We're going to do another three+ weeks of contraint-induced therapy. The cast goes on today. I am excited because I know Shelby is at a critical point right now with leftie where she has a ton of potential to increase its use. Her left arm and shoulder have become much stronger since she began crawling in earnest last fall. I am apprehensive because she is going to hate having this cast put on and I don't like for her to be unhappy. Thinking about Shelby's round of CIT when she was six months old helps remind me how worthwhile this therapy will be though. Before she was casted two years ago, Shelby did not even realize she had a left arm. By the end of the three weeks, she was using leftie to put pacifiers in her mouth. Remember this amazing video:
Payoff like this makes the three difficult weeks so worthwhile, but this skill of using leftie to hold a paci disappeared after the cast came off (because she could more easily use rightie). If you remember from last year, we did constraint therapy a second time but it was a bit of a fiasco. Shelby's friends at school helped her pull the cast off and "free" her early on in the process, and she kept taking the cast off regularly after that. This time around we will do things differently. The cast will not be a bi-valve, so hopefully it will be impossible for houdini girl to remove. We are also drastically increasing her OT and PT schedules for the next three weeks. She will have OT seven days a week, starting tomorrow (sometimes twice a day) and PT two times a week. We are lucky to have an OT who is as excited as we are about CIT and that is willing to work so much with Shelby during this three weeks.
Our main goal here is function. Shelby knows leftie doesn't work like her right arm and hand and has started attempting to intentionally use leftie to help her hold objects, but she struggles a great deal with grasp and release and cannot use leftie to do anything with the object. We'd like to improve this, but are breaking this goal down into increments. For week one, we want Shelby to begin reaching with shoulder flexion (>90 degrees) and to move the shoulder without overcompensating with her trunk and chest. We'll keep you updated....CIT here we go again!