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

Update..since forever!

Wow, I can't believe how long it's been since I've updated. But now we finally have internet in our apartment, so it will be easier for me to update...sorta. Seeing how I can only be on from midnight to noon, I'll be staying up late or getting up early to update. If I get on at any other time we have a limit, and I think blog surfing will use up that limit QUICKLY!! Ok, bullet point update this time since it's been so long and there's so many updates to do!!

• Grace goes to therapy on Wednesday for three hours each week!!! This is an awesome therapy. PT, OT and then speech. I love these people and it's only been two weeks!
• We finally got referrals sent to Primary Childrens hospital in Utah and are receiving phone calls to set up appointments...sad part is they are three months off so far, but good news is that they are specialists, and they are paid for through Grace's insurance!!
• Grace (TODAY) learned how to sign AND say thank you!!! WOW!! That's wonderful girly!!
• Grace is still not walking any better, or any more than she has been, but she has been choosing to walk a tiny bit more rather than crawl everywhere. So if she's standing at the couch or the recliner, she sometimes chooses to walk, but it won't be for long periods of time! Usually just to a leg, or to something else, or else she drops after about 10 steps.
• Grace was accepted by Shriner's hospital in Utah, so any wheelchairs, strollers, walkers, braces, or anything else will be paid for through insurance and them!!! WOW!! She will most likely need braces for her feet/legs, and a bigger stroller that will be more fitting for her, but less bulky.
• We still haven't heard anything about the house. What do you expect with a short sale?
• Grace is sick again. From yeast infection to diaper rash to ear infection and now a cold. That's what we get for letting her play on the four wheeler in Montana after the sun sets. Darnit!
• I start school in January!! I've already started one course online, and will start three more once I get my school ID (as you can see, I am speaking as though I got accepted)
• I've learned a few more bread recipes, which have all turned out great!! We are still eating food storage, so we will have to experiment with recipes as the same ol' are getting old!

I think that's it for now. Of course, I can't think of anything else. It's late...that's why! OH! Grace can count to three. Not that she's counting things in particular, but she can say, "One, t-ooo, weee!" Cutie!!

Amanda

Grace's Birthday Celebration!!!

Well, she's finally two. And holy cow, she had about 28 people at her birthday party!! What a way to celebrate, huh? She absolutely LOVED it!
Sadly, I forgot the new piping bag and decoration tips for her cake at home, so I had to do this writing with a sandwich bag...blah. But I guess it has to do. Next year, I'll definitely outdo myself to make up for this one!!
Grace was SO excited and confused as to what was going on when we sang to her! She just didn't understand why everyone was singing the same thing at the same time!!

Look how little she looks!!! My big girl is 2 now!!
The rocking chair that Grandpa Hildreth made for her. Isn't it beautiful? And she's the first grandchild to receive a homemade chair like this too!

Grace trying to eat off her plate without using her hands...but she just couldn't do it!!

What a good girl eating her cake so nicely...it didn't last long though!!!
And afterwards...what a sugar rush huh?!
One side of the group that was there for her birthday...
And the second side of the group :) I LOVED having so many people there for her!!

All in all, a great birthday celebration. And holy cow I can't believe she's already 2. Sixteen more years and she's gonna be an adult...I hope that goes by slowly!!

Amanda

Grace's PT today

Grace had physical therapy today with her new therapist Ms. Lisa, and I'd say it went pretty well!!

Here's what she accomplished today:

1. Walking with a walker
2. Turning her walker (front wheels are free moving, not locked)
3. Kicking a ball while standing
   
4. Kicking a ball while standing with her walker
5. Bending down to pick up a ball in her walker
6. Bending down to get a ball with Moms help
7. Rolling a ball
8. Throwing a ball
9. Carrying one bowling pin while walking
10. Carrying one bowling pin IN EACH HAND while walking
11. Carrying a ball WITH BOTH HANDS while walking!

Lots accomplished in one day, eh?

And now for some pictures!!

Grace is working on "putting in." She knows how to do it already, but that's into a box, rather than into a small spot such as this! Those are the bowling pins she carried!
Reaching HIGH TO THE SKY!! This stretches her back, and makes her straighten her back as well!
And Daddy was the photographer with this picture!! Caught her in the act walking!

Amanda

Grace's video of her Walking!

She still can't walk completely, but she does these amazing long walks which just impress us to no amount!!! Just watch, and be SURPRISED!!!



And then below is her getting into her high chair with a little help. If I would have put it all the way down, she could have done it on her own!

And then the last one is her walking again. Of course, I had a darn water bottle in her way, otherwise she'd have walked the whole way!! And then when she actually gets going good, she end up in the dark hallway!! But you get the idea! Way to go Grace!!!

Amanda

Grace's MESS!!

8-22-11

Well, Grace has learned how to open ziploc bags...not good!! Of course, it would be good if we were there, watching and helping her...so this didn't happen!!

All the pretzels everywhere...but at least she was able to get herself a snack instead of having to wait on us!!

Amanda

Visiting the Head of Warm River in Idaho

9-1-11

This was a fun trip :) It was pretty warm, but we took care of that by playing in the water!!

Grace and Mommy. I know I look goofy but the sun as SO bright!! I LOVE this smile, and hairstyle and everything about Grace!!

Daddy and Grace climbing up the spring of Warm River!
Shew, it was definitely not warm, but Grace didn't care!!

This is what it looked like away from the spring...beautiful!
Brad went up to refill our water bottle with fresh CLEAN spring water. It was SO GOOD!
Daddy and Grace playing in the water. Mommy didn't get in...it was too cold!

And one more goofy face before we say goodbye!!

Amanda

Grace in Beautiful Montana!

July 1-5th, 2011
Grace LOVES flowers, and so what better than to put her in the middle of a bunch of them!!
Here's Grace in the middle of some beautiful flowers :) I LOVE IT!!
She was so delicate with the plants, and I was just so excited to see her spend her time slowly.

And then in a bunch of dandelions :) I love her smile here...such peace within that smile!
And then comes the VROOM VROOM!! Yes, that's really what she says as she points towards the door. She wants to GO!!
And of course, when we're on vacation, we have to be sure she gets to help drive the tractor!!! She was SO impressed with the huge wheels!
Daddy and Grace driving the tractor with a beautiful Montana background!
I think this picture is absolutely priceless!! I LOVE HER SMILE!!
Just an every day girl doin' her chores with Daddy taggin' along!

Just a wonderful trip once again to visit family in Montana!

Amanda