the therapist and ask for one to be prescribed". Evan has one and walks with it about 50 to 70 feet in a paved parking lot.

There is not a way to know what the next few years hold, but hopefully you will be looking back and seeing where you have come from.

Keep up the good WORK and it is the hardest work you will ever do.

Sincerely,
Joan