Home Based CIMT

Follow Our Experience in Home Based Constraint Induced Movement Therapy

Day 12: …and it’s a Wrap

Woot!  Woot!  Owen rocked it out for 12 days and completely blew us all away!!  We went into the planning and implementation with more thought and focus geared to the OT perspective and he has been just working EVERYTHING!  🙂

Today was the last day of our first intensive session of CIMT.  I think we were both a little giddy about that this morning.  He quickly acclimated to the constraint this morning.  We started out with more gross motor activities to get those endorphins kicked in for our fun day ahead that consisted of dancing, tunnel play and getting that ball out and rolling about.

We invited the bean bag frogs in on the game and then surprisingly he wanted to go back and forth between our puzzles.  He has never really initiated this activity, it has been more of me asking for his assistance but we just went with it!

He wanted to play with the iPad with more thought to the transportation sounds and pointing them out and then using his toy cars to show what items they were, very cool connections going on.

We stacked blocks and played with the bristle blocks, putting them in containers and tossing them around.

We got geared up to go visit Miss Suzy the OT in outpatient clinic for our LAST session during this segment.  He did great but definitely had a lot of energy and a little hard to get some of the videos but I was so thrilled with how much fun he was having.

We tried to revisit some of the earlier activities prior to CIMT or during the 2nd day of therapy.  I could definitely tell that his change of motion, precision and speed were all enhanced.  However, there was also a big difference when he had his neoprene hand splint on, definitely advancement all around but the hand splint definitely helps in those pincer grasps.

Our last activity was putting cubes in the cup without wearing the hand splint and before doing so we told him that we would remove his constraint after he was finished, so he RUSHED over and got it done!  So fast!!!

Title Description Link
CIMT – (Day 12) Putting cubes in cup Grasping and putting in cup http://youtu.be/707xrXjN1Sg 
CIMT – (Day 12) Putting Pegs in Board Picking up and rotating pegs to put in board http://youtu.be/VzGJoaP4pc4 
CIMT – (Day 12) Playing with Bean Bag Animals Displaying various wrist rotations and increased strength http://youtu.be/e9css_TL4QM
CIMT – (Day 12) Pincer Grasp of Small Item Great pincer grasp for tiny object (Kix Cereal) http://youtu.be/P_n9PwsR2l8
CIMT – (Day 12) Revisiting Mr. Potato Head More precise grasp http://youtu.be/BlWXSRC-f-U
CIMT – (Day 12) Putting Cubes in Cup without wearing hand splint Checking the difference in movement without wearing the hand splint http://youtu.be/E7hKfLSfqbE 

Overall we are so beyond thrilled and will keep a maintenance schedule with various CIMT session in the future.

Thank you all so much for ALL your support!!!  We are blessed to be surrounded so richly with many wonderful, supportive people who just LOVE our Owen so much!  From your messages, calls, donations of equipment/supplies to tips in fun food options and ideas in therapy, we cannot thank you enough.  We have felt your prayers and appreciate you all so much for cheering our little guy on!!

Favorite Activities:

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Day 11: Lots of Connections Made Today

My early bird was up and wanting assistance in gathering all his cars up for the big move into the living room.  He adamantly said No to having the constraint put on this morning.  I told him I understood his frustration and we were working on helping Righty be stronger.  After a bit, he let me put it on and he actually ate his Cliff bar without any assistance except to give it a scoot when he got to the bottom.  Then we worked with the iPad and transitioned over to the blocks.  We spent A LOT of time today working on blocks!!  

We had out patient Physical Therapy this morning with Miss Jill the PT and I have to exclaim again how amazing he is doing!!  The best two PT sessions he has experienced happened last Thursday and today!  Miss Jill has such a wonderful balance of being firm with him, giving him great direction, having FUN and talking TO him. He was in good spirits the whole time!  He wanted to first go up and down stairs, his coordination even appears better.  He tackled uneven surfaces without any hesitation, he even went on a balance beam today for the first time.  Granted, he was assisted the entire time, but he took direction great and his focus was amazing.  Of course, he wanted to throw balls and chase after them in between activities too.  He went up to the rock climbing wall and outstretched his arm to grasp a rock and all without hesitation.

One of his goals is to learn how to ride a tricycle, really engaging his core muscles and the right side of his body.  Up until last week, he rebelled mostly when it came time to ride.  He may initially be curious but would quickly lose interest.  However, last week and today, he just kept getting more and more focussed.  Last week, I would have to run ahead and duck into rooms to have him chase me and I’d pop out at him but today that wasn’t needed, you could see his determination.   I could almost SEE the connections being made.  He was so into making sure his right hand was on the handle, left hand resting in the middle and keeping both feet on the pedals.  Miss Jill was beside him on the stool to push him along as needed and to make sure his posture and form was correct.  She did an amazing job!  He even wanted to go around TWICE!!! 

We left and came home for a snack and then I tried to get him to use a mixing bowl and spoon to stir a mixture of confectionary sugar and milk.  He was curious but it was not a success.  He just was not that interested in mixing.  I grabbed some food coloring and he enjoyed squeezing them into the mixture but he wanted me to mix it! 

I reloaded on our supply of FLUBBER so we now have three colors and I think I may have more fun with it than he does.  One came with an insect in it, it freaked him out and he wouldn’t touch it at first but after he saw me grab it, he was fine with squeezing it.  We wrapped his cars in and his bristle blocks (not recommended) and just pulled and squeezed a lot. 

We did more puzzle play and then we got back on the blocks!  Stacking and knocking over!!

We took the constraint off for 2 handed play and I was once again so moved!  He’s so smart!  I had the blocks laying out, the strings that came with them and of course, I have the pipe cleaners out!  Well, he was having trouble navigating the blocks onto the string so he grabbed the pipe cleaner and was stringing it through the beads.  That is AMAZING!!!  However, beforehand, it looked more like Lefty was assisting Righty with the string.  Lefty had the grasp on the string and he was taking his time and using the pointer finger on Righty to pull the string up.

Title Description  Link
CIMT – (Day 11) Threading Pipe Cleaner Through Blocks  2 handed action of threading pipe cleaner through blocks http://youtu.be/WQMtVjLqAXI

Today was such a success and I know I said it last week but I’m just so amazed at the advancements he is making EVERYWHERE!  It is not just new movement patterns, strength and awareness of Righty but it is awareness of his RIGHT SIDE!    It is problem solving skills and increased determination, I’m just really impressed and in awe of this little guy.

Favorite Activities:

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Day 10: Balls, Balloons and Trucks On the Wall!!!

**Quick update from last night, I caught Owen re-threading his straw through the paper heart with both hands! (Look at that expression of determination!!)**

Wednesday.

Owen has officially completed 10 straight days of therapy with ONLY 2 more to go!! I really believe the FUN day we had yesterday gave us a new perspective to get us through the last few days. He woke up early this morning and so we started therapy, he did not love having the constraint put on but he was picking up things and engaging in unprompted activity ONLY after 10 minutes of having it on!!! (When I use ONLY after 10 minutes, he is a tough little guy and that is not being diminished just noting that he is becoming more accustomed to the morning routine.)

We played with the iPad and then on to a puzzle. I would open the doors to the puzzle and he would go through and shut all the doors. We would rotate having it flat on the floor and me holding it up to provide some more rotation in his wrist. Then we stacked blocks and knocked them over.

Then Miss Tara the OT arrived bringing along Mr. Potato Head!!! Owen was SO happy to have Miss Tara visiting this morning!! He had a lot of fun giving Mr. Potato Head various body parts and expressions, he provided tons of resistance too!! He is really impressing us all with his more precise grasp of objects and turning that wrist without being prompted to do so.

He then had a snack of cheese sticks, holding them very well and then he was off to chase balls! Tossing, rolling and throwing in the air, down the hall, across the room, did not matter. He was so giddy.

After Miss Tara left, we continued the ball play for awhile. We kept emptying the bristle blocks and putting them back in the bucket. When he tired of that, I asked him to bring me his cars and trucks for me to attach to the wall for him to then pull off. Well today, he provided a challenge for me (Mr. Smarty Pants!) by bringing me his BIG trucks to attach to the wall!! I had to tie them up with crepe paper and then tape them up. That was fun!! We then just got really wound up and he pulled them all down!!! We kept doing this for a while. He was REALLY into the repetitive play today, I was very thankful!!!

Title Description Link
CIMT – (Day 10) Pulling Cars Off Wall Hand precision is progressively getting better! http://youtu.be/wVRYHmatppw

I then blew up a bunch of balloons, different sizes, none over a 2.5 inch diameter so that he could grasp. I would scatter them on the floor and he would pick them up. Some with an overall grasp and the others with a pincer grasp on the balloon lip. Very Cool!!! He would put them into the bucket and I would empty the bucket over his head!!! We continued this FOREVER!!!

Then we put some puzzles together, I would have to ask for help but he would do it!! Broke out the tunnel and he would go in to get the jacks and cars out to get some weight bearing activity in the mix. We rounded it out by snapping the jacks together either for him to chop apart or pull apart.

We finished up with some pincer grasps on fruit snacks. He is definitely getting the shaping down but needed some assistance.

Removed his cast and boy-oh-boy, he is just doing an outstanding job with 2 handed play!!! I am SO proud of him!! He is truly my greatest accomplishment, I have never had anyone teach me so much and make learning and life so fun!!

GREAT DAY!!!!!!

Favorite Activities (lots today):

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Day 9: Happy Valentine’s Day!!!

Happy Valentine’s Day!!  We made a DAY of it!! Owen woke up a bit earlier than normal so we just jumped to action and he was bummed about the constraint.  I was determined for him to have fun today today (even with the constraint on)!!!  He fought me in putting it on and wiggled his arm around but finally we were settled in.  He was still not as interested in some of the activities from the start. I had a Valentine board with cars tied off with crepe paper dangling so that he could swing them and pull them off to put into his bag (which has a velcro lip for him to have some resistance when opening).  He seemed to enjoy it.  We played with the iPad and he did well with ‘PeekaBoo Barn’ in hitting where needed to trigger the desired outcome.

We tossed around the tissue paper and played tug of war with the crepe paper.

We went to see Miss Suzy the OT and that is always so much fun!!!  She delighted him with a Valentine!!!  He played with the peg board and did very well pulling the pegs out and stacking them on one another.  He also did a great job taking velcro pictures and placing them on the cloth picture along with pulling them off which gave him some resistance.   He was doing very well with the repetitive play.  She did offer a challenging puzzle with the little knobs and he was determined to try his best.  He would pick up pieces but not with his pincer grasp on the tiny knob (although he did try at first), he would angle it to pick it up and then move it into place.

We moved over to the mats and he opened his fingers up to grasp a ball that was a little too big for him but he still navigated a few of them.  Then he moved on to Noah’s Ark, he picked up the animal blocks to put in the Ark..

Title Description  Link
CIMT – (Day 9) Grasping and Resistance Owen picked up and placed velcro pictures which gave him some resistance http://youtu.be/Py9_JYkpn4s
CIMT – (Day 9) Pulling Pegs Out of Peg Board and Stacking Opening and grasping pegs to pull out of board to then stack onto themselves http://youtu.be/ahEuCtoUfPU
CIMT – (Day 9) Picking up and Placing Blocks into Sorter Grasping wooden animals and placing into the Noah’s ark http://youtu.be/aShgIZQIxTo

Then he only had a mind for BALLS!  He wanted to touch, carry, toss, roll and just show them to everyone around!!!  (Did I mention that he is not shy boy, at all!)

We left and came home and he wanted to continue playing with the balls!  So we threw bean bags at them, juggling balls anything to make them move around and bounce!  I was so thrilled at how much fun he was having!! 

We stopped for a break.  I had cut up bananas for him to pick up and dunk in confectioner sugar (a Valentine treat if he wanted to eat them).  He did really well with those  (I think it was more fun to dunk that to eat) and then we picked the cars up and put them away, played some with the bristle blocks.  Hid a few necklaces in the beans for him to grab but then we just wanted to dance!  🙂

I was satisfied that he had made all his goals for the day so we had our own Valentine dance party!!!  It’s Day 9 and I just wanted him to have fun and why not while he is working so hard?!!

We had lunch of heart shaped turkey sandwiches and hummus with crackers.  He really loves hummus!  It’s a great motivator for shaping!!  After I removed his constraint, he played some more with his cars and trucks.  However, he wanted to PLAY with the constraint today.  He pulled the sleeve out and put it on and then rolled it off.  He then tried to pull the velcro straps on the constraint, it was so cute!

Have a wonderful Valentine’s Day!!

Favorite Activities:

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Day 8: Case of the Mondays

It took Owen longer to pick up an object this morning and he was not interested in any repetitive activities or shaping for THREE hours!  I actually called his OT to ensure I was doing the right thing.  He was not fussy…just not interested.  He would do everything once but not repetitively as he would the days prior. 

Finally, I just grabbed a can of silly string and sprayed him down! That seemed to break the mood.

We tossed pom poms into the air and feathers along with breaking out a fruit loop bracelet that he chomped on.  He needed help as far as shaping his hold but then he got it down pretty fast.

He finally took a solid interest in pulling the jacks apart with me.  We also worked on grabbing bristle blocks and putting them in the bucket.  I pulled out his old slinky and he loved it!  He kept bouncing it and tossing it and then would put it in and out of the bucket.

Title Description  Link
CIMT – (Day 8) Grabbing Slinky and Putting into Bucket Owen Grabbing Slinky and Putting into Bucket http://youtu.be/prkZ1_9ON6o 

The happiest moment for him was when Miss Jen, his Speech Therapist, arrived.  This little boy is socially stimulated and  just needed a new face to play with and who better than Miss Jen!!  She bought along a carrier truck with 2 cars and he was just in heaven.  Talking up a storm and just taking those cars off and on from the first level to the second level of that truck and vice versa.  I was so thrilled!  Not only because he was so happy but because his movements were so much more precise!

Title Description  Link
CIMT – (Day 8) Picking Car Up and Placing It in New Location Taking measured movements to pick up car and placing in desired location

He then played with toy eggs that she had bought along and kept taking the tops off and putting them back on. We then took his constraint off for 2 handed play and he just continues to amaze me.

He picked up the balloon pump and started pumping it, using both hands.  He would take a cracker box from one side of the room to the other with both hands, whereas before he would only use one hand.  He’s just so aware of Righty at this moment.

Overall, when we do this therapy again, I am going to ensure he has a special visitor on a regular basis just to make sure he gets that social stimulation as well as waiting to break out the activities so they stay fresh and new!!

Tomorrow I am UPPING the FUN FACTOR!!! 

Favorite Activities:

Graph of Time Lapsed:

Day 7: Early Start to a Day of Beads

**Before we start today’s update, wanted to note that Owen played with the iPad last night (without the constraint) and he led with RIGHTY for the first FOUR rounds!!!!**

Sunday Morning.

The house awoke at 5am this morning…5 AM!  Little man was geared up and the first thing he wanted to do was play with his cars!!!  After we fished the four out of his bed, we then lined them up with all the others so that he could play.  We had some breakfast and then started his day of therapy.

I put his constraint on him and he did wiggle a bit and protest but as soon as it was on he was fine.  It was about 15 minutes before he picked up a car to show me.  I had tried to engage him in the WALL O’FUN by hijacking some of the cars and taping them to the wall.  However, he only wanted me to knock them off for him.  He seemed to enjoy it because he picked up more cars and bought them over for me to tape up.

I had a stack of tissue paper and just crumpled them up into balls and taped them all over the wall, he really liked the pop of color and texture and was really into pulling them off and tossing them up HIGH into the air.  Quickly, he changed the game to pulling them off and taking them over to Dad to toss HIGH into the air!!!!  He then gathered them all one by one to put into his sand bucket and we did the grand finale of tossing the whole bucket of tissue paper into the air to rain down.

When I had pulled the sand bucket out, I had stored a bunch of purple bead necklaces from a picnic we had set up over the prior summer.  I let him run his fingers through the beads for the sensory aspect and then I hid one string at a time in the container of beans and he would dig in and loop his fingers through the beads to pull out.  I was thrilled that he enjoyed it so much.

Owen had us all wear beads for the day, he would pick them up and hand them over for you to put on or want help in having them put on him.  Eventually, he wanted them back from us and he was the only one allowed to wear them.

We took a break for a snack which consisted of a hotdog that he could feed himself and a long wheat cracker with cheese, he navigated that well but when it started to crumble some he needed some assistance as well as at the end of it to assist in rotating the angle.

He wanted to step outside for a second so I bundled him up for the snow and we went on the porch to wave at the salt truck go up and down the road outside the house.

We then started playing with the iPad, his new favorite app is ‘Peekaboo Barn’, which is a repetitive action of tapping on the bulging barn door and being introduced to a new animal.  I highly recommend it for his age range, especially since the barn is a BIG space for him to navigate his tapping AND the door closes with a tap anywhere on the screen for another round to then start.

From there Dad bought out the water bucket and tossed those jacks in the water and today he was really into reaching into the water (sensory) and pulling them out to then toss back in.  He washed ALL of his cars (last night he found the secret stash, so there were a ton to engage him).  He repeated this activity for awhile.  and then we went back to taping cars to the wall and pulling them off to be put into the bucket of water.

We had lunch that consisted of a star shaped turkey sandwich, cheese stick and a banana smoothie.  He wasn’t really into his lunch but that was probably due more to his snack being more of a meal.

We removed his constraint for 2 handed play and he just amazed us!  He went back to those beads and picked each one up with both hands and opened them up and lifted them overhead to put on ALL BY HIMSELF!!!! This is a repetitive 2 handed action that we did not prompt, he just wanted those beads back on!!  It really moved us.

Title Description  Link
CIMT – (Day 7) Putting Beads on With Both Hands  Great use of both hands to pick up and hold the beads open to then extend both arms overhead to put on himself http://youtu.be/A12_xeWajlI 

I initially thought this morning was a bit slow and he was NOT as into using Righty with the same enthusiasm as the prior days. However, when that constraint came off, he showed us that something somewhere is clicking and he really exhibited HUGE bounds in using Righty and Lefty together at the end of the session.

Favorite Activities:

Graph of Time Lapsed:

Day 6 Evening: Impromptu 2 Handed Snacking!!!! Check Him Out!

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Day 6: Off the WALL!

Day 6 fell on a Saturday and I was honestly torn if I should continue therapy through the weekend even though I had set up a continual schedule for 12 straight days.  If we had of gone with the non-removable cast he would be continually wearing it, so we decided to carry on with the inital plan.  I was also nervous that some of his progress might regress and mainly that he would be incredibly upset to start over on Monday after a weekend without.   So in the end, I went with my instincts and we are continuing with the initial schedule.

HOWEVER, I did make the mistake of letting him veer off the daily schedule this morning by sleeping in and diddling in putting the constraint on.  I thought I was doing a good thing for my sweet boy but overall I hurt him.  Being off schedule confused him and when I went to put the constraint on, he was probably surprised and disappointed. I know now to keep to the schedule so that he is not upset by the change.  Lesson learned!

When I put the constraint on, he just layed himself out on the floor, I felt so bad!!!  He just wanted a moment to digest it and then we moved on.

{SIGH}

He was very motivated to get going with the cars.  He did a wonderful job transferring them from his right side over his mid-point into the lunch pail.  He continued with this game for quite a while before we moved over to the wall poster.

 He held onto his favorite car for some time and didn’t really want to participate in the drawing and stickers as much.  He pretty much just told me what he wanted and I tried to draw it!  We had the car and the train and then we added the people by using the stickers.  He did take some stickers off my finger to stick on OR push down if I put them half way on the wall.

So I cut out some BIG paper hearts and gave them a swipe from the glue stick and he managed those quite well in putting on the wall and pressing into place. I followed along and added some stickers (as directed).  I added in some pipe cleaner and then he started picking up his cars…so we taped those (loosely) on the wall too! I had some tension balls that had a little balloon lip and we taped those and then I grabbed the knobby puzzle pieces and taped them on there too!

Dad bought one of Owen’s balloons into the room and I tied pipe cleaner around the ribbon so that it was grounded some but still light enough to go high into the air.  Owen had the BEST time chasing that balloon, rather WE ALL had the best time chasing that balloon!!!  He did an excellent job of grabbing it, either with a big hug or using his fingers to grasp the string.  He did wonderful overhead extensions…it was a lot of fun!

Title Description  Link
CIMT – (Day 6) Chasing Balloon with Both Arms Extended Great extension of both arms http://youtu.be/z03GihlCXsI 

We worked on drinking from the cup (with assistance) and he ate a cheese stick and crackers without any help (other than to peel down the wrapper).

After his break we went to work on the water bucket, washing the big red ball by repetively squeezing the sponges over it.  We threw the jacks around, picked them up and put them back.  Then we attacked the WALL O’FUN!!

Owen just kept going back over and over to get each vehicle off the wall to put into the bucket to be washed!  He would take his time and pull it down, if it fell, he’d pick it up and bring it over.  This continued till they were all down.  Then he worked on the balls, got them down and into the bucket and then I took them out of the bucket, dried them off quickly and taped them back up!  It was so fun!!!

When he was done, we worked on getting the puzzle pieces off and into the puzzle.  I don’t think he loves putting them into the puzzle but I think he loves helping us complete OUR puzzle. So sweet!

We worked on the iPad activities for awhile and then transitioned into running through the tunnel.  He was tickled to have Mom on one side and Dad on the other!  

We took his constraint off and he took out the coloring markers/crayons and scribbled on the wall.  He had to be prompted to use Righty some, but he understood the request and would alternate. 

Favorite Activities:

Graph of Time Lapsed:

Day 5: Glum to YUM!

This morning started off a bit slow, we were BOTH TIRED! 

Did not take into account how draining this was going to be (not a complaint just letting you know it is okay to feel this way).  I got up an hour before Owen to set up some fun activities for us to dive into (as well as gulp down 2 cups of coffee). 

Owen was really glum about wearing his constraint this morning…he cried for 10 minutes while laying on the floor.  I could not distract him with anything.  He has been doing so well and it just hurt to see him frustrated.  But what a fighter he is!  Once he was done letting me know he was frustrated, he got up and wanted me to draw some cars on our poster and then we added stickers.  I had to help and prompt him with these tasks but he was enjoying himself.

However, once we got warmed up and bouncing around the room, he was happy as a clam.  We did some belly flops on the bean bag and crawling over it.  Then he was throwing those plastic jacks and frogs all over the place!  We hit the ball with them and made it roll all around the room.  Then I set up the knobby puzzle pieces on the couch with the puzzle about 5 feet away and he would help me fill up my puzzle by getting the pieces and putting them in for me.  Such a helper!

This morning we added his hand splint onto Righty to help him get a better grasp on items.  This item he has been using for the last year.  We waited to add it today because we wanted to give him time to acclimate to wearing the constraint first.  We worked on the iPad app to choose his favorite transportations to see and hear.

At this point of the morning, he was ALL about going outside to play!  So we bundled up and went about on a new adventure! Lots of walking, squatting and picking up sticks!  Love him, he just wanted to pick them up and throw them, some to pick up again and repeat.

We left to go to therapy to see Miss Suzy the OT.   Today’s focus was feeding, so we had packed up a lunch and took it with us.  When we first arrived, he wanted to play!  He would pick up the bean bag animals and do an amazing overhead extension to put them into the basketball hoop.  After doing this repetively, I guess he worked up his appettite and was ready to sit down for some lunch. He had a peanut butter and jelly on whole wheat bread cut out into star shapes, whole wheat crackers, cheese stick, apple slices, pretzels and goldfish crackers.  This way we could gradually work on advancing his pincer grasp while having a tasty lunch!  He did wonderfully today (so much so I added ‘Eating’ to his activity list), with a combination of the progression he’s making this week overall along with wearing the Benik hand splint he was showing a lot of improvement.

Once done with lunch, he ensued with a pick up the crabs game with Miss Suzy and tossing them into the air!  Such a GREAT activity.  He would have to squat down, open up his hand and grasp the crab, then walk over to his favorite spot while holding it and then tossing it UP into the air!  He was so tickled!!! 

Title Description  Link
CIMT – (Day 5) Feeding – Fine Pincer Grasp (Goldfish Crackers) This is the finer example of the pincer grasp while also wearing the Benik hand splint http://youtu.be/wvjebIISBl0 
CIMT – (Day 5) Feeding – Pincer Grasp (Pretzels) Pincer grasp while wearing the Benik hand splint
CIMT – (Day 5) Example of Grasping and Overhead Extension This is an example of grasping an object, holding it while walking and then tossing it in the air (overhead extension)
CIMT – (Day 5) Grasping and Overhead Extension (Bean Bags into Hoop) Example of grasping and then lifting overhead and putting through basketball hoop

At the conclusion, we removed his constraint for 2 handed play.  When we left, he insisted on carrying his lunch container using both hands.  He walked from the 2nd floor all the way to the car and held it for the drive home and took it into the house to take his reward sticker out to play.  

Overall, today was GREAT!  It started out a bit frustrating, which is fine but he really turned it around and we had a wonderful time!  I’m so proud!!!  His personality and dedication will take him far.

Favorite Activities:

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Day 4: Vrrooooom! Vrrooooom!!!

Owen accepted the constraint as if it were just a regular part of his change in wardrobe from sleeper to day clothes. Once it was strapped on, he just popped down and was ready to face the day.

It took him a bit longer than yesterday to want to use his right hand without me prompting him to do so.  After he had it on for 45 minutes, he was ready to dig around in containers, boxes to pull out balls and jacks. Shortly thereafter, we got ready to leave for his Physical Therapy appointment with Miss Jill the PT.  He actually did really really well in physical therapy.  He would run an obstacle that consisted of him picking up a piece of puzzle, walking over 4 hurdles, up 2 steps and down an angle to then put the puzzle piece into the waiting puzzle.  He had trouble holding his grasp for the first two but on the third one, he carried it the entire way by himself!!!  Also, his gait looked really good today!!  I think that’s the surprising part for me in this therapy is the added benefit from the PT perspective.

He then got on a tricycle, resting his constrained arm in the middle of the bar but grasping the handle better than ever with the right hand.  His disposition was sunny throughout the session, I think he really enjoyed the challenges.  He ate a Cliff Bar all by himself on the way home from therapy, he only wanted assistance once to help him move the remaining half of the bar to the outer edge of his grasp to polish it off.

We came back home and prepped for the birthday party of the day!!!  (Artie the Alligator…who knew we had to name all these animals!)  He just wasn’t into the banana peg board like he had been, he helped to add a couple and then removed the candles twice but that was it as far as repetitive action.  However, he still loved singing Happy Birthday!!!!  He opened the gift (rolled up a Big Rig Truck in tissue paper for him to unroll) and then that was it!  Everything had to be done with this truck and he always kept a car in the trailer!  (He’s napping with them now as I type)

I tried to use his fascination of this truck by incoporating it with a more challenging app on the iPad. Previously, he would get too frustrated if there was a challenge beyond a gentle tap on the screen so we had stuck to the apps that were instantly gratifying, ‘popping bubble wrap’ or the more basic ‘flashcards’.  Today, I tried the ‘I Hear Ewe’ app which had an entire section on transportation.  He had to take it a step up and actually touch the item he wanted to see and hear (which of course was only the big rig truck and car).   I posted a video of the struggles he has today in pointing at the exact item he wants to see and then we’ll video this again to see if there is any improvement.  I was delighted that he would keep trying and not get as frustrated as before.

Title Description  Link
CIMT – (Day 4) Using the iPad First app that challenges him to point at something specific to gain a desired response.  He had trouble pointing at the specific target but he is displaying less frustration and willing to take on the additional challenge.

He was open today to working with the Goldfish crackers to allow me to help him pinch the cracker and he would take it to his mouth to eat.  We actually repeated this for some time before he was tired of working on the pincer grasp.

Another BIG thing he did today was hold his sippy cup to his mouth, actually turn it up WITH RIGHTY!!  Granted I balanced the end some but he held onto it and turned it up!!!  He only did that twice but I think once he continues to gain strength in that arm, he’ll become more adept at that particular task.

We played with the big rig truck and his cars on the race track and then pulled out the water bucket to continue squeezing the sponges and pulling jacks apart.  He has not tired of the game in gathering them one by one to splash in the bucket!! 

We added the knobby puzzles into the mix for him, I would hold the puzzle up while he would grasp the pieces to lift and rotate to put into the puzzle!! 

When I removed his constraint today for 2 handed activities, he wasn’t as into using Righty immediately like he was the day before.  Interestingly though, I handed him a cracker and he reached with Lefty but I asked, “…can you let Righty take it?” and he then made the effort with Righty but rather than immediately tranferring it over to Lefty, he held a two handed grasp!!!  I was very happy with that!!

Just to reflect a moment:

  • I’m really happy my husband took off work on the first day to be a strong support for us.  With the first hour being so hard on Owen, I really appreciated having him home. 
  • Although I recommend having a schedule, KNOW that the first day is all about your child adjusting to the constraint and their comfort overall.
  • Have a therapist arrive on the morning of the first day.  We were so delighted that it just happened that way.  It was a treat to have a new face and added support.  You may have questions and its good to have a professional there to start your day.
  • Let your child lead, I have a lot of ideas but it is up to the child to be receptive to those activities…I want this to F-U-N!!
  • Your child will be tired!  There is tons to process, working those muscles and new movement patterns, they will be exhausted. Let them rest!
  • Be flexible in modifying the overall layout.  We have decided to remove the constraint 45 minutes to an hour earlier to transition to 2 handed play. 
  • Go with your instincts!

Favorite Activities:

Graph of Time Lapsed:

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