We had our IEP meeting today and it went really well. We went over the physical therapist's report which found that Alison basically has no delays in her gross motor skills (can do all skills at the 27 month level and 3 out of 4 at the 31 month level), but she does have weakness in her lower extremities, particularly the right side, and some balance issues. So she didn't find anything that we weren't already aware of. That's always a relief. Everyone present at the meeting agreed that Alison is not the typical child they see with Spina Bifida.

The leg weakness and balance issues qualify her for PT services through ESA, and Alison will start on Thursday. Because of her function level, the PT recommended a wide range of services, so our plan calls for her to get PT 1 to 8 times a month for 30-60 minutes per session. That will enable us to do the 1-2 times a week that the orthopedic surgeon wants her to have for the next 2 months, and then, if Alison is doing well, we can back off to once a week, once every other week, once a month, bump her time back up for a month or two if need be, whatever we feel she needs. We're going to start out at twice a week for a while, so we can get off to a good start and establish a workable program for us to do at home, too.

Alison got her twister cables today. To say that she was unhappy with them would be a bit of an understatement, but she's getting used to them. When we first got them on her, she walked around like a little old lady, shuffling her feet a few inches at a time. By the time we left the office, she was taking more normal steps. She even ran a couple of steps before lunch. They really seem to be doing the trick, though. For the first time ever, her feet are straight when she walks. Whether they will have a lasting effect will remain to be seen. They are not the most attractive things out there, and even though she could wear them under her pants, I think we're just going to leave them on the outside. The pelvic band is pretty bulky and since toddler clothes don't come in slim, regular, and husky, I don't think many of her pants will fit over it! On Monday we have our IEP meeting to discuss physical therapy and hopefully Alison will be starting it soon after that.

Alison had SB clinic today. Overall, I think it was a good appointment. Dr. Hurvitz continues to feel that Alison's doing amazingly well. He did a lot of looking at her legs and watching her walk and run, etc. He now feels that her intoeing is coming out of her hip, not her lower leg and it's due to the inner thigh muscles being stronger than the outer thigh muscles, and it's all tied in to nerve damage. He's reversed his opinion on bracing, again, and is back to feeling that it's not going to be what helps. He said he absolutely will NOT do any Botox injections. She doesn't need them and he is concerned it would cause more problems than it would solve. In his opinion, it would be better to let her have time out of her brace, because the dorsa flexor muscle will be better able to develop that way. While he generally only puts kids in twisters when the intoeing is so bad that it causes them to trip over there feet, it's not going to hurt her to use them for PT and whatnot, but they probably aren't going to solve the problem either. Our best bet is PT to try and help retrain the muscles. We're ok with that, and I'm thrilled that he won't even consider Botox. So, we'll get going on what we're planning to do, cut back her brace time to half a day and see him again in August.

Alison had her PT evaluation with Early On today. She had a great time and didn't want to leave when the evaluation was over! They have a lot of fun toys there.

From what the physical therapist said today, it sounds like Alison is going to qualify for services, at least for a short time, which is fine. Dr. Craig's order for PT was only for 2 months anyway. She does have some gross motor delays, which we knew already, but they are not serious delays, all things considered. The therapist was very impressed with how well Alison is already doing without having had any PT. Energetic and motivated were a few words she used to describe her. That was her nice way of saying she's into everything and only wants to do what she wants to do. :)

The next step is to have an IEP meeting, which will happen in a couple of weeks. At that time we'll come up with a plan of how to proceed.