United Brachial Plexus Network, Inc.

Josh is 1 year old, and 7 months post nerve graft. He has had finger movement since birth, and it has gotten better since the surgery.
The problem is that he does not use his hand even though he has functional movement. And when we put things in his hand, he does not feel them. He doesn't even feel pinches on his hand. Is this normal to have movement without sensation? I always thought that it was normally the reverse. Will his sensation return with time? I am thankful that he has movement because as he grows older, he will be smart enough to use his hand to function despite the lack of sensation, as opposed to feeling things without being able to move. I'd appreciate any insight.

you just descibed Jade to a tee. hand movement but will forget she is holDing something until it falls. we are sencery intagration (SP?) in her therapy. she has gotten better. we do a lot of SAND, RICE, VIBRATING THINGS,KOSH, AND HOT @ COLD WATER. oh yeah alot of those books called touch and feel by DK publishing.

Josh may have some types of sensation, but not all or everywhere in his hand. The different sensations come from different nerves. For instance my daughter picked up a top from a lit pumpkin and her fingers got close enough to get a blister, she didn't cry or feel it. A few days later she shut her fingers in the drawer and cried for 20 min. that it hurt (I was having a hard time being sympathetic to her pain, when I was so excited that she felt it). Josh might feel pressure or a tickle, hot or cold and not pain. But my suggestion is the same as Crystal on gathering sensory items. We did a ton of sensory intergration with Emily. I went to the fabric store and hit the scrap table. I had every type of fabric, fur, felts, vinyls, feathers... you name it and had them cut into strips. Just stimulate and stimulate, then stimulate some more, to try to awaken those nerves. Also on the bicep, our daughter had primary surgery at 6 months old. She had no movement at all until 4 months, post op, with the bulk of her return between 6 - 9 months. I think hand to mouth after primary was around 7 or 8 months post op. Don't give up hope yet, just keep trying to encourage that movement and streghten the bicep. Thinking back, waiting for function to return after the primary surgery was one of the hardest parts of this to go through. Keep us posted on how Josh is doing. Best Wishes to your little guy.

Julie Wolfgram

What is normal with this injury really? I don't know. I agree and I would think the same thing that you might have sensation before movement, but I'm not really sure if there's a typical pattern of what comes first. There are also different types of sensory nerves too -- just to further complicate things. For ex., at some point, he might feel that there is water on his hand, but might not be able to determine the temperature of the water. I've done a little ice therapy with Nicole and I've found that she likes the way it feels in the palm of her hand. I think she feels something b/c she likes it, but definitely not fully b/c she doesn't seem bothered by the temp. of the ice at all (I'm very careful about it and don't do it for very long). I think that I worry more about sensation than I do movement b/c it's scary to me that Nicole could burn herself or hurt herself in other ways w/o knowing it.

The others gave you some good ideas about stimulating sensation. We have a sensory bag with all sorts of different textures. We too went to the local fabric store and picked out lots of different fabrics. Guess what -- they'll cut swatches of as many fabrics as you'd like and they won't charge you for them! We also got a neat therapy brush from Nicole's Early Intervention OT. Plus we have different sponges, brushes, koosh balls, vibrating toys, etc. in the sensory bag. I also massage Nicole's arm / hand everyday. She loves the massage and sometimes helps to do it herself. Maybe you could ask Josh's therapist to show you how to do some ice therapy too. Of course, be careful. Other things you could do is to let him rub things on his high chair / booster seat tray -- such as baby powder, pudding, jello, etc. It's kinda neat to watch that b/c you'll see some overflow movement going on by him using both arms. Well, I hope this helps. -Tina )

P.S. There are a lot of sensory items in the catalog "Sportime Abilitations." You can order the catalog by calling 1-800-850-8602. The co. is located in Atlanta. They also have a website www.abilitations.com, but the last time I checked the site only had a small portion of the items that are in the full catalog. The prices are high b/c it's a therapy catalog, but you could just use it for ideas of things to buy or make yourself for a lot less money. -Tina )