Help! Diagnosis & Physical Therapy Treatment Ideas for 19 month old

Alyssa Posts:

DEAR ERI COMMUNITY: Hello! I am a pediatric physical therapist (Early Intervention) currently struggling with a little girl (19 months old); significant hypotonia, NO head control, dislocating joints (elbows, shoulders, hips and knees), joint contractures in lower extremities, minimal movement, can roll to her side, no other gross developmental milestones met, bright girl, tracking, babbling and responding to her name and to simple verbal requests with vision and limited upper extremity movements in a supine position or supported in her xpanda chair. Has seen multiple specialists on the east coast and all are scratching their heads. MD has been ruled out, SMA ruled out. Is feeding via g-tube but has nice oral motor munching patterns and drinks from a straw. Thoughts on activities for promoting more head control or muscle activation. Cannot stress this enough, NO head control at this point. Have used a Hensinger, Miami J, and DMO suit to supplement supported sitting activities.

Thanks for any input.
Alyssa

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How Much Should PT, OT and Speech Therapy Cost our Patients?

As PTs, OTs and Speech language pathologists we know how detrimental to our patients’ health it can be when they don’t receive the appropriate amount of therapy and care. But for many of our patients this has become the norm as co-pays have skyrocketed to 80 – 85% of the cost of the visit.  

While many of our patients can’t afford to go without therapy, it’s become a truth that many patients simply can’t afford the prescribed amount of therapy. We hear the struggles everyday. “I just can’t afford it,” “My insurance doesn’t cover it,” and so on. As therapists this can be very frustrating. We are trained to help, yet our hands are tied.

However, there may be some good news on the horizon. According to a recent article in Kaiser Health News, States are hearing our pleas for proper insurance coverage for Physical, Occupational and Speech Therapy. Therapists are backing proposals in several states to limit the amount an insurer can require patients to pay for therapy. New York, Pennsylvania, and Missouri have pending proposals currently and lawmakers in South Dakota and Kentucky have already passed these measures. 

While insurance companies worry that these regulations may ultimately increase premiums, as therapists we believe that it may stave off the need for surgeries and further prescription drug treatments potentially reducing overall health costs. 

Are you experiencing the same problems in your practice with patients’ inability to afford treatment? Has this affected the viability of your practice?

Read the full article, “States Consider Limiting Patient Costs for Physical, Speech, Occupational Therapy” and let us know your thoughts! 

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Advice? Challenging Vestibular Case

I sometimes have difficulty calming down symptoms in my vestibular patients. I can usually manage in the clinic, but I would like to give the patient more ideas on what to do at home. I am thinking more of the vertigo-migraine patient during one of their spells at home. I have a few tools that I give patients, but any more ideas, or tips that help would be greatly appreciated!
Thanks,
Inger

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Yoga Improves Balance Following Stroke

A VA study, published recently in the journal “Stroke” reveals that starting yoga – even long after your patient suffered a stroke – may noticeably improve their balance. 
VA Study: Yoga Improves Balance Following Stroke

[caption id="attachment_754" align="alignright" width="91" caption="Tim Dreher"][/caption]

Learn about new tools to enhance functional outcomes, promote balance and decrease falls with renowned therapist: Tim Dreher

ERI offers Tims course: Clinical Applications of Pilates, Tai Chi and Yoga
March 2-3, 2013 – Decatur, GA
May 10-11, 2013 – Staten Island, NY
October 26-27, 2013 – Pembroke Pines, FL
November 22-23, 2013 – Derby, CT

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Child with Oppositional Disorder and Sensory Processing Disorder. Help!

I am a P.T. seeing both children and adult patients. I am seeing a 4 year old child diagnosed with sensory and speech impairments and oppositional disorder. He has shown significant improvement in both sensory and speech areas. His teachers are concerned that he can’t understand other students personal space. He seems to often want to grab them or sit near
them (or even sit on them) and the children ask him to move away or not touch and he doesn’t seem to understand it makes them uncomfortable. Does anybody know any articles or any advise I can give the parents or his teachers. Thank you Jackie P.T.

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