Sagittal planes, weight shifting (not shape shifting), and praxis, oh MY!!
This is going to be a pretty straightforward post. It’s a subject that’s been brewing in my brain for years and in the past few weeks I’ve had some epiphanies that will only make sense if you’re on the same page as I. So parents of children with special needs, this post is for you. I want to encourage you, exhort you, and BEG you to please, please, be with your child during his/her therapy appointments. Please don’t treat your child’s time with a therapist like your car’s oil change. My kids are now 13 & 14 and I’ve seen and heard just about everything in terms of treatments and therapies with kids with special needs, mainly because we’ve done just about everything when it comes to therapies, and if there’s one thing I’ve learned, it’s that there’s still so much to learn. And the great thing is, learning this stuff is fun! No really, it IS fun, not like that whole Ovaltine trick my mom played on me when I was little, “It’s chocolate milk. Really, it is.” Oh, she meant CHALK-olate milk! But I digress.
When the kids were little, in Part C services (and then even beyond that because our local home health care agency provided superb in-home therapists for our kids beyond age 3), we were fortunate enough to have in-home therapies, so with two little ones who were (and still are) 16 months apart in age with special needs, I had a parade of people through my house every week. I want to add here that our therapists were BRILLIANT. RIDICULOUSLY gifted, smart, and completely brilliant. I know beyond a shadow of a doubt that God put each of them on this earth to work with kids and I am SO blessed to have had them in our family’s life, and I KNOW our kids are so much better off for having had them to play with in their early years. I still keep in touch with them because they were, and are, just that special. We are very blessed.
Okay, back to the subject at hand: Did I fully participate in every single therapy in my home every week? No. There were definitely times when I busied myself with housework while the therapist was there. I used it as a babysitter at times no doubt. I know many of you are probably really indignant right now, saying all kinds of bowling-words at your computer screen saying that I have NO business telling you what to do or not do with YOUR time when it comes to your child’s therapies. I’m not trying to offend you, I want to empower you that your presence WITH your child during his/her appointment, DOES make a difference in how/if he reaches his goals. It makes a difference in his quality of life in general. And just as importantly, it will TOTALLY empower you as the parent, the most important person in your child’s life.
Now I’m going to say something that if taken the wrong way, is going to sound like I am beyond full of myself, but hang with me for a moment. I hear from a LOT of people (fellow parents, acquaintances, doctors, etc…) that I sound SO FREAKIN SMART…..they want to know .how I learned all this stuff about sensory integration, praxis, motor planning, dynamic and emotion sharing communication, the layers of executive function, etc……? It’s not because I’m a geekish bookworm. I’d love to be, but I don’t have the time (as I type this a book from the library on autism collects dust next to my bed and is about to come due, because I’d rather read about Stephanie Plum’s latest escape from death. There you have it, true confessions). 99.9% of everything I’ve learned is directly from therapists. By sitting there with them, as they’re putting my 14 month old floppy-baby (think baggy of jello) into the corner of a box of uncooked pinto beans (because cooked pinto beans would be gross) to try to get him to sit up on his own, or as I was sitting at my dining room table as the speech therapist put dollops of peanut butter on a tongue depressor on the back teeth of my four year old who only ate mushy foods, I listened as they explained things to me and I asked questions. LOTS of questions. ANYthing I know, I know because I sat there, asked questions and listened. As I said, my kids are now OLD!! They’re teenagers (eek, how’d THAT happen??) and I have yet to meet a therapist who didn’t welcome a question and who couldn’t explain the how and why they were doing things with my kids. In fact in just the last couple of weeks I’ve learned from my son’s OT/PT (yep, she’s an OT AND a PT!….think about that level of education for a minute!!), that my son is “fixed” or unable to freely moved from, the lateral plane. It’s why his gait is more side to side than it is forward. He recently got orthotics that are more like leg braces (there’s a shoe insert, but the plastic part also goes up his shin and has a velcro strap that keeps it in place) and that has improved his strength and balance TREMENDOUSLY, and I think his gait is improving too, but he’s still pretty “stuck” in that lateral plan. When you and I walk, our bodies typically press forward, promoting that forward energy. When we do that, we’re in what’s called the “Sagittal plane”. Until three weeks ago I had never heard of that. When she first told me, I couldn’t remember what the name was, so I called it the Sagittarius Plane. This stuff isn’t easy and I didn’t learn it over night, but I remembered it long enough to write it down here! So by me getting a handle on what it means to be “fixed”, now I can learn how to get “unfixed”, or unstuck in that lateral plane. Last week we talked about what you have to do to get into another plane, conceivably that pesky little Sagittal plane…….you know what it is? Huh, huh, do ya?? Me either. Before you do ANYthing you have to SHIFT your weight. My son doesn’t shift. Think about that. Before you move from ANY position, before you can move through space, you have to shift your weight. Well, my son doesn’t do that, due to low muscle tone, weak core, and being “fixed”, and probably some other more technical reasons that are above my pay grade. So we’re working on “shifting” his weight through a variety of exercises, both at therapy and at home. But my point is this: there’s NO WAY I could have EVER figured that out by sitting in the waiting room knitting. And trust me, I’d MUCH RATHER BE OUT THERE KNITTING!! But I owe it to him, I owe to his FUTURE to buck up and be there in his therapy sessions while he’s working and playing (and yes, I take my knitting back there, but I also put it down to participate and get my hands on his body so I know what things feel like).
And that’s the other part of this equation: not only are our kids with disabilities NOT in therapy like a car getting an oil change, while we play “Words With Friends” in the lobby, “best practices” dictates that the therapist work with YOU, the parent, first and foremost, and THEN the child. Yes, the therapist has the training, the skills, and the technical know-how, but YOU live with your child the other 167 hours a week. A 50 minute session with only the therapist and child there is not going to amount to a hill of beans in the long run. Your therapist really needs to be working THROUGH your hands so you know how things feels. I’ve yet to meet a therapist who isn’t happy and very willing to teach YOU how to do everything. In fact most of the therapists I know would welcome a parent who wants to get their hands in there and do it all.
For the one person who’s still reading this and hasn’t made a voodoo doll in my image yet (don’t worry, it’s a lousy image to begin with anyway), please know that this mindset of “here’s-my-child-who-you-can-fix-for-the-next-hour” that many of us parents have adopted at one point or another, is not entirely our doing. I think because getting services for kids with special needs to begin with has been such a knock-down-drag-out fight in the United States since FOREVER (and we only have services now because of the parents who have fought for them before us. We owe those parents a debt of gratitude we can NEVER repay, make no mistake), there’s been an unspoken attitude from some institutions and therapists (including, but not exclusive to the school system) that says, “Just give me your child and I’ll work on him for awhile, and then I’ll give him back to you till next time. If you’re really, really interested, I’ll tell you a couple of the things we worked on today, otherwise, I’ll just see you next week.” We as parents, have tacitly allowed an insidious message that goes along with that practice that says “We’re the experts, you’re just the parents”, to take root in our lives, and it’s NOT serving our kids.
I KNOW we as parents need breaks. I home school our two kids with special kids. I KNOW I need a break, or 20, every week. But using your child’s therapy appointment time isn’t the time for it. We as parents CAN do this. Maybe we only do a few minutes each day of two or three activities that the therapist does during their sessions, but that three or four minutes a day is like pennies in the bank. It DOES add up. Just a few months ago when my son started a new round of physical therapy (we had taken a “forced break” while we lived in CA because I couldn’t figure out how to access any PT, OT or ST without going through the public school system, something we weren’t willing to do), I learned about something called long sitting (sit against a wall with your legs in front of you) and how it can help lengthen and stretch my son’s hamstrings. It’s working! We’ve done it a few minutes here and there throughout the week (when I remember) and the PT can tell a difference! Yeah for my son! So, be encouraged, what you do DOES make a difference.
I don’t think therapists expect us to go home with our kids and work with them eight hours a day on this stuff. They know we have laundry and Stephanie Plum books to read. They know we forget how to do some of the stuff, but I do know that it encourages them in their profession when we are there in the same room with them
and that we are at least trying to pay attention and that we DO believe in what THEY’RE doing with our kids, because they’re also highly invested in their lives. I mean the whole reason that 99% are there with our kids is because they really want to see kids reach their maximum potentials.
I hope you feel empowered to join your kids on the journey, even though it may not be as exciting as reading how Stephanie’s next car is going to get blown to smithereens. But I do know that you’ll savor the memories you’ve made with your child long after you’ve forgotten how the book ends