The Golden Thread: Movement and Mobility. Sheree York, PT, PCS: CHS Chantel Jones, PT, DPT: CHSEI Melissa White, PT, MS: UCP/Hand in Hand Betty Denton, PT: Tri-County Services. Objectives The Participant will be able to:.
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Sheree York, PT, PCS: CHS
Chantel Jones, PT, DPT: CHSEI
Melissa White, PT, MS: UCP/Hand in Hand
Betty Denton, PT: Tri-County Services
Part C Early Intervention builds upon and provides supports and resources to assist family members and caregivers to enhance children’s learning and development through everyday learning opportunities.
Families and children are active participants in identifying functional outcomes, goals that reflect needs/desires of individual
Services are provided within the natural
environment of the child
WHERE: natural environments
WHEN: routines and activities, convenience
HOW OFTEN: based on family and child needs, potential for change, support needed for family to learn strategies for supporting development through daily routines and activities
HOW: sharing information, modeling, coaching, identifying and communicating with other providers
Parents and Therapists:
Implications for practice:
Parents seem to understand natural environments (better than therapists) as location and way of providing services where setting, activities, and routines becomes the context for practicing and learning new skills: a source of opportunities for learning and a context for gaining acceptance and making friends.
Therapists seemed to limit this concept to location only, suggesting that the EI services do not vary whether delivered at home or in clinic. (?)
OT, PT, and SLP practice frameworks include coordination, consultation, and collaboration as vital and integral aspects of effective practice
Where do you fit?
Grace is a 6-month-old (corrected age) girl born at 24 weeks of gestation. At birth she weighed 1lb, 2oz.
Due to bronchopulmonary dysplasia (BPD) and other upper respiratory complications, Grace spent the first 4 months of her life on a ventilator in the NICU. Additionally, she had a mild case of necrotizing enterocolitis (NEC).
At 1-month-old corrected age (5-months chronological), Grace was discharged home with her family on 0.25 L of supplemental O2. When awake, her O2 levels are in the upper 80s. While asleep, they are in the upper 90s.
Physically, Grace has slightly increased muscle tone in her shoulders and legs.
Sleeps well through the night
Good head control
Both parents employed full-time
Maternal grandmother provides childcare
When will my baby sit up?
When will she crawl?
How do we get her to gain more weight?
She likes to play with toys when we hold them. How do we get her to play with her own toys?
Grace will pull to sit from lying on her back after diaper changes and when waking from a nap.
Grace will work with nutritionist and OT to address weight gain and other feeding concerns.
Grace will play with her toys without adult assistance when lying on her side, her tummy, her back, and when sitting in her high chair.
Newly diagnosed with mild spasticity
How do we keep her from being so stiff?
When will she crawl?
When will she feed herself with her hands?
When will she hold her own cup?
When will she walk?
Should her feet roll in at the ankles like this?
Grace will feed herself Cheerios.
Grace will hold her own sippy cup.
Grace will crawl forward on her belly to reach her toys.
Grace will pull herself up to furniture to stand.
Grace will be referred to MD & outpatient PT to address foot alignment.
Family will demonstrate comfort and independence with stretching Grace to help decrease her stiffness.
Gaines was born at term with hydrocephalus
He had a VP shunt placed immediately
He has “cortical blindness” and seizures
Both parents work: mom is a nurse and has worked in special ed and hospitals
He attends a home day care
He has a 6 year old sister
Church and work friends are supportive
Extended family lives in Selma and New York
Followed by Neurosurgeon and Ophthalmologist
Family priorities and questions:
Does he or will he see?
Will he develop ok?
What would you do?
Campbell P, Sawyer B, Muhlenhaupt M. The meaning of natural environments for parents and professionals. Infants & Young Children. 2009;22(4):264-278
Resources from United Cerebral Palsy
Journal article on the role of the pediatrician in Early Intervention
American Academy of Pediatrics web page on Early Intervention