Week 3- Post 2

Wednesday 29th of October 2008

Sandy**

Thoughts and feelings in the presenting situation…

Sandy is 15 months old and has been diagnosed with down syndrome. Sandy is a beautiful little girl who has such a gorgeous and gentle temperament. She had clearly visible low muscle tone and this was the first time I have seen Sandy. She was a pleasure to work with and to move around into the crawling position and did not complain once. Although she fatigues after half an hour, so she began crying at half an hour when all her muscles were getting tired.

How I managed the patient…

This was my first time seeing Sandy. Lots of positive reinforcement was given when she would succeed in tasks. She had a much curved spine in the beginning of the therapy session, as this is an indicator of low spinal muscle tone. We got Sandy doing assisted bottom bouncing to increase her spinal muscle tone. We also placed a tall giraffe musical toy in front of her to encourage her to further straighten her spine. This worked incredibly well, and her back was very straight. This also allowed her to play with and manipulate the blocks that went in the toy with correct body position and posture. She needed help getting into the crawling position. We would get behind her; tuck her legs underneath her chest so she was on her knees. We would then rock her backwards using the hips as the stabilising point, to encourage head extension and arm propping forward. She began to get a feel for synchronised crawling with her hands moving forward. She was also beginning to bare weight on her legs which is a fantastic progression and improvement.


What I did well…

I jumped in and corrected her positioning whenever I got the chance, and made conversation with the mother. I always had a smile on my face and am now getting the hang of positioning the children using key points.

What I could have done better…

Be more forward and asked Jenny If I can take control more. But this was the first time I saw Sandy so in the beginning observing was to my advantage to begin with.

Forward plan…

Prepare some progressions for her therapy and some challenges for Sandy.

Changes for next time…

I will immediately get into improving her sitting posture and increasing her spinal muscle tone. This will allow immediate correction before play and activities begin.

Overall thoughts and feelings of how today has gone…

Today was interesting as it was my first time seeing some of the patients. It was great to meet the children and work with them. In the afternoon after Jenny had left I was writing up a report for a client to be sent to a paediatrician. I am proud of the quality of the work and it was interesting writing it as my understanding of the child’s improvements since day one has increased. I also know where he is at, and it helps with planning progressions and challenges for my next therapy session with him.

Strategies to improve my performance…

I’m still a little reserved with new clients, but I think that’s normal. I need to just keep putting hands on to gain experience.

Questions…

**Name changed