Tag Archive: physical therapy

Nutrition, Supplements and Therapy Update

Here is a quick summary of CB’s supplements, therapies, schooling and diet.

Supplements

  • Morning
    • Vitamin D3 – 1 drop (Franklin & Friends – 400 IU)
    • Multivitamin – 2 chewables (Garden of Life Vitamin Code Kids Chewable Whole Food Multivitamin)
    • L-Carnitine – 1 capsule (Now L-Carnitine Fitness Support 500mg)
  • Evening (Before Bed)
    • Probiotic – 1 capsule (RenewLife 15 billion)
    • Fish Oil – 1 teaspoon (Nordic Naturals Omega 3 1600)
    • Vitamin C – 2 chewables (Nature’s Plus Animal Parade Vitamin C Natural Orange Flavor) – Periodically 2-4x a week

Therapies

  • Speech – 4x a week (2 private therapists and 1 therapist through proportionate share)
  • Occupational – 1x a week
  • Physical – 1x a week
  • Extra-curriculars
    • Piano Lessons – 1 x a week (to improve fine motor and motor planning)

(more…)

Summer Vacation

We are away on our regular summer vacation!! Unlike the past where we would home swap, this summer we ended up having to secure a home through airbnb.com. We just couldn’t get anyone to want to trade homes during the dead heat of summer, surprise, surprise :). Sort of surprised we had luck for the past 2 summers. Like usual, the kiddos were great road trippers! We made our way north which took about a week with stopovers with various family members. All of our family visits were short but sweet. CB has always loved riding in his car seat, even as a baby. I think HB has simply followed suit as he has seen how his brother behaves on car rides.

We could not have planned a more jam-packed summer if we tried. I can’t say I would have given up any trip or experience, but I do wish there had a been a bit more relaxation time built into the schedule. I think some of CB’s behavior tidbits this summer were directly connected with our travels. Overall, the summer break has been good for him. He has more chunks of time set aside for play, mostly with HB, which I think is good for him. We have followed the new supplement schedule with just a few exceptions due to traveling and I think the supplements seem like a good fit. We are sticking to the GFCFSF diet. Thank goodness for all the modified diet options we have today. We attended a conference a couple of weeks ago where we connected with other families and learned more about CB’s genetic difference. I think the main things we learned is that an MRI could be helpful, an updated hearing test, signs to look out for for anxiety, an awareness that developing seizures later in life is possible (not sure though if it is really related to his gene or others on the long arm of Chromosome 18) and a few more things to investigate.

I am toying with the idea of piano lessons but then I also want to ensure that he has sufficient off-time/playtime. This is the second time he has said yes. We will see. I guess the next thing I need to figure out is his schedule and to ensure not to pack in too much into it. How do you do that with so many needed therapies? I guess that is the challenge we have as parents with children with special needs. I know that playtime is super important at his age, and his school gets that. I hope this year if things get to hectic, I will be aware enough to back off a bit and see if things balance back out. I also should see if there is an insurance-covered OATS-like test to test his levels to see if the supplements and anti-fungal cleanse helped.

 

Summer is Now in Full Swing

I can’t believe it has been a whole month since I last wrote a post. With school ending, camp starting, and trips to two states and another country, it has been a bit of a whirlwind. It is hard to determine where to start.

Well, for the latest nutritional update, CB had blood taken today so we will know in a week or so whether his vitamin levels are back to normal. I believe I mentioned we ultimately decided to completely cut out dairy again. It just really seemed like the factor contributing to the declining levels. We will see soon. Otherwise, for the last month, CB regularly gets probiotics at night, but that has been the only supplement. We will most likely add the enzymes back in to help with his regular smelly gas after he eats. We were waiting to make any additions/changes till after we receive the blood work results. We quite giving him the vitamin D drops b/c he is getting so much sun everyday. We will also need to think about adding the multivitamin back in. I am really curious to see how his Vitamin E levels and to see if his fat absorption has improved.

I have now met another family with the same genetic mutation as my son. It was so affirming and feels really good to know you are not alone. Although our children are different, it is easy to tell how the genetic difference greatly impacts both our children’s lives. Still not much is know about SETBP1 loss-of-function mutations so we still have to address each symptom, i.e., speech therapy for the motor-planning disorder, OT for the fine motor challenges, PT for core strength, balance, and coordination, diet for sensory needs, etc. It would be nice to be able to help the root cause, but who knows if/when during CB’s life this level of information will even be known. I am reaching out to as my knowledgeable professionals and researchers as possible to find out what we can. (more…)

Impulsivity and Reflected Emotions

I’m trying to figure out how to even start. This last week and a half have been quite hard. Poor CB has been sick with a fever that lasted for 4 days, plus a cough, runny nose, sneezing, and increased impulsivity. The impulsivity started before the fever and it has grown to such a degree that we opted to remove cow’s milk from CB’s diet again. The decision also took into account reviewing his latest blood work and past stool test to determine that his gut does not seem to be performing at optimal levels due to the high fecal fat content and the lower vitamin levels of zinc, D3, and iron saturation. Goat’s milk is still currently in his diet and he is eating goat’s milk kefir in the mornings to help combat the antibiotics he is taking. He still also gets his probiotic at night. Since he has been prone to yeast infections in the past when he takes antibiotics, I try to ensure to restore with good bacteria. Olem and I still feel that diet can make a big difference and are just trying to see if there is an optimal diet that suits CB best. There are always so many factors to consider that it is typically not one thing that we can pin such behavior changes on. Additionally, some of CB’s therapies and his preschool are coming to an end. He could be feeding off my and/or his teachers’ energies. He can be very sensitive to others feelings and we see his behaviors reflecting/modeling back others emotions. We talk with CB about some of his therapies and preschool ending but CB doesn’t say much or respond much to these comments. Who knows if this is affecting him more than he can show us.  (more…)

CB – Almost 5

So, it has been a year since I wrote the original bio for CB. How is he doing now? What progress has he seen? Well, I thought it would be good for me to explore these ideas. CB has worked so hard this year and has progressed beautifully. He is still our happy, silly little boy. He remains just as curious as before and can find humor in just about any situation. Making funny sounds, screaming, and saying words that he finds humorous entertains him to no end. Asking questions every few minutes (if not more often) is still one of his traits. If he is not playing with his cars, you can often find him playing outside either digging in the dirt or exploring our backyard. He loves water, whether it be swimming in it or splashing it in swim class, playing with it while washing hands, pouring it out of his drink, pouring it from one container to another, or just pouring it out of anything.

His speech has improved tremendously. He can express himself in complete, short sentences, although he will still resort to phrases a good bit of the time. His speech therapists are primarily working on articulation, vocabulary expansion, and usage, sentence length expansion, and focus. CB continues to spit or hit when he doesn’t want to do something. Fortunately, he uses his words more often though. A huge step has been to expand his automatic response of “No” to just about any question to include “Ok”, “Yes”, silence, and sometimes a longer reply. He was in the habit of responding No to anything asked of him. It was his default response. If you waited a few seconds, he would many times comply or say another response. I think changing this has helped him also change his viewpoint a little. CB has gone through a stuttering phase. This came about when he started speaking in longer phrases. His speech therapists mention that they think this is due his desire to say something before having it planned out how to say it. He still does it some and I just ask him to take a deep breathe or to slow down. This usually works and he can start getting his thoughts out.

Fine and gross motor tasks still remain a big challenge for CB. He is currently working on writing his letters in pre-k and has started the “Handwriting without Tears” curriculum at OT. It only takes up about 5-8 minutes of OT. Sitting still, holding the pencil correctly, understanding where to start writing, understanding where to hold his body and head in relation to the work he is doing, planning the next stroke, and understanding where he should put his visual focus adds up to a very challenging set of tasks for CB. The hope is that by practicing now will help him achieve more success once he is in kindergarten. CB’s strength has noticeably improved. This has enabled him to endure and enjoy activities in OT like swinging in prone position/superman pose while playing games for 8+ minutes. I haven’t seen this translate into longer endurance during activities like running around and chase or increase his running speed. CB is still the slowest runner of his peers and just not often play games involving chase outside. He can climb higher, jump 1-2 ft down to another surface, peddle a trike, and jump over a low object. He is starting to catch a ball a little better. His visual tracking is definitely improving. You will notice above that I mention him swinging. For the swings at the park, he will now tolerate sitting in the swing with a little movement for about 30 seconds – 2 minutes. He is still not comfortable with that specific movement. (more…)

Therapy Schedule Update

Here is a quick update on CB’s current therapy schedule and the changes we are making for the start of 2016.

For the fall, CB’s schedule was as follows:

  • Monday – 9:15am-12:15pm pre-k; 1:00pm-2:00pm private speech therapy; 3:00pm-3:30pm swim
  • Tuesday – 8:15am-12:15pm pre-k; 12:30pm-1:30pm private physical therapy; 2:15pm-3:00pm private speech therapy
  • Wednesday – 8:15am-12:15pm pre-k; 2:00pm-3:00pm private speech therapy
  • Thursday – 8:15am-12:15pm pre-k; 1:30pm-2:15pm private occupational therapy; 2:15pm-3:00pm private speech therapy
  • Friday – 12:45pm-1:30pm group speech therapy at school
  • Saturday – 8:30am-9:00am karate

Updates/Changes for the spring:

  • Starting in January
    • Tuesday – 8:15am-12:15pm pre-k; 12:30pm-1:30pm private physical therapy; 1:45pm-3:15pm pre-k (eliminating 1 private speech therapy session a week and adding some more pre-k time)
    • Checking out 2 horse therapy places. Considering adding horse therapy on the weekends and quitting karate. CB is the least excited about karate and it is still quite hard for him.
  • Starting in February
    • Monday – 9:15am-3:15pm pre-k; 4:00pm-5:00pm private speech therapy (adding more pre-k time and moving speech therapy to later in the day)
    • Wednesday – 8:15am-12:15pm pre-k; 2:00pm-3:00pm private speech therapy, 3:45pm-4:15pm swim (moved swim to Wednesdays)
    • Saturday or Sunday – hopefully horse therapy sessions

Test results from Organic Acids Test (OAT)

So, after 7 months, CB finally peed in the cup needed for the Organic Acids Test. We actually ended up taping the plastic bag Great Plains Lab provided in the middle of the night. Come early morning, he had a slightly wet diaper but nothing in the bag…argh. So I reattached the bag and CB slept a couple of hours longer. The bag ended up not collecting urine, however, to our surprise, CB wanted to pee as soon as he woke up. He even peed in the cup – yay!! Small achievements :).

Well, we got the results back and it is not surprising that the report indicates excessive yeast and bacteria in his gut. You can view the results at OAT Results. Additionally, he may be low on serotonin and need L-carnitine supplementation. Based off the results and info we already knew, we plan to implement the following supplement schedule.

Morning

  • Multivitamin
  • GSE or garlic extract
  • NOW L-Carnitine (start with 500mg a day) (UPDATE: didn’t start this till 10/5 and started with 250 mg)
  • Fish oil
  • D-3

Afternoon

  • Probiotic

Nightime

  • Oil of Oregano

Daily

  • Limit sugar/carb intake (UPDATE 10/7: begin limiting oxalates)
  • Drink lots of water

We have to consider whether we want to add 5-HTP supplements, but I read it can cause seizures and gut problems. 5-HTP was recommended due to his lower serotonin levels and high High quinolinic acid / 5-HIAA ratio.  That doesn’t seem like a reasonable risk. Will definitely need to research more.

Some good news is that CB seems to be able to ride a tricycle pretty regularly now. He just sometimes needs help with initiation. I just now need him to be successful at home :).

We are still seeing tons of verbal growth from CB. He sometimes emits responses with up to 7 words. His STs are also happy with his progress. At this point, CB will get 4 days of private ST and 1 day of group ST through the school system. He also gets OT 1 day, PT 1 day, swims another day, and has karate on the weekend. He started a private pre-k last week and attends for 15 hours a week. I believe he is with the 3 year olds right now academically but he is progressing and really enjoying himself. I am really happy with the schedule we have lined up this year, even though we are driving all over the place Monday-Thursday :). We know this is just the plan for this year and I have a feeling he is going to grow tremendously in all areas. Both his OT and PT are big proponents of reflex therapy and they know each other. They plan to collaborate. We also implemented a therapy journal and so far I think it is very helpful.

It feels good to be in a positive place :)! With our kiddos and I guess life itself, we take it moment by moment. When we have these moments of comfort, it feels so good to just relish in them and appreciate where we all are. The future is unknown and all we can do is put the wheels in motion now to help our children be better prepared mentally, physically, and emotionally for what life deals them.

 

 

CB’s Evaluation, Therapy, and Treatment History

CB is 4 years old …

I touched on CB’s diet in an earlier blog, but I don’t think I have gone through CB’s evaluation, therapy, and treatment history.

CB was 10 months old when his daycare provider informed us that CB was developmentally behind and did not seem to catch on to things like his peers. This was extremely hard to digest.

CB’s first introduction into the therapy world was with a warm, yet challenging Physical Therapist. He was 15 months old. She helped CB learn to walk. He started walking (ability to walk across a room) at 17.5 months. His PT would push him further than I ever would but she knew just how much to push him to help him grow and move past some of his frustration. It was a good experience and we ended therapy shortly thereafter.

CB started gymnastics at around 19 months old. We thought it pretty much worked kind of like PT as it got him moving and trying new and different physical activities. He hated the big parachute for most of the year and needed a lot of herding to keep him somewhat engaged.

The month after CB turned 2, he was evaluated by a PROMPT speech therapist and given the diagnosis of a moderate receptive-expressive language disorder and a moderate-severe neuro-motor speech disorder.  He started PROMPT speech therapy the following week 1x a week. The next month, Early Childhood Intervention (ECI) evaluated CB and determined that he had a significant speech delay. They started their services within the month and came to our house 1x a week. The ECI interventionalist helped CB with speech and social skills (i.e., sharing, taking turns). After 3 months of private ST, it was determined that the PROMPT speech therapist, although nice, was not pushing CB enough. We decided to end private ST and continue with just ECI. About 2 months before CB turned 3, a licensed ST from ECI started coming to the house 1x a week, as well. CB progressed but at a pretty slow pace. ECI evaluated CB for OT help but he was not far enough behind to get help. Although, I think if I had replied more accurately, he would have qualified. As a parent new to the special needs processes, I responded to most things with the best case scenario response. I think I replied that he ate pretty well with a fork and spoon. He still doesn’t eat well with a fork and spoon. It is still challenging and he gets food all over himself 9 out of 10 times when eating. ECI was helpful in training us how to talk to CB and how to play in a more helpful manner. My husband and I are not huge talkers so it felt very unnatural to talk about what we were doing all the time and to repeat what CB was saying. I think this information helped us tremendously and helped CB’s confidence. When we started saying what we understood him to be saying and not phrasing it as a question, I think he started to feel that we really understood him.

At 2 years 11 months, the school district evaluated CB and determined that he qualified for the PPCD (Public Preschool for Children with Disabilities) program due to his delayed speech. For his school district evaluation, he mainly produced 2-3 sounds for everything. Most of his responses were bah, buh, or duh. When the evaluator asked if we thought the evaluation was representative of his skills, we responded proudly that we thought he tested well because he had tried to answer every question with a response. He normally didn’t do that. He many times wouldn’t even provide a response when you asked him to say a specific word or to repeat after you. CB received 2 private ST 15 minute sessions and 1 group ST session at PPCD. CB also started private ST at the same time 1x a week. 2 months later, CB started taking Nordic Naturals Fish Oil, Probiotics, and a multivitamin. AT 3.25 years old, CB’s pediatrician approved blood work due to CB’s chronic loose stools (sometimes with undigested food bits) and developmental delays.

During the summer, there was no PPCD so CB attended a language camp for a month. Then he took a month long break from therapy because we were out of the state traveling. He still continued to progress during the break. When the fall semester started up, CB moved to swim classes since he could not move up in gymnastics since he was not potty trained. I am so thrilled the switch was made. He absolutely loves his swim class and the class is only 2-4 kids total each class. He also started private OT services 1x a week and increased private ST to 2x a week. CB also started karate. It is a class for kids with special needs. At 3.75 years old, I determined from the blood work performed earlier that year that CB had a much higher than average chance of being celiac. The next day, our household went (GFCF) gluten-free and casein-free. Within 2 months, we saw improvements globally for CB from speech to gross motor to fine motor to sensory awareness (he could feel temperature changes outside). Our household also went soy-free within 1.5 months of going GFCF b/c CB started to present with a soy allergy. His ST sessions at PPCD remained the same. In March, we added Physical Therapy to his schedule to focus on integrating his retained primitive reflexes. He has a long list of unintegrated primitive reflexes. She also works on other gross motor skills, as well. I perform the developmental exercises at home anywhere from 2-6x a week. For most of the exercises, I have to do them in passive mode. Surprisingly, CB handles his schedule quite well and enjoys all of the activities.

Some things we have learned along the way 1) the PPCD structure has been extremely helpful for improving CB’s executive function, focus, attention, independence, social skills, speech and potty-training skills. 2) CB has visual, auditory, gross motor planning and execution, fine motor planning and execution, coordination and balance, food sensitivities, speech, and sensory issues 3) to listen to CB and to work within his limits and abilities 4) stop/change therapy if it isn’t working 5) seek answers and ask questions 6) even though we have heard it over and over again, we are our child’s biggest advocates.

Positive Progress: 1) CB is now completely in underwear except for diapers at night. He has been wearing underwear at school since the beginning of Dec but continued to have accidents on a regular basis. We let CB direct when he was ready to start wearing underwear at home and that is working out well. He also decided this week that he doesn’t want to wear diapers during naptime. He still needs quite a few reminders so that he pees in the toilet, and not accidentally in his clothes or on the floor. He even had 3 days accident free. Yay!!

2) We arranged to meet with an expert in the dyspraxia field in the upcoming weeks! We also have talked with a director of a motor planning and coordination lab. We are feeling very positive this week and feel we are moving in the right direction.

3) We upped CB’s fish oil earlier this week. He is now taking Nordic Naturals Omega Complete liquid form .He was CRAZY for about 2-3 days. However, his articulation, fluency, and the amount of language he used improved. He also climbed a new type of monkey bar about 6 -6.5 feet tall (4-5 times) to get on a playscape.  It seems like in the past, the days/weeks or so following an increase in fish oil, CB makes a big jump cognitively, physically, and verbally. We then see a little dip and then a leveling off at a higher level from where CB started.

Low: CB still has light shiners under his eyes, a rash on his bottom, and some digestive issues periodically. Arghh…we have made quite a few diet changes but we still need to keep tweaking and testing to see what is still ailing CB.