Yo soy La Lay

adventures in family, faith, and Down syndrome

Lesson #20: Developmental Therapy is a thing

This is part of the 31 for 21 Blog Challenge!

Pre-Tessa, I had heard of Physical therapy, speech therapy, and even OT wasn’t completely lost on me.  However, Developmental therapy (DT) is a totally new concept.

We get DT once a month, but now that Tessa is sitting, we will increase to once a week in November-ish.  A developmental therapist is kind of like Tessa’s first teacher.  She works with her on intellectual development – concepts like “in and out,” cause and effect, object permanence, all that fun stuff.  During sessions, we play with toys and watch to see how Tessa interacts with her environment.  In the beginning, we worked on getting her eyes to track objects and to show interest in faces, then toys.  Our DT also works with our family to get us connected to the Down syndrome community.  We talk about our own emotional development, our concerns and frustrations… I don’t know if this is in her job description, but Shannon has been a bit of a social worker along with Tessa’s DT.  🙂

Right now, our major hurdle has been Tessa’s startle response.  When anyone (besides Ellie, that is) laughs loudly, Tessa displays the same kind of reaction that you might see in a child who was just given a shot.  Sweet little pouty face, big fat tears…. She has the same reaction to dogs barking.  Other loud noises don’t affect her at all.  We sit right next to our Praise Team (essentially, a band) in church and she has no negative response to the music.  When we play peek-a-boo with her, she often cries when we reveal our faces.  Some strong smells bother her as well.  I know that many people who interact with Tessa feel bad when she gets upset.  However, it’s important for them to know that we would rather teach Tessa to react appropriately than to create an environment in which she doesn’t have to deal with this stuff.

Sometimes, children with Down syndrome can have a sensory processing disorder that causes them to struggle with different types of input.  We don’t necessarily think this is something that Tessa is dealing with, but it’s certainly part of our conversation about her development.  It’s something that we will continue to work on with her DT and also in occupational therapy.

Soon, Tessa will be at four therapies a week.  Sometimes, that can feel like a lot.  Right now, two therapies (Speech/OT) are at daycare and two (PT/DT) are at home.  We just recently changed her Speech time so that I could potentially be there to help out with that.  Recently, she hasn’t been able to get through a session of speech without crying uncontrollably or shutting down and going to sleep, so we hope that my presence will help her manage her feelings better.  So far, it has worked.  I don’t know if it is realistic to think that front-loading all of the therapy will help her in the long run or not, but if nothing else, the consistency in our weekly routine is nice.  Plus, the therapists give some really great tips for working with Ellie, too.  She is more work than her sister most days!!

Still cute when she cries.

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Lesson #19: Occupational Therapy: No occupation required

The most recent addition to Tessa’s therapy regimen is Occupational Therapy (OT). Around six months, we noticed that Tessa wasn’t really engaging her hands. In fact, she spent most of her time with her hands balled up tightly in fists. There was very little reaching for objects and if she actually got hold of something, it was released almost immediately. At her IFSP review, we all agreed that it was time to add weekly OT.

OT focuses more on the fine motor skills required to function. Since starting with Kate, Tessa’s therapist, we have seen great strides in her ability to use her hands. She will reach for toys and play with them. She plays with her toes. When on her belly, she will use her arms to push up. Most of the time when she does that, she has her hands open.

We are still fighting with her left hand. She has a tendency to keep a couple of her fingers curled up when she’s pushing up onto hands and knees. She grabs more frequently with her right, using her left to stabilize her body. In therapy, we work a lot with engaging the left. Her issues are small, but on the radar.

OT is one of the therapies that Tessa gets at daycare, so I don’t have a lot of info about what a session might look like. However, Kate sends me detailed notes so that I can see how she did. Right now, just like in PT, we are working on sitting and playing with objects. We have to get Tessa to build strength in her core so that she can stop counting on her hands for stabilization. Kate puts her in a lot of different positions (belly, knees/hands, sitting, etc) and then uses different toys to motivate Tessa to reach for them. We’re also working on getting Tessa to hold her own bottle.

OT, PT, and Speech are once a week for an hour. The last therapy, saved for tomorrow, is Developmental Therapy. More on that tomorrow!

Sitting at 6 months (see the hands?!)

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Sitting now… Progress! (Also, the only happy Bears fan in the USA today)

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