OT/PT question

It seems like a lot of members in the 1st year forum have twins who see a PT and/or OT. My twins were born at 30 weeks and are now almost 9 months old. They have been seen by neonatalogists, nurse practitioners, pediatricians, a pediatric cardiologist (they have PDA's), an eye specialist, etc. Yet, no one has ever suggested they should be seen by a physical or occupational therapist. Given that I sometimes have concerns over milestones and when they are (or aren't) reaching them, it has made me curious - for those of you whose kids do go to a PT or OT, why and what prompted your dr to refer them?

 

Eve was referred to early intervention (EI) due to her being high risk as a result of her very low birth wt. Lia was too big at birth to qualify but was referred because of her brain damage (a result of the TTTS). Eve has surpassed her sister in multiple ways but Lia is now officially delayed even when you adjust her age. She also has bilateral stiffness in her lower extremities that could be normal or it could be related to possible cerebral palsy. These two reasons are why she has been referred to PT. They are coming to evaluate her after the new year and if the PT thinks she needs it (which EI says she probably will) then we've been approved for once a week therapy. I don't see a need yet for OT and definitely not ST-she eats just fine

This is why we're going. Sometimes I wonder why I needed nursing school, lol.

 

Thanks for the response. It sounds like your twins are getting some great care/assistance. I just wonder if OT/PT is something I should be asking for or if it is safe to assume that if no dr/healthcare person has suggested it so far, then there is probably not a concern or need for it. It's one of those things where they have been seen by so many different people that you start to wonder if everyone is assuming that the other guy is taking care of it.

I think I will talk to their pediatrician in a few weeks at their 9 month appt just to be sure.

 

My boys were born at 31 wks and referred to ECIP right from NICU. They were seen by the Pedi from the ECIP center in NICU because all their prems are and my boys got their first appointments at 4 months. We saw them once a week for the longest time but now only go once a month. My boys didn't have any bleeds or any other damage that we know of they got referred simply for being prem and IUGR. I have found it very helpful and will keep taking the boys until they tell me not to. It is different here though because I do not have to pay for it which is maybe why more kids get referred? With my little guy he had a very high tone to his muscles which is gradually getting better and my bigger boy had a loose tone. After working once a week with PT/OT we were able to find positions and excises that have helped them a lot. Now they are on par for their corrected age which I didn't think would happen. I say if you have concerns it definitely wouldn't hurt talking to your pedi about it. The earlier the intervention the easier it is to help with the problem. I know that there can be a negative stigma attached to taking your children to PT & OT but it is soooo worth it!
Also I have learned to never assume that their doctors know what is or should be going on. I have had to push for a lot of things for these boys that has gotten overlooked but thankfully pt/ot wasn't one of them.
Best of luck.

 

We were referred from the NICU as well due to their low birth rates. At 3 months (actual) they were evaluated and did fine, then were scheduled for a follow up at 6 months. It was actually 7 months when we got in and based on their lack of saying consonant sounds (ba, da, ma) they qualified for speech but not fully. It basically just gave them another evaluation at a year. and then they qualified for ST because they 1)weren't following oral directions 2)because they had concerns from the previous visit. We were seen by an ST once and she just had us schedule a hearing exam. The exam was fine and that was the end of it. I declined further services and just asked the pedi for advice on things. She was really helpful and gave me guidelines for their speech by age. It was SO helpful. If you are concerned about anytime, talk to your pedi about it. They will be able to point you in the right direction. I always say "better safe than sorry" and that's how I looked at their evaluations.

 

Makenna had a neonatal stroke possibly at the end of my pregnancy, but most likely soon after birth. She has a huge lesion covering most of the left side of her brain. She hasn't been able to use her right hand, wrist, elbow, arm or anything. She does much better with her right leg and foot. We will soon be needing to see a opthamologist.

She's been in OT for a while and will start PT after the New Year. It has already helped her sooooo much!!!

 

My guys were born at 36 weeks. Ryan saw a PT from about 4.5-7 months for low muscle tone issues and Michael has been in PT/OT from 3 months - he has torticollis and had low muscle tone. If you're concerned about your LOs physical development I would recommend seeing your ped. Mine wanted to take a wait-and-see approach, but I'm glad I pushed and got them in to PT early. I've been told starting early is more successful. Good luck!

 

I have boy/girl twins. My girl was referred to a PT for tortocolis (spelled wrong) which is a stiff neck and favors one side and holds her head at an angle and one side of her head is very flat. Or was! It wasn't that bad but the PT works with her to stretch it out and strengthen the other side. She is doing great but that one side that is flat in the back still is a little bit flat which she might have the rest of her life but no one knows for sure. Hair will disguise it pretty well. Apparently she liked a certain pose in the womb. To this day she loves to hug her head with her hands which is how she was inside.

 

I honestly don't remember how exactly we were referred to Early Intervention - everything has been a blur this year. I think because our twins are on medicaid and they were 3 months early and Jaxon has had sooo many problems we were automatically signed up for an evaluation. Jaxon automatically qualified because he is legally blind due to optic nerve damage, had grade 2 and grade 4 bilateral brain bleeds, which caused hydrocephalus and periventricular leukomalacia, and chiari malformation (decompressed September 2009). Noah does not receive early intervention, although he does participate because they come to our house and we don't want him "left out" of anything and jealous of the attention Jaxon gets. Jaxon is doing much better since beginning OT and Vision in October at 7 months old. It won't be long until he catches up to Noah.

If you are concerned about them meeting milestones, talk to the pedi about a possible referral to a developmental specialist - or ECI if you qualify.

 

The girls were born 36wks, low birthweight and Ruby had IUGR they spent 2wks in NICU. We were offered Pt only after Ruby fell behind on her gross motor skills. They have both had there eyes checked for strabismus and both seemed fine but because of history of glaucoma and shortsightedness in our family we have been referred for a full eye exam. I am based in the uk and we don't have EI over here unfortunately so i just pester people until i get them seen to.. it sucks! I would of thought that your lo's are doing fine since it has never come up at any of your apptmts