Progress of Neurosuit & CST therapies

It's been some time since I wrote specifically on the progress of his Neurosuit therapy. I'll write on his progress of both the Neurosuit & CST as I feel it's difficult to attribute specific changes to just one or the other of these therapies.


1. Drool
There's definitely been less drooling. There are times in the day that he does not need to wear a bib for e.g. this morning when he's out and about at the shops.


At last week's speech therapy, he did not wear a bib at all but his drool did drip a little. It was just a little, probably requiring 5-8 times of wiping off with a hanky, which is very good.


He will still drool a lot when he's very focused on reading or a fine motor skill that's very challenging.


It was told that the Neurosuit would help him drool less eventually (initally there'll be more drool) & I guess we're seeing the results!


2. Breath & speech
He is voluntarily speaking more. It's not the incessant chatter of a chatterbox preschooler, but I definitely noticed he's initiating more and carrying on conversations. He's able to say things that I had not modelled for him to copy.


Just 4 evenings ago, we were in his room mucking about and his blanket was in his path. Out of the blue, he said this long sentence "Excuse me blanket, I want to go there". He then moved all over the room and when the blanket was in his path again, he said it again "Excuse me blanket, I want to go there".


The Neurosuit does indeed help his breath such that he's able to speak longer phrases/sentences in a single breath and to speak more often.

3. Balance

A definite improvement. Even his speech therapist noticed that he's steadier on his feet. When he's on his balance beam, there were a few occassions (just a few but that's already good) that he did not rely on me to help him balance. It does not happen often but the very few times that it has shows that he is progressing. Also, I noted he was able to bring his legs/feet forward comfortably on the narrow beam, without being so broadbased as before. I still have to hold his hand as he's not gained enough confidence yet to try the balance beam on his own.

4. Flexibility

He his less tight (spastic). He is able to move more like a 'normal' kid. It's still slow though but I think that'll improve with more practice and more therapy.

For e.g. he will now try to dance or follow the movements on Mickey's Clubhouse or Dora when they ask him to. We can also passively move his arms much easier. In the past, if we were to try to move his arms, he'd immediately retract them back or it'd be very difficult as it'd be very tight.

These are the areas we need to continue working:

1. Oral Motor

This is not addressed by the NeuroSuit. We're currently getting him to suck on the crazy straw & fat straw (the bubble tea straw) daily. He still bites down on the bubble tea straw but the bites are less hard. We occasionally have him suck from the tiny straw when I do buy Yakult for him.

He also has a wide variety of blowing objects. Different types of whistles, kazoos, feathers, toy flute etc. It's still very hard for him to get a sound out.

He plays with bubbles often. He again has a variety of different bubble wands to blow through, bubble pipes etc.

I try to stimulate the inner cheeks using the electric toothbrush. This is hard to do cos he resists having his teeth brushed in the first place.

2. Retained reflex of the arm

His CST therapist explained that his "bat wings" (arms) come up when he runs because it is a retained reflex of an infant which he has not lost. The reflex pattern movement to be done prior to putting on the suit is meant to address that. I did not know that.

I knew we were supposed to do it, together with the joint compression and massaging, prior to putting on the suit. But I didn't know that the reflex pattern movement was supposed to resolve the "bat wing" problem.

In the first place, it's already hard to suit him up. We've to do it really fast, while he's distracted in front of the TV. He dislikes the suit as it's uncomfortable (a lot of resistance training from the bungee cords & a lot of proprioceptive input from the tightness of the pieces & it's warm/hot especially in our climate).

I've to do what I've to do to help him. So we will incorporate the reflex pattern movement prior to suiting him up. Before that though, I'll need to get a working copy of the VCD showing how it's done. Both of ours get stuck half way through.

Playdough

Having spent the entire morning at the hospital today, there wasn't that much time left for other activities after his lunch, nap, snack time, toilet training etc.


Brought out the playdough as we havent played with that for a while & I needed to work towards improving his pre-writing skills. In the past, he would not play with playdough. Based on recipes from internet, I made some in the past but he didnt like them. Too sticky or too oily. He hated the bits that stuck to his hands. He couldn't manipulate it like his peers. Showed him what he could do & make with it, but that would have only caught his attention for a very short while.

Earlier this year, bought some commercially sold ones at Jusco (half price). Smells yummy & came with a few moulds. Doesn't stick to the hands. Not too oily. Thankfully, he begun to take an interest to it. Slowly. Later, bought other colours from Tesco which are cheaper. I got some different coloured Play-Doh brand ones which were offer. All of them state "non-toxic" but who knows.


Started off by asking him what object he'd want made. To gain his interest, I suggested police car, ambulance, fire engine...not that I know how to make them! He wanted helicopter. And he wanted it "flat like a pancake" (as opposed to 3 dimensional) - it's one of his current favourite sayings!


I let him choose the colour. Restricted the choice to just 2 colours otherwise based on past experience, he'll merely want to remove the wrapper from all the coloured playdoughs. This time, he wanted both pink & orange. So much for "or".


He's not at the stage to be able to create his own models. He's not even at the stage of being able to roll it into a sausage shape or ball. So, I place my hands over his & show him how. At least he now allows me to do that. In the past, he'd pull his hands away & I'd show him how using my own hands.

Fine Motor

This activity is good for developing his fine motor. It works those hand muscles. Important for a lot of daily life skills like writing. So we rolled it into a ball, flattened it (body of helicopter). Rolled into a sausage & curled it (tail of helicopter). Pinched it, rolled it into smaller cylinderical shapes for the rotor blades.


He's still not good at pinching larger pieces. He pinches tiny pieces smaller than the size of his little fingernail. When flattening it, instead of using the palm, he still uses the fingers part of the hand. Slowly. Just need more practice.

Drawing/poking

I wanted to take this activity further by getting him to "draw" the pilot using a toothpick. He decided to poke his finger into it. I had in the past showed him how to poke. But instead of using the finger pad part of his finger, he uses his fingernail to dig into it. That's just like the way he controls the cursor on the touchpad of my laptop (it's like scratching). Will need to work on that (I think it impacts the way he holds the pen).


Photo shows what it looks like with the digging marks & that's him starting to poke with the toothpick.

I took the activity further by flipping the piece over for a smooth surface & showed him I could write the alphabets using the toothpick. He was not keen to try it. I wasn't going to force him if he's not ready. So I let him take the lead. Worked the dough into a smooth surface again & let him play.

Inscribing a face

He "drew" a smiley face. The eyes aren't aligned horizontally & nose wrong positioning cos he still has a problem controlling his hand muscles. He tends to jab at it from a distance rather than slowly approach it to ensure correct placement. Same technique when using marker pen on whiteboard.

The 2 eyes & nose are those 3 dots placed close together in the middle of the dough. The 2 lines at the top are the eyebrows. The ears are those lines on the left (horizontal line) & right (not so clear in the photo). The 2 dots nearer his toothpick - one's the chin, the other I dont know cos I didnt understand what he was trying to say.

Oral Motor (Blowing candles)

Decided to take it further again. This time, as an oral motor activity. Got this idea from speech therapy, but modified, and from a manual on oral motor exercises. He wasn't keen on blowing the paper butterflies on a stand, so had to think of new activity to achieve the same objective.

Started off with just one candle on a "birthday cake". Lighted it & sang a bit of "happy birthday" song. My objective is for him to blow. I remembered that he couldnt blow the candles of papa's birthday cake in June. Therefore, I was surprised that he blew it off in just a single blow!

Challenged him more. Got another candle. Lighted both. He blew the 1st easily. Couldn't blow off the 2nd. He was repeatedly taking shallow breaths, so it wasn't strong enough to put it out. Had to tell him to stop giving small blows & take deep breath & blow hard. He succeed. Yeay!

Repeated it by upping the challenge to 3 candles. Same problem with shallow breaths after the 1st. But succeeded easily after reminding him to take a big breath in. I'm happy enough. Next time, will challenge him by increasing the distance between him & candles. I can also increase the number of lit candles & see how many he can put out in a single breath.

Sunday, 19 July 09

Morning exercise at neighbourhood park

Gross motor
15 mins only this morning at the neighbourhood park. Parked at bottom of row of houses which are on a slope - we walked up & back down. That housing area was designed differently - the inclination of the slope alternates...it is a bit of a short steep walk up a slope up then flatten out at the next 2 houses, then the slope again etc. So he gets the "steep bit" to stretch his achilles, gastroc muscles etc.

Speech
He'd name all the brands of cars parked outside the houses e.g. Honda, Alfa Romeo, Toyota, Ford, BMW. Noted his pronounciation of "B" is better (when he says "BMW"). It used to sound like "bern". Now its "bee". Hooray! I use whatever interests him as opportunities for therapy activities, so he's been naming cars for a long time now.

Maths
In future, I can introduce him to counting 2 by 2. Since the houses on one side are even numbered & the other odd, I'll use this opportunity to further his maths (addition).

Garden
- He picked up dried leaves from the grass (bend down, squat, fine motor, hand eye)
- He also plucked all the tiny red flowers from one of the plants (fine motor, hand eye, both hands)
- He ran along the drain cover (visual) which he likes cos it makes a loud sound

Oral Motor
He can now suck up his Yakult using a normal sized bendy straw which has been cut in half, with the straw maintaining it's shape. Straw was placed past his teeth but he didnt bite down on it hard. Only faint teeth mark was visible on the straw. Hooray! We see progress resulting from activities using the various sized & shaped straws!

Kitten
He did quite a bit of squatting & "squat to stand" at the restaurant tonight because he was playing with a kitten.

Ball play
Why?
I wanted him to stretch up high.

How?
- Balls & a basketball hoop. The hoop was given 2nd hand from a friend (easily found in hypermarkets, Jusco). Very useful as it's adjustable as he grows taller - it has suction caps. Actually, it was more like he dropped them through the hoop rather than throw, but it's ok cos he did stretch. But he did only a few balls, so did a variation....

We went upstairs & he dropped the balls over the banister (banister high enough to still require stretching). He wised up after just a few throws & rolled them down instead. So changed the game again...

Helper & I held up an old towel & got him to throw over. Perhaps this was something new so he did quite a few throws. Actual throwing, good strong throws (not dropping), which is good.

Drool

Less drooling towards the end of the week. Perhaps due to more oral motor work?

Crazy straw:
I know there's a hierarchy but the helper just started off with what seemed easier. If straw is positioned with slight incline (instead of perfectly vertical), then he's able to suck it up. But we're happy enough as it's a start. In the past, the tip of the straw would be in his mouth (ie past his teeth) but now, it's placed before his teeth so he has to exercise the muscles nearer the lips.

Hard to find it in shops here. Party shop in Ikea had only 1 type but too expensive for me (RM20+ for 1 piece, I think). My UK friend got me these, from Amazon.co.uk.

Note: I use it only with plain water. It's hard to clean as there are twists & bits of food get stuck there easily.

Butterflies on paper stand:
Better today. Increased distance to about 15cm. Couldnt blow them down initially. Had to ask him to take deep breath & give one long blow, then butterflies fell.

Electric toothbrush:
He still hates having his teeth brushed. Need distraction. Sometimes can't stimulate the inside his cheeks with the electric toothbrush. It's a cheap Tesco own-brand electric toothbrush.

Bubble tea straw:
It's cut in half to shorten it (less strength needed) to start off with. We get him to blow through it/suck in various activities. E.g. blowing off loose bit of cotton at opposite end; aim & blow a tiny rolled up piece of cotton ball that's on a "race track". The cut out cardboard in the photo is his "race track". He chose & stuck those stickers - allows him to feel good that he helped decorate it Stickers also help give a "target" for him to aim to- e.g. can you tickle "superman" by blowing your cotton ball to him.