Thursday, February 9, 2012

10 months after a baby stroke, an update

It seems that Baba is growing up all at once.  He has reached more milestones so I thought I'd do an update.  It's also close to his doctor's appointment, which makes it duo-purpose.

10 month Assessment:

Gross Motor Skills (large body movement):

Baba is able to push to stand from a squatting position, without holding on to anything.  He is also able to play with his toys, while standing, without support.  While standing, he is able to pick up a 3 inch diameter ball from the floor and throw it approximately 5 feet.  He is able to climb up and over a 15 inch barrier.  He is also able to crawl up 3 flights of stairs with 3 rest breaks.  While standing and using the wall as support with one hand, he is able to open and close bedroom and bathroom doors when a stopper is used to prevent the door from closing completely.  He is currently attempting to manipulate the bathroom door handle and may be able to open it soon!  Ugh!  He is also cruising around the furniture, though not often.  Baba took a step, three times, just yesterday.

Working on:
Baba is still bear crawling most of the time, though he is capable of cross crawling.  This may be due to a weak Cross-Extension Reflex.  Though he has started to cruise around the furniture, he has great difficulty walking while being supported with both arms.  Usually, the Automatic Gait Reflex kicks in, but it appears to be absent in Baba.  He appears to have decreased body awareness, though it's difficult to tell if it's just his temperament.

Fine Motor Skills (hand skills):

Baba is able to point his finger, but has difficulty curling his thumb in (so it really looks like he's making the gun gesture).  His accuracy at pointing to specific objects has dramatically improved and he is delighted to use the IPad.  He is also able to stack 1.5 rubber block, a 3 inch cloth covered foam block, and a 1inch building block (kind of like Legos).  He is also able to carry the Oddball, while he crawls.  He is able to manipulate a variety of objects that very in size, texture, and shape.  He is able to turn the pages of his board book, with moderate set up.  He is also able to tear tissue, by holding the tissue with one hand and pulling with the other (usually right hand, his affected side).

Working on:
Baba's pincer grasp is still immature.  He is sometimes able to grab objects with a modified pincer grasp (pad of index finger against the side of the thumb, instead of against the thumb pad).  It is not very effective and is a source of frustration for him.  For this reason, Baba is unable to feed himself the tiny melt in your mouth snacks, though he has been trying for 4 months.  Baba is able to press the buttons on toys.  Recently, he succeeded in pressing the keyboard buttons on his Leapad Laptop.  His gross grasp is very strong and he is now able to pick up a 6 inch diameter sensory ball with his right hand and throw it.

Activities of Daily Living:

Baba is able to feed himself with a spoon, when the spoon is placed in his hand with sticky food.  He is able to feed himself crackers.  He just learned how to drink from a small sippy cup today, though he needs reminders to drink a little at a time and needs help placing his hands in the handles correctly.  Baba is able to assist with donning and doffing his shirt, by pulling his arms out of the armholes to undress and pushing his arms in to dress.  Baba is able to imitate brushing, using a toothbrush. 

Working on:
Baba is having difficulty feeding himself small finger foods.  He is less than 10% successful at being able to place food in his mouth, despite concentrated effort for 4 months.  He is not really delayed, but it is a great source of frustration for him. 


Baba is very curious and loves to explore.  He is cautious in new surroundings and frequently checks with mom for reassurance.  He appears to be interested in other children, but is usually the observer.  He plays with a variety of toys, though he has clear favorites.  When he is finally able to achieve a personal goal, like press a button, he will squeal in delight and repeat the action many times.  He is happy to receive outside praise, but seems pretty satisfied with his own achievements.  Baba is self motivated and usually does not require encouragement to learn new tasks.  Baba is able to play on his own with supervision for 30 minutes at a time.  Baba is able to request attention, using sounds and gestures.

Working on:
Baba is often frustrated by not being able to an activity the way he imagines it.  He will sometimes get very frustrated at himself and start to cry.  Baba wants to imitate everything his mother does and will often get frustrated when he can't imitate the same action.  He is also unwilling to receive help and will frequently give up, rather than be assisted in most activities.  Baba also has difficulty with transitions and will sometimes protest intensely if not given fair warning.

Sensory Skills:

Baba displays increased ability to tolerate loud sounds when given warning, so he can prepare for it.  He is also showing increased tolerance for touching sticky substances with his hands.  He is showing increased tolerance to touch on his feet, recently tolerating grass on bare feet.  Baba displays decreased carsickness after his carseat was turned around.  (It's against recommendations for forward facing until 1 years old, though he is 5.5 pounds over the weight recommendation).  He is finally enjoying being swung on a swing!

Working on:
Baba can be overstimulated in crowded places and has a difficult time calming down after an outing.  Baba can still get startled with loud sounds and will sometimes cry.  He is still working on vestibular sensitivity and tactile sensivity.  As he increases his motor skills, Baba will also need to learn how to self modulate.  Currently, he sometimes sucks on his index finger to self modulate.

Cognitive/Language Skills:

Baba has learned the simple cause and effect principle.  He is able to recognize mommy's and auntie's picture.  He seems to understand the concept that the symbols he sees on the page are what we are reading.  Baba understands object permanence and is able to look for items that have disappeared from view.  He is able to remember some recent events, like recognizing the park in the photos I show him.  He is also able to play with toys in a variety of different ways.  He seems to enjoy learning the names of objects, the alphabet, and numbers.  He seems to understand some cue words, like "hot", "no touch", "out", and "all done".  Baba is able to do an activity for 3-5 minutes at a time, but is frequently able to come back to the activity after a few seconds to achieve a self made goal.  Baba is very self directed and can often play for 30 minutes by himself, as long as mom is within 5 feet.  He loves being read to and we can frequently read 3-4 books in on sitting.  Baba is also able to choose an object in an array of three choices.  He is able to say "mom" and he sometimes imitates sounds.  He has great inflections and his vocalizations are more complicated, with seeming attempt to communicate.

Working on:
Baba can often be frustrated by what he wants to do and what he is capable of doing.  He can sometimes get very upset and start to cry.  He is working on simple problem solving and learning his limits.  Baba is experimenting with his voice, sometimes screaming to his own delight.  He seems to be learning more vocabulary and sometimes surprises mom with his understanding.


Baba is doing very well.  Despite the injury to his frontal/parietal lobe, he has made amazing progress.  He no longer displays spastic tone or muscle weakness of his right side.  He is on schedule for all his milestones and some of them are slightly ahead.  He has some remaining issues with his cross-extension reflex and the automatic gait reflex, but mom will continue to use the Masgutova Method to integrate those reflexes.  This will hopefully help Baba eventually walk.


  1. Hello! I saw your comment on Caleigh's page and had to check you out (the OT in the name sent me over). I am a pediatric occupational therapist and although I mostly work in schools, I have also been doing early intervention for the past two years. EI is definitely my passion.

    I love your assessment of Baba, although I can't even imagine what it's like to be a mom of a kid with special needs and an OT.

    I hope he continues to make such progress and I'll not be following your blog :)


  2. Hi Shelly!

    How cool to have OT's visit! Thanks for the encouraging words.

    I'm totally new to Early Intervention. My son is my youngest patient ever! I mostly saw 3 and up...working in schools.

    EI is really amazing! Baba is doing great!

    I hope you have a wonderful day!

  3. I LOVE EI because so much can change in those early years. I also really love the therapeutic effect on the families as well!

    I just read the wearing baby and SI blog and I am going to recommend that to a mom I know (I miss some of these things since I'm not a mom yet)! So awesome that it decreased his tone!

  4. Hmm...I didn't think about the therapeutic effect on families. That's so true!

    Thanks for recommending me. I really appreciate it. I'm hoping to make this blog a resource though I'm still working on writing more therapy articles.

    Thanks for stopping by again.


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