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The Data Are In…

… And Simon has qualified for physical therapy in the First Steps program. He had his assessment today, and I learned much about him from the fabulous therapist, Beth, who came to our house.

In some areas, I learned what I already knew. He’s on track linguistically, he’s very social, and his cognition is fine overall. He is, of course, quite late in his gross motor skills, operating where an average child of 9-11 months would.

Then there were two huge surprises. The first is that Simon’s gross motor delay is affecting his fine motor skills, which used to be ahead but are no longer. Simon can’t scribble the way he’d like to, and he struggles with squares in the shape sorter and sitting up posts in pegboard, all because his underdeveloped upper body isn’t providing the strength or agility he needs to rotate and balance objects.

The next big surprise was that Simon’s delayed locomotion has had an effect on his cognition. When Beth put a wash cloth on top of a ring, Simon knew to lift the cloth to get the ring. When she put a wash cloth on top of a ring and laid down a second cloth beside it, he knew which cloth to lift up to get the ring. But when she laid down the ring, covered it with a cloth and put a second cloth down beside it, and then reversed their positions, Simon consistently reached for the wrong cloth. Beth explained to me that this level of understanding only develops when a baby has been mobile for a certain amount of time-longer than Simon has been mobile.

Beth pin-pointed several reasons for Simon’s delay:

  1. His reflux prevented us from giving him adequate tummy time, and the Back to Sleep campaign prevented him from getting comfortable in that position at times the reflux was better.
  2. His body shape is working against him. Simon is rather tall, which raises his center of gravity. He is lean, which also makes him less grounded. He had an ill-timed growth spurt just as he was getting mobile. And he has a large head, which throws off his balance completely. You could call these combined features a biomechanical storm of delay.
  3. Genetics are working against him. I was a butt-scooter and a late walker. Matt was always a bit uncoordinated (yes, more than me). Since butt-scooting delays bilaterial coordination and he wasn’t destined to be super-coordinated to begin with, he got hit from both sides.

Wrap all these together, and it’s really no wonder that he is delayed. So what do do? I will learn more when I have my IFSP meeting next week and therapy begins. (Thanks for the explanation, Beth! You were right.) Until then, I’ve been given a few tips:

  1. Move objects further apart so he has to get more adventurous in his cruising.
  2. Have him hold on to a stuffed animal or towel that I hold instead of my hands, so he’ll have to power himself more.
  3. Weigh down the push-toy he has so it moves slower on the hard-wood. The more he uses this toy, the better, as it encourages confidence and independence in walking.
  4. When Simon walks holding on to my hands, I should kneel down so his hands are at chest or waist height-not over his head.
  5. We should put him in wheelbarrow position regularly; when he’s strong enough he can then “walk” on his hands and develop better muscle tone.

At times like this, it’s hard not to engage in a bit of Monday morning quarterbacking. Should I have been firmer about tummy time? Should we have intervened earlier? Was I too cavalier or nonchalant about Simon’s delay? Beth mentioned that she would have liked to have tried Simon on a wedge for tummy time (she says bolsters do little good if any), and that she would not have been happy with his level of cruising (nearly non-existent) at fifteen months.

On the other hand, he’s happy, he’s social, he’s smart enough for now, he’s eager to develop, and Beth doesn’t think it will take long to catch him up. I hope she’s right. Simon’s preschool begins mid-August, giving us exactly three and a half months to get him where he needs to be.

Let’s roll!

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