Therapy. Aka “Play.”

November 29th, 2010

I dreaded this aspect of Down syndrome.  From afar, it all seemed overwhelmingly burdensome.

But now…

Therapists?

I must have forgotten…

Therapists are people.  I like people.

Therapists are guests.  I like having guests.

Therapists are teachers.  I like to learn.

Marcia prayed for us the day she knew we were were quitting bottles.  She was overjoyed to hear the wonderful answer to prayer, and see it in action on her next visit!  Doesn’t she sound like a friend?  I love having friends!

Well then, how about the therapy itself?  Doesn’t that ever feel stressful?  You know, trying to fit it all into each day?

Yes, of course it does–sometimes!  Those times provide me with excellent opportunities to remind myself of the truth that God did not make a mistake when He gave me this assignment!  When I wish we could do more, I have to trust Him to multiply our efforts.  My disposition definitely emanates outward toward the rest of the family.  I am not a good mom if I am stressed or discouraged, so there’s another big motivator to practice some quiet trust!

(A long-practiced ability to fake a calm I do not feel comes in handy in the interim!  Hahaha!  This is also known as “self-control,” by the way!)

This pressure also spurs us on to become more organized and efficient with our household operations.  We can tell when it’s time to adjust our routines because some important things don’t happen!  We’re in the process right now of making changes to reflect Verity’s current habits, and fitting it all together with the rest of the family.

Daniel, Laura and Jane know how to do all her therapy activities, in varying degrees.  Between the four of us, Verity can go through her routine a couple of times each day, but rarely all at once.  I just planned this one big session for the sake of getting pictures.  And some days it doesn’t all happen, but we just keep fitting in here a little, there a little.  So it rarely feels burdensome.

We talk to Verity all the way through, telling her what we want her to do, telling her what she is doing, and giving lots of enthusiastic praise.  We try to work from the hardest tasks to the easiest.  The praise, by the way, takes no extra effort on our parts!  We are so proud of her cheerful cooperation, her hard work, and her accomplishments!  She is such a little sunshine!

We are reading, researching and learning more all the time about what we can do to help train her up in the way God designed her to go!  In fact, today we watched some instructional videos together as part of the school day.  As she progresses and we learn more, we’ll take some of her activities away and replace them with others.

Laura did a fabulous job of taking all the pictures for this post.  (Thank you, sweetie!)

In the first picture I am teaching her to hold up her head when she sits, instead of allowing it to slump forward, as she did until about a month ago and still does when she is tired.  I push her pelvic structure as far back into me as I can get it, and hold my abdominals up as tight and straight as I can get them.  Helps the baby.  Helps the mama, too.  With this support, I encourage Verity to reach forward for a toy.  We do not put toys into her hands, only cue her to grasp them by touching them to her hands if needed.

What looks like a typical baby behavior, reaching for a toy, grasping it, and bringing it to her mouth while in a sitting position, was something she didn’t do until recently.  It is so rewarding to watch her gain strength and skills!

This is the perfect time to read a book.  I help her point to the pictures and turn the pages.  We bought a laminator at a deep discount, and we’re learning how to make various flash cards for her as well.

Encouraging her to pull her tongue in and close her mouth.  You can try this on yourself; we think it’s a neat trick!  Hold your finger straight and place it across your mouth so that you can feel it on both sides of your mouth at once.

What did your tongue just do?

Neat, huh?

While her tongue is retracted, we quickly nudge upward on her jaw to close her mouth.  She’s less likely to thrust her tongue forward when she is interacting with someone face to face.  She allows her mouth to hang open more often when she gets sleepy, so that’s one signal that it’s time for her nap.

Having her lean on one arm and reach for a toy with her other hand.  I feel some minimal resistance from her when I have her do this; it’s the hardest work I ask her to do right now.  She is such a trooper.

Switched to the other side.  Reach for that toy, Verity!  (She did!)

Reaching forward to play with toys from sitting.  I have her reach with her left hand and her right.  She tends to use her left hand to bring toys to her mouth, and her right to shake toys, as you see her doing in the picture.  I always have her practice switching these actions around, too, and she is starting to catch on.

Mostly I posted this picture because she is cute!

With my hand gently pulling downward on her chest, encouraging her to tuck in forward as I begin her back-to-front roll at her hips.  Otherwise, she tries to do it by arching her back, which is a big no-no.  That’s how she managed to roll in the first weeks after her birth, before I knew better.

Roll, Verity!”

Providing motivation for her to roll by tempting her to reach for a toy with her upper hand.  She’s not so great at this yet, but she’ll get there!

“That’s right!  Reach for the toy!”

She tucked her tummy muscles in and finished rolling over.  Everything is done first on one side, then the other.

“Good girl, Verity!  You did roll!  Yay!”

After this, I had her do weight-shifting while on her tummy–first leaning on one arm while reaching for a toy with the other, then switching sides.  I will drop that one soon, because I am beginning to see her do it on her own fairly often now.

Then I briefly supported her up on a hands and knees position, just to help her get used to the feeling.  Sometimes I drape her over a Boppy pillow, bearing weight on her knees on the inside and playing with a toy on the outside.  Children with Down syndrome often resist bearing weight in standing or crawling positions.  (The pictures of these actions didn’t turn out so well, so we deleted them!)

Here I am signing to her,  “Come!  Come, Verity!  Come!”

“That’s right, Verity!  Come to me!”  I pull her up, then lower her back down.  Then I have her do the same thing, only tilted over on one hip, first one side, then the other.  Up and then down.

Time for a rest!

“Verity, nose! This is your nose! Nose!

“Touch your nose!”  (Left hand, then right hand, touch her own nose, touch my nose, rub her nose with my nose.)  “Nose, Verity!”

Head, Verity!”

‘This is your mouth!  Mouth!

I am also teaching her “ears,” and have her touch her ears.  Then “eyes,” by widening and blinking my eyes.  She gets a lot of amusement out of that one!

“See your feet!  Feet, Verity!”

“Yes!  Big girl, Verity!  Touch your feet!  Feet!

I let go of her feet, had her look at my face, and just said the word “Feet,” over and over to her until she pulled them up herself, then I praised her energetically!  “Yes, Verity!  Those are your feet!  Feet!

Deep pressure input on her hands.  “Hands, Verity!  These are your hands!”  Ever since she was a newborn, she has made these funny eyes when I put pressure on her hands.  I do this kneading sort of massage on her arms, hands, legs and feet to provide sensory stimulation.  Today I learned how to refine my technique!

We have sensors called proprioceptors in our bodies that pick up information about where our bodies are in space, and where our body parts are in relation to each other.  So that, for instance, you could close your eyes and know if your right arm is waving back and forth over your head, or if it is resting on a surface in front of you, or if you are sitting on it.  The previous activity helps to fire up Verity’s proprioceptors.

Some of these sensors are also located in joints, and can be “woken up” by action like you see me doing with Verity below.  I am holding her itty-bitty leg straight, and giving firm but gentle pushes to the bottom of her foot.  This is helping to stimulate the proprioceptors in every joint in her leg.  It also accustoms her to the feeling of bearing weight on her feet.  I do this many times throughout the day to her arms and legs.

Waking up those proprioceptors!  That’s a fun word to say.

At the very end I had her do some tracking with her eyes.  First horizontally from one side to the other and back again.  Then vertically from the midline all the day down, then all the way up, then down again.  We didn’t get good photos of that, either.

So.  Doesn’t that look like I’m just playing with my baby?

What mama doesn’t like to play with her baby?  Therapy right now means I get to play purposefully with my baby without feeling guilty that I am wasting time!

How could I have forgotten that Verity would not be a computer to be systematically programmed and handled with precision or ruined forever?  She is just my baby.  My sweet-smelling, sweet-faced baby.

How could I have forgotten that I like to teach?  Therapy is me teaching my baby.

I love to see my children learn.  Therapy means I get to watch my baby learn.  And see our other children learn how to help their sister best.  Most of them now know far more about infant physical therapy than I ever did, and they’re learning more all the time!

It is just plain FUN to teach someone who loves to learn!

Now she is done her hard work and is resting with her head supported in the midline position.  Making it easy for her to play with her new favorite toys!

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12 Responses to “Therapy. Aka “Play.””

  1. Tami Swaim says:

    We have this soft plastic brush that is used for taking the ‘hairs’ off corn cobs that we used to use for Joel to wake up those proprioceptors (especially at his joints).  We were showed how to press down hard and rub away from the joint on his legs and arms. This was also used to help calm Joel down.  Another trick was to roll him up tight in a blanket.  He still needs this from time to time. In fact he will sometimes ask for it.  Somehow he can feel overly anxious if he can’t quite feel his ‘body in space’…it’s an out of control feeling I suspect.  It comforts him to get a deep rub down or rolled up like a hot dog in a blanket.  We should have started working with Daniel sooner.  We are beginning with him now.  His biggest need is in the area of oral muscles awakening and speech but he also has some gross motor skills to refine to be ‘age appropriate’.

  2. Shauna says:

    did you get all of this from your therapist?  sounds like you have an amazing therapist!  Reagan’s teacher is coming for the first time on Wed and I’m excited to see what we learn.  I’m like you, I LOVE to teach!  So this is a great adventure!

  3. Stephanie Blanchard says:

    I love it when you show us things like this!   And of course I love seeing all the extra pictures too!

  4. Denise says:

    Yeaaa  Verity!!!!
    Yeaaa   mom and family!!!

    Susanna– it sounds like you have a good therapist.  She prayed for you– that is amazing–  God definitly lined that one up!!!!

    Your family and this blog is such an encouragement.
    I would love to come and see you guys again sometime– see that little girl in person!!  :)
    Maybe in January at the FarmShow– the boys already asked if your family would be there this year!! :)

  5. Susanna says:

    Shauna, we’ve gleaned little bits from various places–both her OT and her PT, other moms, books, common sense, et cetera.  It IS fun!  Do you have the Woodbine books?

    How old is Reagan?  V’s therapy started pretty small and it expands as she gets stronger and more capable.

  6. Susanna says:

    Tami, thank you for another tidbit of info!  (It was good to hear your voice last week!  :) )

    Peachie, thank you!

    Denise, the Farm Show and YOU GUYS crossed my mind recently, too!  With the pumping/nursing I am sticking pretty close to home, and I haven’t asked Joe yet if he’d want to take the other children without me.   We’ll have to figure out how to get our two families together.  :)

  7. Shauna says:

    Reagan is 10 weeks old now so obviously she won’t do all that yet, but it’s good to see what looks like a really good routine so I know what to expect/push for.  I’m concerned that they won’t want to put her with PT and OT for a while so I want to know what to do myself :)  the Woodbine books…is that the Gross Motor Skills one?  I haven’t got it yet but its on my list to order.

  8. Susanna says:

    Yes, it’s worth the money!

    I’d recommend lots and lots of tummy time, deep pressure in her fingers, hands, arms, toes, feet, and legs (avoiding joints), and laying her on her side with a lightweight, easily-grasped toy in her hands, like a single link.  If you put her on her back, you can roll up a towel and put in around her head and shoulders to give support under her shoulders, then encourage her to reach upward for things.

    Depending on her head/neck control, a nice way to give her tummy time is to lay her on your chest and recline, so that you’re helping her out a little, and do some face-to-face interaction to encourage her to hold her head up.  She could also do a little supported sitting at that age.  Here’s a post from when Verity was just shy of 10 weeks old:

    http://theblessingofverity.com/2010/09/hard-workin-gal/

    I still do the tummy-time-on-my-chest w/ V. when she is tired at the end of the day, but I still want her to give it a little more effort.  I just can’t stand to see her “blob” if you know what I mean.

  9. Shauna says:

    thanks!!  yes she loves the chest tummy time so we do that a lot!  I just want you to know I love coming here and reading about Verity and you since she is just a few months older than Reagan and your scriptures and song quotes always bring me such encouragement :)

  10. Ilisa says:

    I could cry right now!  She is doing so great!  We are not doing anything with Calvin and I’m feeling bummed, gosh.  Better start praying…Thanks for all this!  I still don’t know where you get time!  Oh yeah, we have to make it…

  11. Susanna says:

    ((((((Ilisa))))))  I do NOT at all want to discourage you!  When Verity started EI at 10 weeks, she was 5 weeks past her OHS.  Calvin is still in the recovery period!  He will be just fine!  You will be able to work more with him than ever before and see him make huge strides and that will motivate you even more!

    Please know that some days I am crying, and praying, right along with you, even with the multiplied effort we can give V. thanks to having so many capable older children.  Remember, we have five children who can help, not just with her, but with the household.  Often what it takes one person an hour to do can take six people ten minutes to do, if that makes sense.  Big families really are an efficient use of every kind of resource when they are in this stage (past the labor-intensive time of all small children) and functioning properly.

    I knew that when I posted, some people would think it looked like a lot, and some would think it looked pathetically small, depending on their own approach and resources.  Take courage, hang in there, and do what you can, and God will multiply your efforts!  He knows all about the timing of Calvin’s coming and his OHS and every other detail, and He IS your Helper!

  12. Marilyn Osborn says:

    Wow!  That was amazing to read!  Susanna, this blog is such a valuable resource on SO many levels.  May He be praised as it is so evident that He is using this for His glory and for so many people’s good!!!!!!  Wow!!!!!!!  I am so blessed to read, to learn, to grow, to be inspired!  WOW!  Love you!  I’m so proud of sweet Verity (and her mama!)!!!!!

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