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WWYD physical therapy for my 18 month old


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My 18 month old dd has been having PT through Babynet for about 2 months, and has been having Early Intervention services for about 4 months. She has/had low muscle tone in her legs, which resulted in her not crawling properly (scooted on her bottom) and resisted putting weight on her legs. On about 8/24, she pulled up to standing, and got down, again and again and has been climbing, crawling, cruising and everything else since then. It really seems that on 8/24 she just decided it was TIME and got going. Now she does all sorts of stuff the PT works with her on voluntarily. So we don't have to pay for these services, but our tax dollars do. My other dd had PT for largely the same reasons, and one day (at 18mos) decided it was time to walk, walked across the room, and that was the end of crawling for her. The PT did not help for her. I'm just wondering how long I should continue with this? It involves appts twice a week (at my home), and costs the taxpayers a lot of money. Anyone with any input on this, sorry this is long!

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That's thing, I'm not sure it is helping her. It really seems that she "decided" it was time to start pulling up and proceeded from there. I do believe in PT for adults, but with babies they have to "want" to do it. My other dd's development in the physical realm made me really think about hs because she just wasn't READY to walk when she was supposed to--although she could talk. Just like with academics. If babies don't walk by 15 months, then something is WRONG with them, per the MDs. If I knew it was definitely helping, then I'd definitely continue--at least I'm getting something for all the taxes we pay.

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What are they doing at PT? If she has low muscle tone, they could be doing stimulation activities, which encourage muscle action, which improves muscle tone. I used to work with some people who did PT on babies. Most of them worked on babies with Down's who have low muscle tone. In their experience, these babies who did not have early intervention had more motor delays that those that didn't.

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Honestly, I say that therapy is working. It may appear as she just decided to do it on her own, but my opinion is that they did make her stronger so that she could do it. My dd is in PT for low muscle tone as well. She is 3 and just this week I started realizing she was now doing many activities (like climbing and using stairs independently) that she had never done before. I don't believe tht she suddenly started by herself but htat it was instead the strength buiilding the PT has been doing with her.

 

You can ask the PT what she thinks at this point. When my dd was a late walker, the PT suggested we stop therapy after her walking began and she gave me a long list of things to watch for in the future. We managed a year or so without PT but at age 3 dd was lagging behind peers again. I wander now if her delay wouldn't have been so severe at age 3 if I had continued therapy instead of dropping it. Another choice may be to reduce therapy time. I completely understand how taking 1 to therapy interrupts the day.

 

And, FWIW, IMO I would rather a child who needs therapy recieve it on my tax $ than a child who doesn't. It could be cheaper to fully resolve the issues now than to stop and not address them until much later. I think your chld is a child who has shown need. And while I know PT is expensive, I don't think your costs are more than a small drop in the bucket.

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If babies don't walk by 15 months, then something is WRONG with them, per the MDs. If I knew it was definitely helping, then I'd definitely continue--at least I'm getting something for all the taxes we pay.

 

None of my dc walked before 15 months, not even the one that rolled over at 6 weeks!

 

Low muscle tone and not walking by 15 months aren't the same thing. Though low muscle tone can cause late walking, it is not the only possibility. I suspect your MDs did see more, just used the not-walking thing as the simplest excuse, and your dc has gotten something from the PT - the muscle tone has improved.

 

And, FWIW, IMO I would rather a child who needs therapy recieve it on my tax $ than a child who doesn't. It could be cheaper to fully resolve the issues now than to stop and not address them until much later.

 

:iagree: A stitch in time...

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15 months is considered by professionals to be the average age for walking. Some walk before, some after..

 

Low muscle tone and not walking by 15 months aren't the same thing. Though low muscle tone can cause late walking, it is not the only possibility. I suspect your MDs did see more, just used the not-walking thing as the simplest excuse, and your dc has gotten something from the PT - the muscle tone has improved.
:iagree: My dd disn't walk until 20 months. But she had been premature and her walking age was adjusted for that so her first round of therapy didn't begin until she was almost 2. Every child is different. Low muscle tone can effect more than just walking. At 3 my dd could not walk up stairs, jump, keep up with same aged or younger peers, run efficiently, and so on all because of low muscle tone. The low muscle tone also effects her fine motor skills.
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Thanks you all for some perspective on this, & hearing from folks who have had the same problem. With my first dd, she really did just decide to walk, and there was nothing at all wrong with her. So my perspective is a bit skewed because of that experience. I'd love to hear from anyone else who has done PT with their baby/had low muscle tone issues etc.

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Well, my son started PT at 6 months also with low muscle tone.

 

When he started walking (17 months) they kept him for another month or two and then discharged. Things seemed great to me but he ended up back in sometime past 2 years old though I can't remember the exact age. At that point he was doing all he should have been except jumping. However, his form or technique was compensating for the weakness and needed work. Particularly, he needed orthotics to stabilize his foot as he was rolling the ankle. I would have never known. I guess I'm saying it may have looked ok to me but it wasn't really ok and I do think the additional PT helped him.

 

I'd go with the PT's assessment of need particularly since you've got a low muscle tone child rather than a simple gross motor delay.

 

Side note not for OP: It's not officially late walking until 18 months.

Edited by sbgrace
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I would quit as for me, it was a big time eater. My DD is not going to decide to be fine one day and never need services- she has CP (high tone) and will always struggle with some things but at a certain point we realized that PT was not doing anything for her. We could do everything at home on our own if we wanted and she was not regressing or progressing with her PT. We pulled her out against their wishes and she has not regressed in almost a year and has actually made a lot of advances on her own! She was in therapy at your child's age for her tone issues too and it was a complete waste of time because she was not compliant at all. She just refused to do whatever they wanted and kicked and screamed if they tried to make her. When she was older she was better and more cooperative but after a point, you sort of get a feel for what they are doing and why and can do it at home just as well. I am sure she will eventually regress because that's the nature of her disability but the PT could not prevent that cycle. When she regresses, we'll put her back in therapy for extra help for a while, but it shouldn't be forever. We know what to look for and her pediatrician also keeps an eye on her. Also, with low tone she should at the least be seen and followed by an orthopedist or neurologist for a while. If he or she thinks that she is doing well and therapy can be done at home for a while or if he or she recommends going back into therapy or additional treatments, then you can be confident that you are covering your bases. I doubt that our therapists would ever have suggested we quit services and our insurance covered 100% so it wasn't my money but it was my time that was being wasted. And also, I thought the constant therapy was not good for my DD's spirit.

 

Similarly, my girls had state funded EI for speech from about 15mos-2 and I requested that they end their program when they were meeting all of their goals and exceeding the averages for their peers. Again, I had to ask to leave because they would have kept me in as long as they could have. I just felt it was becoming a waste of our time and it was no longer necessary. Now, my girls definitely needed their therapy at one point as they were extremely delayed but I have had many therapists and we see many specialists and have only had 1 who didn't keep asking us to come back (a cardiologist) and we have had to decide on our own that no further appointments are necessary with some of them for the time being. I sort of feel that once you get on the therapy or specialist track they never want to see a client or patient leave! Sometimes there's a valid reason for all the follow ups and sometimes not so much.

Edited by Paige
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It sounds like it would be reasonable to discuss this with the PT. The PT can probably tell you whether there are still any delays to concern yourself with or reason to belive that lack of ongoing therapy may cause an issue down the road. It isn't fool-proof, but it'll give you a little more information by which to make a decision.

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None of my dc walked before 15 months, not even the one that rolled over at 6 weeks!

 

Low muscle tone and not walking by 15 months aren't the same thing. Though low muscle tone can cause late walking, it is not the only possibility. I suspect your MDs did see more, just used the not-walking thing as the simplest excuse, and your dc has gotten something from the PT - the muscle tone has improved.

 

 

 

:iagree: A stitch in time...

 

I have 5 dc that walked at 15 months or later - 2 at 18 months and 1 at 22 months.

 

I would talk to the PT about new goals since it seems that the old ones have been met!

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I talked to the Early Interventionist yesterday and she indicated that Clara's meeting her goals, wanted me to talk to PT to discuss it further, which I will tomorrow. She doesn't have CP or anything, and I have been told nothing that will indicate she won't get over this and be completely normal. One thing that bothers me with the Early Intervention programs and all the stuff is that my MD in particular, and I think lots of the younger MDs (including my sister who said the same thing) are taught that at 15 months the child must walk or something is just wrong. I don't think it's that simple, and I wish they'd give babies more credit and time to figure things out, when there is no obvious major problem--like CP with symptoms apparent from birth (I think that's how it works). Clara's development has otherwise been totally normal, and her fine motor skills are great (especially when she's picking up little things and eating them!)

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I'm a little confused. You said in your OP that she had low muscle tone in her legs. Is that an assumption or she really does have low tone? Because low tone doesn't go away with time (nor does PT improve it for that matter).

 

If she was placed in PT solely because she wasn't walking at 15 months that's too bad in my opinion. That wouldn't happen here or anywhere else that I know of as that isn't a delay or concern. Crawling isn't a motor skill so the butt scoot thing is insignificant as well by itself. On the other hand if you've got tone issues that will be something to watch going forward whether PT is still needed now or not.

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I'm a little confused. You said in your OP that she had low muscle tone in her legs. Is that an assumption or she really does have low tone? Because low tone doesn't go away with time (nor does PT improve it for that matter).

 

 

What she said. True tone issues are a neurological issue and won't go away completely. They can be managed, they can be made to appear as if they have gone away for a time to outsiders but it isn't going to disappear if it is really low tone.

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