Early Intervention is a program that most states have some variation of. Basically, it is a state funded program (thank you, tax payers!) that offers health, educational and therapy services to meet the needs of infants and toddlers, from birth through age three, who have developmental delays and/or disabilities.
Although Andrew is almost nine months old now (six months adjusted), he is developmentally at a one-month-old level. Andrew was evaluated and currently qualifies for twice-a-week sessions of physical therapy, occupational therapy (just started last week), and speech/feeding therapy (haven’t started this last one yet). Eventually, we will probably add some kind of hearing therapy, as soon as Andrew is fitted for his hearing aids (funded by Early Intervention as well, but taking a REALLY LONG TIME for the paperwork to process…). So, Andrew is a busy baby. Thankfully, all of the therapy sessions are in-home and the therapists come to us. At each session, the therapist teaches us what to do and how to do it. And then it’s our responsibility to make sure those exercises are ongoing on a daily basis.
For now, we have been focusing mostly on the following goals in therapy: head control and range-of-motion exercises and stretches.
Andrew has abnormal muscle tone. His arms and legs are sometimes extremely loose; other times, extremely tight. So we make sure to move and stretch his arms, legs, fingers, torso, and head really well so that his muscles are nice and loose. If they get too tight, Andrew’s limbs and joints would lose the fullest range of motion and could develop painful contractures. For example, if we go too long without stretching his arms, it’s sometimes really hard to lift Andrew’s arms above his head. There is much resistance and, sometimes, cries of pain. Why does this happen? In really simple terms, the pathways from Andrew’s brain to his muscles have been disrupted. The healthy brain, to avoid injury, would know to tell the arm muscles to relax if someone were to lift the arm up quickly. In an injured brain, however, that message doesn’t always get conveyed. So instead of ever relaxing, the arm muscles might be in a constant state of flexion, causing it to become tighter, tighter and tighter (this is also known as spasticity). Thus, stretching is very, very important.
Head control is the other big one we work on with Andrew. Andrew has very poor head control and pretty much zero trunk strength. Parents might wonder why pediatricians and other experts advise parents to do plenty of tummy time with their babies. Well, here’s why: head control is the key to proper physical development. Development in a baby starts at the head and ends at the feet. With the establishment of good head control while on the tummy, a baby learns to observe the world around him while strengthening the neck and shoulder muscles. This, in turn, strengthens the trunk muscles. If a baby has good head and trunk support, he will eventually learn to sit. And we all know the benefits of sitting and having one’s arms freed up to explore. And if a baby has the proper head control, trunk strength, and ability to sit… there is an excellent chance that he will eventually walk. It all starts with the head. Truthfully, though, even if a parent chose not to do designated tummy time, their baby would probably grow up to walk just fine. But for babies like Andrew, it is especially important.
Here are some old pictures from back in November of Andrew in therapy action. Andrew cries a lot so we’re often limited in what we can do with him in any particular session. But this particular session was especially productive and Andrew was able to get into many different positions and stretches.