Daughter born with OBP

[AZmom]

Hi, I so happy I stumbled across this website... our daughter was born on 4/4/05 with OBP in her left arm. She originally had no movement but now can move her shoulder, a few of her fingers and starting to move her wrist (left to right). She has been in PT but our therapist just informed me that she is leaving and moving into a different line of PT. The new therapist just called me to say that upon review of my daughter's case she has determined that she only needs PT once per month as long as we continue to do the ROM everyday. I wanted to get some feedback on if PT only once per month will be adequate or if I should push for more PT. Thank you in advance for your feedback.

[admin]

Our son is now 9 months and didn't have similar movement as your daughter though until he was 3 or 4 months. We started out with monthly OT at 2 weeks, and each month she would say that the next month we would start weekly, but we didn't really start weekly until he was probably 6 or 7 months. The challenge with weekly was that our son wasn't yet doing much with his strong arm (i.e., reaching for things or grasping toys), so you really can't expect him to do anything with his weak arm - so there wasn't too much the OT could do except ROM. I'm not an expert, of course, and it doesn't necessarily sound like this is the reason your new PT has said monthly, but just wanted to share our experience. Incidently, the one thing I regret is not putting him on his tummy enough. You might want to talk to the PT about that and see if your baby's arm is strong enough to be in that position (or how to position her). For all babies that really makes a difference for helping them crawl.

[BrokenWingedAngel85]

Welcome AZmom,
I'm not sure how severe your daugter's BPI is so I really can't say whether or not once a month is enough. My son is nine months old and is in therapy twice a week. We also do ROM exercises every day, and take him swimming once a week. If possible, I would ask your daughter's old PT and her pediatrician what they think. Good luck!

Johanna

[admin]

The BPI therapist by us (in Toronto) only sees her BPI patients once a month (if that) for evaluation. Otherwise, it was recommended that we do all of the ROM at home each day. I was never comfortable with once a month so I found another therapist (not a BPI specialist) who my daughter sees every 2wks. Again, I would prefer weekly but since the Ontario government covers the visits and there is a shortage of health care providers in general here, we don't have much choice, which is extremely unfortunate. For the 1st 5 months, we did the monthly visit to the BPI therapist and then at that time started seeing the other therapist.
Trust your gut and go with what makes you the most comfortable!

Take care and congratulations on the birth of your baby girl

Shellie

[anon for legal]

We had a PT tell us once a month was fine until our daughter was 6-7 months old when 'gross motor' skills started kicking in...........I was never comfortable with this (mother's gut feeling) so I found an OT that said that my little one needed once a week

The Physical therapist works with gross motor...ie sitting up, standing, walking, crawling
The occupational therapist works with fine motor skills....ie finger grasp, hand function, reaching, mid line crossing (arms cross over left to right) and hand tranfer, eating, and day to day life activities

IN MY OPIONION (not trying to start a fight) that most PT's work with and understand the lower body and that the OT's work with the upper trunk especially the upper extremeties (arms)

There are execptions to this: BPI Pt's (and some others)have specialized training in upper extremeties: but most pt's that I have delt with have said that once my little one walked there was nothing else they could do

Please go with your GUT...if you feel that the therapy is not enough then fight for more and try to find a OT to do an evaluation

[Mandie]

we did the once a month until sarah was a year old, then we went to every 3 mths for a year, then we had OT come to our house once a month for about 3 mths. We now do everything @ home and only call her PT if needed. Sarah has been doing great and didnt see the need to go more.

[admin]

My daughter had PT once a week and OT once a week and then we added more as she got a bit older. She needed PT because she was developmentally delayed. And she needed the OT because changes were happening often and we needed to watch and see the progression and splint as necessary as time went by.

BUT the most important thing that we got out of the therapy was teaching ME what it is that my child needed to do on a daily basis. I learned hundreds of ways to get her to move her arm. Like that commercial on tv - PRICELESS.

There were things throughout the years that the therapists caught and I didn't because I had no idea what I was looking for.

I didn't know how to teach my daughter to weight bear or to crawl. My other children did all these things on their own naturally - I never evaluated how they did it.

So obviously, I am all for weekly therapy. But then again, I only have the experience of my own child and she has a severe injury. I'm sure that the experience would have been much different if she had a moderate or mild injury. And this is why there are so many different opinions in this post. Every child is different and every injury is different.

[admin]

in addition to range of motion - give lots of sensory stimulation massage, rubbing different textures warm cool, patting - put a little jingle thing around wrist so the child learns there is an arm there. We didn't know to do any of that and it was never suggested to us and my son has a lack of brain /hand connection to some extent.

[Samsmom]

Hi AZmom

Where do you live in Arizona? I have a 20 month old son with a LBPI. I also live in Arizona. Who is the therapist that you are seeing? Write me an e-mail and we can talk further.

[admin]

I would push for more PT. My daughter also has a BPI on her left side. She started therapy shortly after birth. She was in PT 1 X weekly and OT 1 X monthly. I believe that the PT helped her so much. At birth she had movement of only her fingers and NOTHING else at all. Improvement started to become evident. As time went on I knew the PT along with us at home doing her ROM was working well. Since your daughter only has little movement at this time I would push for more PT. Maybe as she begins to improve even more you can lessen the appointments. If i were you, I would push and prefer at least one time weekly. Thats just me b/c I have seen what the benefits of PT are.
Good luck with whatever you decide.
~Krista~