Action....Reaction!

Paxton had a speech therapy appointment at Inova Farifax Hospital Rehabilitation Center this morning. This was his fourth visit and things had been going really well. Susanne was beyond thrilled with the progress he was making thus far.

Susanne could tell that Paxton was tired when they arrived. She was hoping that it wasn't like last week, which definitely hindered his performance. It was such a difficult thing to try to figure out an ideal schedule for all of the appointments Paxton required and not interfere with his nap schedule. It just wasn't going to happen. He was a fighter though and tended to push through his sessions regardless of his state.

While they were waiting to get called, Susanne noticed a sign that said there were free books available for the patients of the Rehabilitation Center. Susanne decided to skim through the pile to see if there was one that would be perfect for Paxton. She was ecstatic to find that the most memorable book from her childhood was sitting right in front of her. She could recognize the black and white checkerboard cover anywhere. It was "The Real Mother Goose" book. She remembered her father reading it to her a lot as a child. It had been a special gift from her Grandmother that they both cherished. She smiled at the memory of her Grandma and the joy she brought to Susanne's life. It brought tears to her eyes when she realized she had found the book that she thought she would never see again. It was funny how things worked out sometimes.

The session started with all of the usual oral motor exercises to wake up Paxton's mouth. He seemed somewhat irritable, but tolerant of what was going on. When it finally came time to feed him solid food, he wasn't feeling it at all. He managed to get down a few spoonfuls of pureed squash before having a total meltdown. He did recover nicely once he was in his mama's arms. The rest of the session the therapist spent playing peek-a-boo trying to get him to anticipate what she was going to do. He acutally caught on quickly and started laughing before she said the magic words. They also worked on object permanance. The therapist encouraged Susanne to show Paxton an object and then hide it partially so that he could see that it was halfway gone. This way they could start to teach him that just because an object is hidden, it doesn't mean it had vanished into thin air. The goal was to get him to eventually look for an object once it was removed from his line of sight. Susanne looked forward to practicing this over the course of the week.

The next appointment was with the new occupational therapist that Paxton had met with for the first time last week. This was set up through Children's National Medical Center at one of their satellite clinics. Today, the therapist started Paxton out on a bolster, which was a long, narrow foam cushion. He was able to work on tummy time in a different fashion than he was used to, which was exciting. The therapist also rolled him from side to side on the bolster, which allowed for him to engage numerous muscles when trying to right himself. He was surely going to get stronger from these exercises.

The therapist determined that Paxton's center of gravity was pretty high up his back. Her goal was to transition this location down lower over time. A lot of the session was spent with Paxton in her lap. She worked with him in the different positions he would go through to go from laying down on his tummy to sitting. She indicated that it was important that he work a lot on a dynamic surface instead of a static surface so that more of his muscles would be activated. It would strengthen his core and stretch out the muscles that he wasn't necessarily used to using. If he always worked on something like his wedge, the floor, or boppy, then he wouldn't get the same opportunity to feel that give and take with the movement. The therapist had Susanne sit on the exercise ball and lift her legs and try to maintain her balance. This was so that Susanne could get a sense of how hard Paxton's muscles were working even when it appeared like an easy task. Paxton rarely put weight through his feet when sitting on Susanne's leg so it was the equivalent exercise as what Susanne did on the ball. It was shocking how difficult it was for Susanne to do that for minutes. It gave her a whole new perspective on how hard this little guy was working just to do simple things like sitting.

The last exercise they worked on was similar to what they had done in the speech therapy appointment earlier. She wanted Paxton to anticipate what she was going to do before she did it. She did this through working on protective extension of his arms. She would prep him for falling to one side or another by saying, "AH, AH, AH....BOOM!!" His arms would be placed down on the ground to catch him from falling. He eventually caught on the verbal cues and anticiapted his hands being placed on the ground. It was so cute to see his face light up with excitement for what was about to happen. He was definitely getting stronger every week. Once again, the increase in his therapy services as well as Susanne being available to work with him 24/7 really made a huge difference.