Friday Therapy Day

Ann and Krista (OT & PT) visited Summer at Kids Camp to see how she is doing with her right wrist splint.

I love receiving these reports from Ann as they give me great material for the blog and some nice insight into Summer cooperating with adults, which I can assure you is hit and miss in our house.

Ann's report:
The visit was delightful as usual! Summer is such a character. I just love her.
Observations: the splint is a neoprene with a metal piece down the palmar surface moulded to fit her forearm, wrist and palm. Summer made a good attempt to get the splint onto her hand but needed some assistance to get it positioned properly over her thumb. The splint does a good job abducting her thumb into a functional position and it supports her wrist in slight extension.

Krista and I both noted that Summer is not keeping her index finger extended to the same extent that she was. She is able to flex it to touch her thumb and to help grasp objects.

Summer was using both hands during play when required. If she was able to complete the task with just one hand she used only her left. With cuing she would reach, grasp and release items with her right hand. She spontaneously and independently used both hands to separate duplo blocks - usually using the side of her right thumb to brace one block as she put pressure on an adjoining block with her left hand. She used both hands to hold open the heavy doors on our way outside allowing Krista and I through - minimal assistance was needed. She was able to achieve almost full elbow extension on the right. When riding as a passenger on one of the bikes outside Summer spontaneously held on with both hands - no reminders needed.

As usual Summer was talkative and very imaginative.

During play outside in the sand she was using a large bucket to dump sand. She readily dumps it to the left. To try to encourage some supination I helped her dump it to the right several times. She generally rested the bucket on the back of her right forearm to support it and used her left to tilt the bucket. She did not really use any supination of the right forearm in the process.

Assessment: Summer seems to be getting some better function back in her right hand. She seems to have more active control over the movement of her index finger. She continues to demonstrate good problem solving skills and uses her right hand functionally when needed.

Plan: schedule some visits at school in mid-late September. Investigate whether or not theratogs would be helpful to Summer's right upper extremity function - particularly with supination.