PT evaluation

So Henry had his PT evaluation last week with a new private therapist. This was something we really never considered him needing at all, but as stated in a previous post, a PT looked in on us during a speech session and noticed some areas of concern.

The evaluation was about an hour and was part discussion with me regarding his history, and part play based evaluation with Henry. It was obvious to her immediately that he had severely pronated feet. He will need orthotics in all of his shoes indefinitely. I was hoping this would be something that would self correct in a year or two with orthotics since he is still growing, but no such luck. It’s not  the end of the world, he will just always need this monitored and as he grows his inserts will have to change and be adjusted. Pronation can lead to leg and hip pain so I’m glad we caught this early, especially since if he’s having issues now he can’t really express that to us. He does take breaks when playing or walking around the block…he will do a full squat in the middle of the street and rest. I never thought much about it but the PT felt it could be related to the pronation. Hopefully these inserts will be a fix.

The PT also tested his vestibular system and to me this is where there is overlap with what she does and what the OT does. I find it a little confusing but they said at his age there is overlap. Just like the OT she could not get him on the exercise ball and had a lot of resistance to anything that took his feet off the ground. This is typical of someone with vestibular issues. The swing was a huge challenge as well but she did finally get him on it to spin.  She then put him on a board that was lower to the ground and spun him while he laid on his side. What was interesting that his vestibular response was abnormal when he was spun upright (sitting or being held in her arms).. he had an over response but a delayed response. When he laid on his left side and was spun he had a normal vestibular response! I had never heard of this being a possibility but she said this does happen. When he goes for his next appointment she will test him while he lays on his right side.

She is suggesting we book four visits minimum. She can teach me exercises I need to do at home with him since we are having coverage issues with our health insurance. I have started a binder of exercises for vestibular, proprioceptive and heavy work since we were at Kaufman, so I guess I can add them to that. Our OT from EI also suggests Henry be on a sensory diet with vestibular exercises followed by proprioceptive exercises every two hours. I have yet to be able to implement this. I have been doing a sort of sensory diet with him but not in such an organized and timely way. It’s feeling a bit overwhelming… I have input from a total of six therapists now plus Kaufman and I’m trying to make sense of it all and doing what needs to be done without overdoing it.  Sometimes I wish I could just take him to therapy and walk out the door with that behind us for the day, but it doesn’t work that way with apraxia. There is a lot of “homework” to be done. I just need to find a way to do it all without burning Henry, and myself, out.

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