We started physical therapy at TCH yesterday. During her assessment last week, she was found to have “scattered skills,” meaning that her skills ranged from the 4-month level to the 8-month level. She has incredible upper boddy chest strength but incredibly poor abdominal and trunk strength, which is what is possibly causing most of her skill setbacks because she is using the wrong part of her body to do certain tasks.

Common sense tells us that because her abdomen was so huge that she compensated by using her upper body and her shoulders to get done what she wanted to do. Explains why she can sit, but she can’t get to a sitting position or crawl.

Today, Pam, her therapist, also noticed that she has low tone in her lower legs and ankles as well as no arches in her feet. When she stands, she rolls her ankles or angles out her feet to try and balance.

Mommy and Hannah’s homework:  The homework for this week is:  1) positioning Hannah in sitting with her hips leveled with or slightly higher than her knees to facilitate weight bearing through her legs ; 2) encouraging Hannah to lean her trunk forward when moving into the stance position so that her body weight is shifted anteriorly onto her forefoot, bilaterally, instead of her heels; and 3) encouraging Hannah to stand while holding on to facilitate balance reactions in the stance position.

So, she wants Hannah to get orthopedic high-top shoes called Supramalleolar Orthosis (SMOs) from SureStep.  They are similar to the picture on the left.   “The SureStep system is designed around the child with low muscle tone. It is a truly remarkable early intervention tool to help stabilize and align the lower extremities of children with hypotonia.”

The cost of these custom-fitting orthotics?  $1300 A PAIR (made by a local company because they are “custom”)!  And she would probably need a new pair EVERY 6 WEEKS until she figures it out on her own.  I hope our insurance company will cover it because there is no way we can afford these.  Pam is going to write a medical letter of necessity and ask Dr. B., our pediatrician, to write a prescription for them.

We’ll see how that works out…