Development Assesment

Janelle is coming to 3 next month, mummy gets very worries of her development. Her classmates are having much more improvement than Janelle. and janelle had one huge problem, is that she cant sit still and listen in class. If this she cant do it, how can i sent her to mainstream?? So I would like to solve this problem, and had been seeing KKH OT and School OT for coming to 1.5 years, no improvement with her at all, so now i started to looked out.

Referred to Tr Sanjeey, a senior OT from ex-rainbow who had sees many special needs children. He did a developmental assessment for janelle and a few points and goals he set for Janelle:

• Although Janelle is 3 and can walk, but her development is at about 8 months... she doesnt walk freely.. she will locked herself by facing down to walk.. this gives her the control of herself not falling... but she dont look left and right or even front.. that's why she tends to trip and fall or knock into some things.


• Her truck muscles seem to be very weak, hence she cant focus while sitting down.


• She needs to do things with a meaning.. She can do it... Now activates to her are meaningless hence she is not learning and progressing.


• Need to get her seizure controlled, else we will be going round the cycle.. today she can do it.. after seizure... she cant do it again..

Tr Sanjeey mentioned that he will start sourcing for toys for janelle... toys where she will enjoyed and learn something... and will start with her next weeks and need something that she can had a huge progress to catch up.

All the above he mentioned, it's all very challenging to me. after the assessment, i got burned out, feeling very low and depressed. Asking myself what else i can do.. how can i do better??

Next day we had an OT at KKH, i flagged out my concern with the therapist. and then she did a reviewed with janelle and restructured the program. I dont like KKH OT as they dont set a goal for janelle... they are doing the same thing each session without assessing much on her... even there is no improvement, nothing changed till parents flagged out. Will be dropping KKH OT.

Met GH, Janelle's PT outside the OT room.. she asked me how is Janelle.. I gave her a sigh and when we talked, i have no ideas why my tear just flowed down infront of her... so embarrassing.. She wanted to meet me over the weekend to catch up, but i know she has 2 kids to take care, so didnt want to disturb her free time. anyway, thanks GH!!

After the OT, we had doctor reviewed on the same day. The same old things.. "let's monitor and change drugs.", i didnt asked much and just returned with a smile and "Ok".. just before i stepped out of the room, dr asked if i need parents support, he can help me to arrange... The OS in me is that "as long as you can help janelle... that's already helping me"... i shaked my head and walked out the door with tears around my eyes.

This strong mommy no longer strong.... these 2 days i tried to escape from janelle.. have been going to into office to take some time off away.. so that when i returned home, i have more energy and appreciate every minutes with her. i really dont know what's the next step i can try... told me hus, let's try TCM... but his silent had tell me off. what else??

God, you gave me pretty janelle but you forget to give me her health.. can you return it to me... I just want her to be a normal child who goes to school like normal kids.. play, talk and run around like them...

Speech Therapy

29th April 2010, Wednesday

We skipped the hydro-therapy and went for one to one speech therapy session. Teacher Dino monitored Janelle's feeding skill and had came out a home plan for her.

Plan, to control her drooling:
1. Massage: help to simulate the jaw muscle
2. Tools: to get some tools for her to chew more
3. feeding: feed her at the side of the spoon, and wait for her to take the initial to bring the food into the mouth
4. food: to give her more chewing food likes baby bites, bread

Speech Therapy

21st April 2010, Wednesday

Today Janelle had a special session with the speech therapy in her school. She was reviewed on her feeding and here's the comments from ST:

1. Janelle has very weak jaw muscle, hence she dont suck or chew
2. Janelle has very bad sitting position. Cant be stable

Things to do,

1. stop the ikea high chair, that's no good for Janelle cos there isn't foot rest hence she will keep her weight to one side.

Physio

05th Jan 2010, Tuesday

yesterday afternoon, i took off to bring janelle for physio.

according to the therapist, janelle can stand better but her left leg since not in her control, always will go on awkard position.

1. let her stand more, especially on her left leg.
2. more ball practice, need her to have more control on upper body so that she wouldnt throw back for often

will be going to therapist session these months, as janelle delay gap is getting bigger and bigger.
had arrange for 2x a month till we can get into EIPIC.

Therapy had put a remark to recommend for EIPIC, and yesterday night, we received the call from social worker saying that doctor had give her approval and 2 weeks later i should be receiving calls from the center.

Physiotherapy - 1

Today we had our first physiotherapist session. Ms Ong noticed that from the last meet up with janelle, she had improvement.

According to Occupational therapist's notes, janelle tends to push herself backwards. In today's session, we have noticed that these had reduced.. So now she is able to sit very well. :)

today session lasted 20 min, as usual, janelle didnt co-operate, she was crying... so daddy bring janelle walk walk while mummy listening to therapist on what exercise to help janelle to improve.

this week homework:

1. put her more on kneeing position

2. put her more on side way and allow her her to support herself

3. encourage her to play with toys and also her legs.

Occupational therapy (1st session)

Today we went for the first session of occupational therapy at KKH's rehab center. After 20 min of moving Janelle here and there, she gets angry and the session came to a stop. I have make used of the reminding 30 min asking questions.

Recommendation from the therapist for Janelle

1. Reduce the time lying on the bed, truck no energy, continue lying down will make the truck no improvement. Remove the walker from her, she is picking up the wrong method to stand.

==> Put her on bumboo chair instead.

2. Give her hard object to hold

==> Let her learn how to hold

3. Guide her to take things

==> Gentle guide her hand towards the object and wait for her to take the initially to reach out for the object and not pull her hand to the object.

4. Increase the time for rollover

==> Gentle push her backside to sideways and wait for her to take the initially to roll over and not roll her over.

** Have to give lots and lots encouragement to Janelle for initially

Comment from therapist:

Janelle is not lazy, is just lack of explorsure

==> Mummy really don't know what kind of exposure should give it to Janelle. I think i need to go and get some books to read up. When i says i want to get the cot mobile, kogan stopped me. And when i says i want to get the bumboo chair, kogan stopped me too... hmm.. now mummy will buy everything i think is needed for Janelle and dont listen to daddy anymore.. Daddy, don't say mummy anyhow spent money, i'm giving Janelle exposure...

Told my sil that i can borrow the bumboo chair from amanda yiyi, but she says "I buy for Jing Xuan, dont need to borrow". And she went to mothercare and got it immediately after the session and get a bumboo chair $85 and a toy $14.. (paid by gugu).

Today session cost $70, therapist says she would like to see us every 2 to 3 weeks.. ask me if i'm ok anot.. cos i'm paying at a private rate of $70 every session is expensive.. to get subsidies, i need to downgrade my class in KKH. If downgraded, we will not be able to see the same doctor (dr derrick chan in neurology's) and not be able to see the same therapist each time. errr... and the price we going to pay is 40% less... still considering