Grace's Physical Therapy Evaluation

Observations/behavior:
She did not seem to process/follow any specific motor commands except for to "walk". Overall muscle tone appears to be decreased with normal to hyper-flexibility of peripheral joints and appears to have some milk L thoracolumbar scoliosis.

Most of his evaluation is in PT talk so I REALLY can't understand it, but I'll write the jest of what it's saying...

Recommendations:
Recommend skilled PT intervention to address deficits in strength, balance and gross motor function.

This is also certified as a chronic condition needing 6 months or more of skilled therapeutic intervention.

Amanda

Grace's Speech Therapy Evaluation

09/21/2011

We had Grace evaluated at Camp Hippo, which is where she goes on Wednesdays from 8-11 for PT, OT, and speech therapy. This evaluation is from her speech therapist, Michelle.

Language:
Auditory Comprehension has an age-equivalency of 8 months.
Expressive Communication has an age-equivalency of 1 year 1 month.
Total Language Score resulted in an age-equivalency of 10 months.

Grace could:

• shake/bang objects in play
• actively search for source of sound when source is not visible
• look at objects or people the caregiver calls attention to
• understand a specific word or phrase for family members, pets, objects or social routines
• use more than one object in play
• demonstrate appropriate use of objects in play such as a ball, and identify body parts on self.

Grace could not:

• complete age appropriate tasks such as anticipate what will happen next
• respond to no-no
• follow routines or familiar directions with cues
• identify familiar objects from a group of objects
• understand inhibitory words
• understand verbs in context
• understand spatial concepts
• understand pronouns such as me, my, and your.

Expressively, Grace was able to:

• babble two syllables
• demonstrate a vocabulary of at least one word
• extend toys or point to objects to show others
• use 5-10 words.

Grace was not observed to:

• produce a variety of consonant sounds
• initiate a turn-taking game or social routine
• imitate words
• produce different types of consonant-vowel combination
  
• babble short syllable strings with inflection similar to adult speech
• name objects in photographs
• use more words than gestures to communicate
• ask questions.

Oral motor:

• demonstrated decreased lingual and labial tone, causing drooling, inefficient feeding skills, and decreased speech intelligibility.
• does not have appropriate labial seal, causing difficulty drinking from a straw and loss of food from the mouth during chewing and swallowing.
  
• Due to decreased lingual tone and strength, Grace has difficulty forming a cohesive bolus, causing residue to be left in oral cavity.
  
• Difficulty moving food from side to side of mouth
• Munches food with front teeth rather than molars.
• Decreased feeding efficiency and speech intelligibility.
  

Pragmatics:
During a structured activity with her peers, Grace was observed to require maximal physical and verbal cues to refrain from over-engaging peers, turn-taking, and initiating/maintaining eye contact with peers. Services would be most appropriate in a natural environment where peer-to-peer opportunities are provided. Grace's pragmatic skills are not within normal limits and are a concern at this time.

Recommendations:
Results indicate an auditory comprehension/receptive delay of 1 year 4 months, and an expressive language delay of 1 year. Based on results Grace should participate in speech therapy once weekly for 60 minutes...

This is certified as a chronic condition that necessitates 6 months or more of skilled therapeutic intervention.

Shew...that's it for speech. Basically, she should have been getting speech that whole time in CA.

Amanda

Grace Talking, walking, and MORE!

Grace is doing so much better at walking! The picture below shows her climbing the stairs by herself! Yep, I said it!! She can do side stepping climbing on the stairs. My baby girl isn't a baby anymore!! And we are still patching, which is why her eye is covered.

Below is Grace at the park. It's a special needs park, so that's pretty sweet! Her dad helped her get onto the hippo of course.

And I just love getting pictures in motion of little Grace!!! Isn't this awesome?!!
And I absolutely LOVE this face picture of her while she's walking!!! Mouth open, arms balancing her. Just adorable!
And we are experiencing the feelings of fall. I loved the smell of the drying leaves, and she had a blast kicking them!!
That's so sad that I can't upload these videos either. I guess they're too big, and so they never load, it just keeps sitting there. Dangit. But at least we have the pictures. I haven't taken any pictures of her at her three hour therapy session yet, mainly because I forget to take the camera! But I'm really hoping I'll remember this week. I'd love to show off what she does!!
Here's Grace trying on a super cute hat from Bear World!! I just LOVE IT!!
And our first snow of the season. It came and went in a matter of a couple days. It was SO fun, but Grace HATES the snow, so now we have something to work on with OT.
And this is just a super cute picture of Grace having snack!! The milk...it's soymilk. We've found out once and for all that she is DEFINITELY allergic to cows milk. She gets a bazillion spots all over her body that itch like crazy, and she gets HORRIBLE diaper rash. Poor thing. You'd think with all the milk I drank while pregnant, she would have come out with spots like a cow!

Oh well, such is life.

I love you Grace!!

Amanda

My Walking and Talking Girl!!

10/13
Once again, Grace amazes me with her walking and talking. With just one 1 hour session with her in home physical therapist, Grace now knows how to get up to standing from sitting, by herself, without support!! WOW! We now have a fully mobile daughter!! Does she still choose to crawl. Yeah. But does she get up when we ask her too? Heck yeah!! Woo Whoo! You're doing great Grace. Once again, pictures and videos are the only thing that can do justice, but alas, the internet connection is too slow in our apartment...so we'll have to wait till I can get to the library, which might be Saturday at the earliest.

Amanda

Bear World

Sept 8, 2011

We went to Bear World and had a blast! Grace loved all the animals, and her sissy got to feed baby bears, so I pretty much think it was a great trip! I'll let the enormous array of pictures do the talking!

Grace enjoyed trying on the different hats with Daddy, and I enjoyed snapping the pictures!!!
Grace got to ride a bear!!! No, I'm just kidding. She looks scared, doesn't she? Yeah, she kinda was, but one I showed her how soft the FAKE bear was, she was happy.
Watching the baby bears play when we first got there. They were so cute!
Grace really liked this white elk, but as you can see, it wasn't very fond of us. It walked right down the middle of the water the entire time so we just couldn't really reach!
Oh the pig...do you see how I'm doing hand over hand with Grace? Yeah, the pig scared her!! But I didn't want her to not try, so once I helped her, she had a new problem...she didn't like how it felt!
This deer was so sweet to Grace, until of course it figured out we didn't have any food. And then it took off from us so fast to go find the next hand that might have some food!
Grace loved this baby deer! She really wanted to stick her hand through to pet it and let it lick her, but we didn't let her since they wanted the baby to stop licking everyone!
By this point Grace was VERY tired. She'd not had a nap at all, and this is in the afternoon when we were visiting the baby bears!
There was a scavenger hunt, like an easter egg hunt, and among other little treats, Grace found 2 PUMPKINS! They had treats inside, and she won a small bear, which is on the counter, and 1/4 lb of fudge! Good job Grace!!!

All in all, a wonderful day. I loved watching Grace's face as she saw all the animals, and it totally made it worth it. She also went on a roller coaster.

She was REALLY not sure about the roller coaster. She pretty much white knuckled it the whole way, but she was a trooper!

Amanda

Snow Day!!

10/6
Well, I can't believe I can say we had a snow day!! Grace's first snow day EVER! I mean, she's gone to the snow to play, but we've never lived in it. So of course I was so happy for Grace to have her first snow day ever!!! And she was so excited as well!! Of course I loved seeing her all bundled up in her jacket, thermals, and all the other get up! But it didn't last long. 2 days or so and it melted away to sunny days once again. But it will be back :)

Pictures later.

Amanda

Here we Are

Well, obviously I've been WAY too busy to update about Grace. Life gets hectic and when there actually is time to post, it's way past midnight and time to go to bed so I can do it all over again.

Yesterday we went to Bear World. It's absolutely PACKED with bears, wolves, deer, elk, and all sorts of other animals.

Hm...Grace is done eating, and even if she wasn't, there's a TON of updates to do, and a double TON of pictures to put up. So I'll have to wait till some day in the future when Brad watches Grace for a few hours so I can just do this and not worry about her.

Amanda