Week 4: Entry 2

Today I saw my client who I am doing my SOAPIER for the 3rd time. He is 20mth old with history of chronic renal failure from birth. He is an incredibly petite child who is very weak and dependent on his mum. When we first saw him he was bunny hopping, not crawling, and not pulling to stand but would pull to 2 pt kneeling. However today, after home exercises and physio that promoted increasing strength especially in upper limbs, the movement experience of pull to stand via 1/2 kneel and improving his endurance, he was stepping for the first time when held in standing at his arms. Although he is still very weak, he is also trying to pull himself into standing and will take more weight on his ULs in 4pt kneeling although greatly resists it.

He is a very difficult child to treat as he cries and screams with all activities and will strongly extend his neck and body to get out of a challenging position. He would be the baby that is the most resistive to physio sessions, which may be impacted on by his severe medical history. Mum is very understanding of the importance of physio for him and will take in all exercises you give her and ask if she can have a turn so she know's she is doing them right. I admire her perserverance as she has been through so many hard times with him and is constantly seeing different allied health professionals.

Although I am not performing the exercises with him, I have learnt a lot being able to observe the sessions and also get the continuity of seeing him a few times and the changes that occur in a week. Although most babies will crawl before the walk, the main goals for this little fella is to get him pulling to stand and cruising then walking and then later in a year or so come back to crawling when he has greater overall strength and endurance.