Monday, February 8, 2016

Therapy evaluations


Wait, making grilled cheese sandwiches isn't part of the test?
Allie had OT and PT evaluations last week.  She's been out of OT for about 7-8 months and, while we've thoroughly enjoyed the break, it's nice to check in.  The OT said that Allie is doing really well (particularly with her elbow isolation) but could use some more wrist stretches and strengthening. We'll be doing a handful of OT sessions to get some fresh ideas and see how things go.

The PT evaluation was more standardized, using the Peabody again (here's her last evaluation).  I'm including more information than usual because the write-ups reference some of the information directly.


Stationary
Raw Score: 57
Age Equivalent: 67 (She's currently 59 months old)
Percentile: 63
 
This subtest measures a child's ability to sustain control of her body within its center of gravity and retain equilibrium. Allie has improved from a raw score of 55 since August. She is able to stand on her left leg for 19 seconds and her right for 4 seconds. She can stand on her tip toes for 8 seconds. She is able to imitate 4 movements with her arms. She completed 21 crunch like sit ups in 30 seconds. She completed 5 push ups which was impressive. She will soon max out of this category (max score 60).


Locomotion
Raw Score: 172
Age Equivalent: 63
Percentile: 50

This subtest measures a child's ability to move, including running, hopping and jumping forward. Allie has improved in this area from a a raw score of 167 in August.
Stairs: Allie is able to complete a reciprocal pattern ascending and descending the steps without the rail 
Jumping: Allie is able to jump down from a 21" bench landing on her feet. She is able to jump forward 33.5" with both feet. She can jump over a 9" hurdle. She can jump forward on her left leg 13" and jump up with air time. She is able to hop 8 times on her left leg and 1-2 reps on her right leg with a break in between. She can complete a turning jump and jump sideways. She can hop on her left leg across the room in 4 seconds. Harder to hop on the left and then switch to the right. Hopping on her right foot is a huge accomplishment but this was her biggest limitation in this section
Balance: Allie is able to walk on her tip toes on a line. She is also able to walk on a line with work on tandem pattern and backwards without heels touching toes.
Running: Allie is able to run 45 feet in 4.97 seconds. She runs with a flight pattern but no arm swing on the R. She is able to run and stop within 2 steps with a verbal cue. She is able to run and retrieve an item in 3.28 seconds. 
Other: Allie can complete a forward roll without deviation from the center
Gallop and skip: Allie is able to gallop. She attempts skipping but with decreased smoothness. This is another area to focus on.

Object Manipulation
Raw Score:41
Age Equivalent: 50
Percentile: 25


This subtest measures a child's ability to coordinate arm and leg movements in order to manipulate balls (catching, throwing, kicking). Allie scored the same in this area as she did in August.
Throwing: Allie has a very strong throwing arm on the left. She is able to throw over and underhand strongly. Still working on accuracy. From 5 feet away she is able to throw to a target accurately 2/3 reps underhand and 3/3 overhand. More challenged from further away, 0/3 overhand.
Kicking: Allie is able to kick the ball across the room but not in the air.
Catching: Allie has improved with catching but it is still inconsistent. To catch a ball she needs to bring the ball to her chest to trap it. She is able to catch a ball if she brings it to her chest. She can catch 1/3 reps with her left arm alone if she brings it closer to her body (not hands alone). She was able to catch a bounced ball 1/3 times.


EVALUATION
Allie has improved in 2/3 of the areas in the Peabody. She is on target for her age. We have not focused on catching much these past several months. She does very well with throwing. She has greatly improved with her jumping skills especially hopping and single limb stance. We will continue to work on right leg hopping to progress skipping and higher level motor skills.

Continued physical therapy will address:
Body Functions and Structure
  • Balance
  • Endurance
  • Range of Motion
  • Strength
  • Hypertonia
  • Flexibility
  • Gait
  • Coordination 
Activity Limitations
  • Unilateral stance
  • Walking on uneven surfaces
Short Term Goals:
  • Allison will gain >5 degrees of right ankle dorsiflexion to help prevent tripping and optimize gait pattern. Time Frame: 2 months. Goal Progressing
  • Allison will be able to perform single limb stance on each leg x3-5 seconds demonstrating improved balance. Time Frame: 2 months. Goal Met on 10/14/14
  • Allison will be able to step onto uneven surfaces without falling 3/5 reps demonstrating improved balance. Time Frame: 2 months. Goal Met on 10/14/14
  • Allison will be able to jump over a 6" hurdle with a two foot take off and symmetrical landing. Time Frame: 2 months. Goal Met on 01/13/15
  • Allie will be able to walk across a 4.5" balance beam in tandem with a 3 second pause without stepping off. Time Frame: 4 months. Goal Progressing: Able to walk across and is starting to attempt tandem 8-18-15
  • Allison will be able to hop on one leg 10 reps each without support. Time Frame: 5 months. Goal Progressing: 2-4-16 Able to hop on her left leg 8 times and R 1-2 reps. Will continue to work on right leg hopping
  • Allie will perform single limb stance x20 seconds on each leg without additional support for balance or grounding. Time Frame: 3 months. Goal Progressing: 2-4-16 able to stand on her left leg almost 20 seconds. Right leg is more stable at ~4-5 seconds. Continue to progress stability.
Long Term Goals:
  • Allison will ride a tricycle without leg stabilization x10 feet. Time Frame: 4 months. Goal met- Allie is able to ride a tricycle without leg support now.
  • Allison will be able to catch a >5" ball with 2 hands 3/5 reps. Time Frame: 4 months. Goal met 10/14/14
  • Allie will be able to gallop with a smooth pattern x15 feet. Time Frame: 2 months. Goal met 8-18-15
  • Allie will walk with a consistent heel strike or heel contact without catching her toes >75% of the time. Time Frame: 3 months. Goal Progressing:
  • Allison will be able to consistently complete a reciprocal pattern ascending and descending the steps with one rail or less. Time Frame: 4 months. Goal Met 2-4-16. Able to complete much more comfortably down the steps now without the rail
  • Allie will be able to skip smoothly >10 feet without stopping or loss of balance (2-4-16). NEW

1 comment:

  1. Tell Allie I can't wait to make Grilled Cheese sandwiches with her! Glad she doing so well. She's my hero!

    ReplyDelete