this damn PT is going to be the death of me!

i am not sure if everyone remembers but i have a pt come to my home through ei to work with the boys.
one is doing wonderfully; stands, almost walks everywhere, doing great.
the other? he cruises a lot; crawls when he wants and is beginning to take steps. she thinks he's going to have speech delays because he has such low tone?!?!?!??!?!! ARE YOU KIDDING ME! i was going to get another PT but their 3 month eval is in august and i told myself to suck it up and then get a new one.

im very upset now.
im worried about him and that he'll have additional issues! she said his mouth shouldn't be open as much as it is and he drools excessively for a 14 month old.

any thoughts or experience with this?
should i be additionally concerned bc he doesn't keep his mouth closed all the time? still isnt walking, etc?

 

Sounds to me like a strange diagnosis for a 14 mo old who's probably teething right?? My girls have their mouths open a lot unless there is a binky in them. They drool constantly, I'm changing their clothes a couple times a day to prevent them from getting chapped necks, etc... I wouldn't read too far into that one!! That's just my opinion though, good luck!!

 

TY! he has 7 teeth but i assume they are teething??? he only has his top 4 and bottom 3. i mean this lady is out of control always saying things like this.
i am not saying he is perfect but i think she stresses me out more than i need to be. im anxious as it is!

 

I wouldn't wait until his eval. I have one son that is seen by both a PT and OT. From what I experienced, it is better to work on things right away. Just call your service coordinator that is assigned to your case and let them know the situation. Besides, at the 3 month eval. they are going to write new strategies and goals and it would be better to have them written by someone you trust than this person.

Good luck. I have been very fortunate with our therapists. But I know a lot of people that don't have good things to say about EI.

 

Well...Colin just turned 14 months old today and we saw a developmental specialist and OT last week. We were concerned because Colin's tongue still protrudes some though not a much as it used to. If you'll remember he was dianosed with hypotonia (ie. low muscle tone) much like your LO. The dev specialist and OT didn't seem too concerned about his mouth hanging open, they just said it was part of the hypotonia and would continue to improve. However, we also had EI come out to evaluate Colin 2 weeks ago and he qualified for services, speech therapy in particular, due to expressive language delay (which the dev specialist also confirmed) but also his eating issues. If I understand the EI side of things they think his hypotonia/tongue protruding issue is related to his eating issues (he often times chews on food and then lets it slide out his mouth, or he pockets the food). And my SIL is a speech therapist who says that hypotonia and tongue protrusion commonly cause issues with eating in babies. Has your son been screened for expressive and receptive language delays? If not that would probably be a good idea because if he does have such a delay then speech therapy would benefit him.

 

If he does have low tone, I am sure your pediatrician would have said something at any one of his well child checks. Open mouth is only one sign of hypotonia. It is more noticeable in the larger muscle groups. Kids with low tone often have trouble holding their head up, sitting, standing because it takes a good amount of central muscle strength to do this. I do agree with possibly having a speech eval done if they seem at all behind or if there are any eating difficulties because twins have a higher incidence of speech problems and so do boys. Are they saying any words yet? Understanding if you ask them to do simple tasks (give me the ball)? Responding to their names or the word no? Playing games like peek a boo? Responding to questions like "How big are you (Raise arms "so big")? If not I would definitely have a speech therapist evaluate, but that has nothing to do with tone.

I agree that the drooling is likely in part to teething, but it is hard to say without looking at him whether there is anything more going on. My DS's mouth is always open and drooling, but he is constantly mouthing, chewing or babbling which is why it is never closed. That is different than if he was just sitting there with it open and drool pouring out. As for his motor skills, I think they sound just fine. The average age for walking is 15 months. Note the word AVERAGE. That means some do it much earlier but some do it later. Milestones are just a guide, nothing else. They basically tell you the progression you should notice. If your son is cruising, then you know the next step is walking. If one were walking and the other were just laying on the floor playing with his hands, then I would worry. My DS started pulling himself up at 7 months, DD not till 10 months. DS was walking at 10 months, DD not till 3 days ago. They are different children and it does not mean there is something wrong with one if they do it a little slower than the other. Personally, I think EI is great for helping kids that might fall through the cracks, but if your boys were my patients, I wouldn't even think they need PT with what they are doing now.

 

I did not read the other posts...but didn't you talk about getting a new pt?? Get one!! You don't need somebody stressing you about the future. One day at a time. None of us know how much our children will or won't progress in the upcoming months and she should not make assumptions based on one thing. I had a 5 yr old in my class one year who literally could not have been more low tone..almost boneless (drooling and all) He was intelligible in his speech and age appropriate (not to mention social and bright!)

 

he responds to NO (he whines and gets upset if it's something he was playing with)
he responds to his name
he LOVES peekaboo. but he plays behind a door? he closes it and opens it again. but he does this with a cabinet, too. maybe it's not peekaboo??
he does not do, 'how big.' i've tried to get him to do that.

he says mamma, dadda and our dog's name. thats about it. when i saw ball or show him something like an object, he looks at it and his lips move but he can not mimic the word.

 

Take it with a grain of salt. At his age it's still early to come up with a definitive diagnosis. My daughter had a bit of high tone actually, but the physio was convinced she had CP. Our pediatrician and neurologist said no way. Now she is walking beautifully and is talking up a storm. Give it time, give him therapy, but I wouldn't continue with a health care professional you are not comfortable with.

 

Fourteen months is young!! Try to relax a bit and get a new PT. This person seems trigger-happy! I am sure it will all be okay, your boys sound perfectly normal to me

 

I think I'm really going to call today and get a new PT. I was trying to make it to the 3 month mark and she was trying to be 'kind' when diagnosing him but i knew what she was getting at! she told me low muscle tone and expressive speech delays go hand in hand and his mouth open and constant drool is a marker. he is not ALWAYS drooling and his mouth isn't ALWAYS open. :headbang:

 

FWIW, my son had his mouth hanging open with his tongue protruding for a very long time, so much so that I consistently asked his ped if he had Down's Syndrome. This was before I had any knowledge of other physical signs, of course, but I was always so concerned. The ped always told me he was just fine and there was nothing to worry about, and he was right. He's 6 now and still hangs his mouth open when he's concentrating or watching TV or over-tired. He has absolutely zero health or sensory issues and is very social, bright, and intelligent.

 

ty. his tongue doesnt protrude; he just hangs his mouth open a lot. i am not sure what to do ladies. do i call and get rid of her now or just stick it out until their 3 month eval at my house. would she come? it would be very uncomfortable with her here if she was no longer their PT lol!

 

You obviously do not like this PT (and haven't for some time) and no matter what she says you will probably second guess, even though she may just be trying to make helpful suggestions in the best interest of your LO, since that is her job. It seems like you are taking her suggestions personally. So I think you need to just call and ask for another PT that hopefully you will trust more.

 

Call and get a new one NOW!!! :lol:

14 months and drooling-- :woah: who would've thunk it?!

My youngest didn't walk at all until he was 15 months old, he's in PT because of his vision and even they weren't concerned and said that they don't even look at the walking thing until they are closer to 17 months and aren't making any progress (like not cruising) which yours is def. doing!
:hug:

 

I'm so sorry she has you so worried again That's one thing I can't stand is being told that there may be something wrong.. but they dance around the question and you're left wondering and googling and dissecting your dc's every action!

I never in a million yrs thought that a child could drool as much as my boys do. My dd's only used bibs for eating, these boys have about 20 each and need to wear them constantly. It just pours out of their little mouths. They are teething but even when they're not, they drool.

Everything you have said that he does sounds normal! I hope you can get another PT and soon!

 

When our PT made statements that pertained to 'diagnosis', etc. especially when she was thinking CP (which didn't exist) I asked her to write a formal letter to the pediatrician. This way the pediatrician knew exactly what she was telling me and could discuss it with me, or even call the physio him/herself to discuss it. The PT is not responsible for a diagnosis, the physician and specifically neurologist is. I think she is trying to be thorough and doesn't have bad intentions. You can either speak to her about her approach and your concerns, and also involve the doctor, or if you really can't go further with her talk to her supervisor or whatever and arrange for another physio. You are clearly stressed and health care professionals are responsible for providing appropriate care and involving you in a collaborative and caring manner (I know I am one!!!). Good luck

 

My boys are 19 months. One is very low tone and one is on the higher tone side. My low tone guy has terrible oral motor skills and needs to have his mouth muscles woken up with excersises before he eats. That being said he is the better talker and always has been and his words are pretty clear too. His Pt, Ot and SLP have never mentioned that he would have problems with his speech because of his tone so perhaps that is not always the case. Best of luck