Saturday, February 9, 2008

What's Mendele up to?

The answer is a lot! Here is a summary of his therapy routine.
What he is really up to will be next time.

Speech: We are working on 5 main signs: more, bye-bye, finished, give me, and up. The sounds Mendele has so far mastered are: Na-na and Da-da. Now he's working on lip closure: Ba-ba, Ma-ma. One way we do this is using a Popsicle stick, which automatically encourages his lips to close. The mirror is a big part of his chattering. Mendele babbles away when he sees himself!

Feeding: Mendele is slowly mastering how to swallow with his tongue in. His chewing is improving as he learns to move his tongue laterally. He is also working on drinking from a straw. Currently his tongue is still visible as he drinks like a suckle, but with practice hopefully it will be tucked in! We are also doing (or should be doing ;) ) "Pre-feeding exercises" with him before each meal. These excersizes come from Lori Overland, MS CCC_SLP ( The excersizes we are working on are: palatal massage, upper lip mobility (with toothete), maintaining lateral tongue movement, chewing hierarchy and cheek massage.

Special Ed: Mendele is learning to put toys "in" and "out" of wide containers. He just about mastered the "out," but the "in" is a close miss each time ;) We are singing "Open, shut them" hoping that Mendele will anticipate the next motion and eventually do it himself. Socks and shoes are exciting for Mendele. He sees BIG shoes, and little shoes. Encouraging each step of the way is very important. Mendele cannot pull off his socks by himself. We do the hard part and let him do the last pull. Applauding this small pull will help encourage him to pull even harder. With time, he'll pull off the sock all by himself.

OT: Mendele is working on weight bearing and hand pushing. We encourage pushing with push toys and buzzers. We first want palm pushing before finger isolation. Once the palm is strong enough, the finger isolation will increase. Hand over hand is very helpful here. Mendele is also learning to kneel on his knees. He loves standing and wishes he can walk. We encourage him to stay in the 'crawl position' with Cheerios. Mendele can now hold his bottle himself while in 45' angle! This was mastered by propping his elbows up, giving them support. At first we needed to hold the bottle with him. His OT instructed that as soon as he lets go of the bottle, we should also. This way he learns that as soon as he lets go the bottle will fall. Well, he sure learned fast! Now we don't even prop his elbows anymore!

PT: We welcome Mendele's new PT. She specializes in the Feldenkrais method from Anat Baniel. This is a different approach than NDT, which is the most common PT. Feldenkrais works to 'connect' the different parts of the body, making the brain more aware of their existence and use. This is a softer approach which is known to be very effective. In PT we are working on diagonal reaching, crossing over midline. When Mendele is on his back, we work on his diagonal foot to hand (left foot and right hand) with a slight rock. When Mendele is in the 'crawl position' we work on the diagonal input of his arms and legs. In our daily routine, most of our movements are diagonal. We are also working on slightly rocking the pelvis forward and back while sitting, this connects the back and thighs. The last thing we are doing in PT is transitioning from laying to sitting.

Note: "We" really refers to our most amazing team of therapists who put in so much time and effort working with Mendele. You each deserve a huge THANK YOU and a standing ovation!!

1 comment:

Estee said...

Yasher Koach Rivky & Shmuli! Mendele you are so lucky!