Wednesday, November 30, 2011

Physical Evaluation: A Place To Start

Today a physical therapist and an occupational therapist came to our home to evaluate Noah for participation in the "Early On" program. They did a test that measures Noah's development against the average child. They also asked, and answered many questions. The results of his test weren't exactly ideal, but far better than we thought they may have been a month ago.

The pair asked us all sorts of questions. About his feeding, his activity, movement, vocalizations, you name it. And then they gave him a little test. But like they said, there is little they can truly know about his condition this early in life, but any score will give us a baseline to work from. They were also impressed with how much we seemed to know already and what we had been paying attention too. Which i credit to U of M hospital's amazing support staff as well as good old internet research.

As far as results, They don't really say all that much, and a lot of it is kind of confusing...

The results are tallied up and given a number score with 8-12 being the "typical rage." This number is then translated into an age that marks about where the child is compared to their actual age. This is where things got confusing to us. Noah was considered 6 weeks for the testing purposes even though he will be 7 weeks tomorrow. (they wont count a week until the actual day) Quite a few of his areas came back as "0 months" but he got a score in the "typical" range...basically saying that he is still very young for this sort of testing and the ranges are so large that at such a young age it can seem like a lot.

Here are Noah's development scores:



  • Adaptive
    • Self care - 8 points - age equivalent 0 months 
  • Personal - Social
    • Adult Interaction - 8 pointsage equivalent 0 months
    • Self Concept  - 4 Pointsage equivalent 0 months (mostly based on vision which is one of our areas of concern ) 
  • Communication 
    • Receptive Language - 9 pointsage equivalent 0 months
    • Expressive Language - 10 points - age equivalent 0 months
  • Motor
    • Gross Motor - 12 points - age equivalent 2 months
    • Fine Motor - 10 points - age equivalent 0 months
  • Cognitive
    • Attention / Memory - 7 Points - age equivalent 0 months (again this test is mostly based on vision)
    • Perception / Concepts - 8 points - age equivalent 0 months (vision again...)

So all in all these weren't the greatest results we could have hoped for. But the therapist said that some of them were probably artificially low. but some may also be artificially high due to not really being able to test properly due to Noah's age. 

They pointed out a few areas of concern: Vision, Hand clenching, Not turning to his right, and excessive tone in his left side. All things I was aware of myself, but had no confirmation of. They gave us some tips on how to get his head moving better, and how to get him following with his eyes more. So we will be adding that to his daily exercises. 

Noah was accepted to the program not as much for his scores, but because of his history of brain damage and seizures. They seemed optimistic about his outlook, which is always good! But as with everything with a child with a developmental disability, it will be a long road. We meet again on Monday to get the paperwork out of the way and set up our first appointment. They will give us the option of weekly or monthly visits. We are hoping for more of a bi-weekly arrangement which will fit our schedules as well as get Noah extra care. 

So begins a new chapter in Noah's Ordeal....

4 comments:

  1. It's wonderful that he is getting help now at this early age. It sounds like a good program.

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  2. I am sure the results are a bit confusing for you but they are baseline. It is hard to test infants this young but at least it gives you a few focus points as well as exercises to help strengthen the weaker areas. You and your wife are very diligent with researching your son's condition which is really going to give your son an advantage.

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  3. Hey Ryan- I'm Sophie's mum from the Sophie's Journey blog, just following you back here to say hi. I love your blog and I love your attitude- you guys sound like you're ready for this fight, and that means huge things for Noah.

    Gross motor and vision are really the two most important areas at this age, in my experience, so it's great that his gross motor skills are age appropriate. And vision is an area where a lot of different kinds of therapy can be called into play, depending on the cause of any delays or deficits.

    All in all, you're exactly right when you say it's impossible to predict outcomes at this stage. But you might be surprised at just how many people out there are fighting the same fight as you right now- if you're on Facebook, please check out the Newborn Brain Cooling page (400 HIE families) and the Hope for HIE Foundation page (the private forum for families of HIE kids there has about 170 members). There's also a third page called Beautiful Faces of HIE, which I don't admin. And lastly, there's the Yahoo HIE Support Centre group if you're not on Facebook, which is also private- you can request access here:

    http://health.groups.yahoo.com/group/HIESC/

    The benefit of these groups is that they're full of people who've had the same worries (and ones who have them right now), and no question you have will go unanswered because of the very wide range of experiences. It's also just good to know that there are others out there who know exactly what you're going through at the moment and can support you.

    I'll keep following Noah's story, and I have my fingers crossed that he'll keep on doing great things.

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  4. @ClairGregory, I linked Ryan to your blog about a month ago, to give them hope. It's amazing that now you are following Noah's story! Sometimes the world is so small!

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