QRI and CP
Haley Age 26 months. Initial Evaluation: 9-01-15 at 23 months.
DX: Right Hemiplegia, Cerebral Palsy, Optic Nerve Hypoplasia, Epilepsy
Initial evaluation: Haley had minimal active movement in her right upper extremity, her arm just hung in place. She was unable to raise her right arm at all as in a “high five” movement. If an item was placed in her right hand, she would attempt to grasp it but was unable to maintain a sustained grasp for anything over about a second. She had total neglect of the right side. She was also blind in right eye and vision was low in left eye. She had limited verbal skills – maybe 15 single words. She wore a right AFO and has significant foot drop. Feeding: Client stuffed her mouth and required direct line of sight for eating. She was able to drink from a certain sippie cup independently and can take single sips thick liquids open cup with an adult holding the cup and monitoring the liquid flow. Noticed patient lose liquids anteriorly with thin liquids open cup. Extreme tactile defensiveness and sensory processing disorder. Unable to self-soothe and did not sleep through the night. She presented with fluctuating muscle tone, decreased strength, decreased coordination and was easily frustrated. She was unable to get herself into a standing position independently due to the right sided hemiplegia.
Began QRI protocol in October 2015. In 4 short months, she is able to do the following;
- Raise right arm in a “high five”
- Open right hand and grasp easy to hold on to plush toys, maintain a grasp for about 2 seconds and intentionally release the object.
- Neglect of right side improving as noted by her calling her right hand / arm “righty” and looking at it as she said the name.
- Visual scanning slightly improved as evidenced by her tracking a slowly moving object across midline while maintaining a visual lock on the object, tracking is not smooth
- Verbal skills have increased to two word sentences, almost on age level
- Stuffs mouth during feeding less, overall feeding and drinking skills have improved, continues to require direct line of sight for monitoring of mouth stuffing
- Can now drink from several types of sippie cups, one straw, can now blow and take single sips thin liquid no anterior liquid loss
- Tactile defensiveness and sensory processing have improved, parent is extremely proactive in helping with this area
- Sleeping through most nights
- Coordination has improved, she is able to reach across her body with minimum assistance to reach for toys and get on toys with minimum assistance or stand by assistance
- Frustration tolerance is improving slightly. I took two weeks off over the Christmas holidays and noted a significant regression in above skills, most noticeable was the regression in motor skills. Her body reverted back to minimal use of her right extremity, and she had no interest in using her right arm -and verbalized that also.
She requests the laser be placed in certain spots on her body – especially her back. I continue to look forward to seeing this little girl progress, it is quite exciting.
Rosemary Slade is a pediatric occupational therapist, practicing in Texas. She uses QRI daily with her clients. She can be reached at: email@example.com and her website is www.RosemarySladeotr.com
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