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:
Home Based CIMT 