After a weekend in London and visits from family we embarked upon Week 2 of Bobath.
We had a lot of involvement with physio in the first week but now it was Athena’s turn to show us her Occupational Therapy (OT) tricks!
We had never really had any OT involvement other than with some equipment so Athena opened our eyes to a very much more functional view of therapy. We had asked her to have a look at dressing, drawing and eating for us which she set about with gusto! Another note worth mentioning is that although these OT sessions were lead by Athena the MDT approach of Bobath meant that Marie didn’t ‘pop for a coffee’ but aided and developed the work.
Firstly Athena sat with Charlie and asked him to take his AFOs off. Charlie looked perplexed… ‘take them off?’, with all our efforts helping our boy we had never actually involved him in putting on and off his AFOs so he was clueless. We would just put them on and pop them off ourselves- simply for timeliness. Athena spent some time helping Charlie become aware of his AFOs and his legs and the positions that made manipulating them easier. She found that popping Charlie’s leg up onto his other leg and pulling his ankle up onto his thigh meant that his tone dropped nicely and he could grab his shin, thumb off his shoe and start unstrapping his AFOs. Within minute Charlie has learnt the principle of taking off his aids- by doing it for him we had stripped him of the opportunity for the learning required to do such a simple thing. She moved to dressing and held up a tee shirt- ‘which is the top Charlie?’, again he seemed a little confused and didn’t seem to understand that a tee-shirt had a top and bottom, front and back or waist, head and arm holes! Whoops- our rush to get Charlie ready had skipped a vital stage of development.
Fantastically, within a day of this session Charlie had already shown a willingness to ‘do it himself’ and an interest in his clothes etc. Within a few days Charlie knew how to orientate his clothes and could understand what he needed to do to put them on. Particularly his upper clothes- he still finds his pants, trousers and socks difficult but that is more to do with his disability as opposed to not knowing how.
Athena also was interested in Charlie’s manual abilities and dexterity. We told her how Charlie likes ‘crafty-things’ and how we weren’t sure whether he was right or left handed. She told us that some children haven’t decided at Charlie’s age but that in view of his disability he would use the hand easiest for him not necessarily his ‘handedness’.
She set Charlie up and immediately targeted his seating. By getting him sat better she was able to ‘free’ him up and reduce his tone by keeping his head back, sitting straighter. She felt that his dexterity and control were a little immature and got us to target shape drawing to help his hand-eye co-ordination and perception of shapes. Using a writing slope also helped Charlie sit up straighter and not have to reach as far.
Charlie had been much better with his drawing since these interventions- we purchased a writing slope and our NHS OT equipped us with writing grips and perceptual exercise books. We hadn’t noticed but Charlie had been increasingly getting us to do pictures for him- we just thought he liked our drawing but it was becoming difficult for him and so he was purposely avoiding it. He’s now back into happily drawing and we ensure we send a wedge, writing slope and grip to pre-school with him every day…