Author: Darlene K. Sekerak, PT, PhD
Meadow and her mother, Ashley, just had their first home visit by the physical therapist with the early intervention program. Ashley is relieved that it went so well and is feeling encouraged by the suggestions the therapist made. Ashley is a young single mother who had a difficult pregnancy and delivery. Meadow was born a little early but nothing seemed to be seriously wrong. She is being followed at the clinic at the hospital because the doctor said she was ?high risk?. At Meadow?s last visit, which was when she was three months old, the doctor suggested that the therapist from the early intervention program begin visiting her at home because Meadow did not seem to be lifting her head as well as most three-month-old babies.
The therapist was really friendly, played with Meadow, and asked Ashley lots of questions about Meadow?s routine and about issues that were of concern to Ashley. She complimented Ashley on the colorful decorations she had painted on the wall in Meadow?s room and about how happy Meadow seemed to be when Ashley sang to her. That meant a lot to Ashley. She was self conscious about being such a young mother and was trying very had to prove that she was competent. The concerns the doctor raised about Meadow had her a little rattled, not only because of her concern about Meadow, but also because of her concern that she might be doing something wrong. The therapist noticed how loving Ashley was and also how protective she was of Meadow. Ashley admitted that she did not have a lot of experience with infants and did not have anyone close she trusted enough to ask for advice.
The therapist explained that every child develops differently and at different rates. She went on to explain that development can be affected by many things including genetics, emotional stress, nutrition, and the learning environment. Meadow appeared to be a happy child who was growing normally. According to the doctor there were no obvious nutritional concerns. There were no obvious signs of other medical concerns. It was too early to be sure about how Meadow would develop but that it was important now to provide Meadow with lots of opportunities to practice the next developmental steps.
The therapist explained that babies need to spend time on their stomachs to practice lifting their heads and strengthen the muscles in their necks. Ashley was concerned because she had heard that babies should always be put down on their backs. The therapist explained that yes, it is usually best for babies to sleep on their backs, but that it was perfectly safe and actually good for babies to be on their stomachs much of the day. The therapist suggested that perhaps Ashley would feel more comfortable putting Meadow on her stomach just when she was playing with her at first. She showed Ashley how to position Meadow across her lap and also how to carry her in her arms on her stomach rather than on her back. She demonstrated and showed Ashley how this position challenged Meadow to lift her head especially if she entertained her with some of her rattles. She also suggested that Ashley practice while she was there and to guide and encourage her.
Ashley agreed that she would like for the therapist to come back to talk with her about Meadow?s development and other things that she could do to encourage Meadow?s development. Ashley decided that if there was something wrong with Meadow, at least she could give her lots of opportunities to learn.
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