Re: Proposed IEP report includes things we've NEVER heard of...

[Guest guest]

Hi !

I have heard that any of our children with hypotonia or low tone in the

body that have hypertonia in the extremities 'could' be diagnosed as

having cerebral palsy -but they don't have to use that diagnosis as

it's probably very mild. Some pediatric neurologists however use CP to

help a child secure services which may be why in this case -but some

know that the diagnosis name will upset a parent and since CP is not

degenerative -they don't use it. There are probably quite a few

children here who could have been diagnosed with CP -but were not. Yes

I'd ask the doctor why she said it now as she may have used it to help

your child secure more services? Also I always say second opinion -and

some go for more than that.

Let us know how it goes- and please know it's OK. He's still the same

child. It's obviously very mild too or you wouldn't need to be told.

She probably just again wanted to help him secure services.

For the MDs in the group as well as from those of you with children

diagnosed as CP- please correct me if I'm wrong as I don't know as much

about this.

=====

[Guest guest]

, I have a child in my classroom with apraxia whose outside

(private) SLP said she thought he has CP and told the parents to get

him tested. This really upset the parents. I am not a SLP, nor an

expert in the area of apraxia, but after everything that I've read

about it b/c of my own son (w/ apraxia) I was thinking that this

student is probably one of those kids w/ dyspraxia. He has very low

tone and since he's been in my classroom, I've gotten him PT, OT and

APE (adaptive gym) along with his ST w/o having the dx of CP. Good

luck to you. By the way, this child's reg. dr. has never mentioned any

concerns with his motor skills or lack of language. When I first

approached the parents for the OT, mom immediately shouted at me that

her son wasn't autistic. I've had to take baby steps with them and now

they are very comfortable with me and realize we all want what's best

for their son.

If I were in your shoes, I'd probably call the dr and ask why he/she

never shared their " impression " before.

Bonnie

[Guest guest]

Hi,

My child does not have cerebral palsy. She has hypotonia (low muscle

tone)along with apraxia, and was given a diagnosis of cerebral palsy

from the neruologist with my blessings because it was the only way to

secure funding to pay for additional services. As a result, we

received OT, PT and Speech coverage under our secondary insurance

which is through the state to pay for whatever our primary insurance

does not cover. This was a huge financial relief for us as my

daughter goes to quite a bit of therapy for her apraxia and low

muscle tone. Both of her physicians said that with the hypotonia,

they could " get away " with the dx of CP and it was strictly to secure

services and I understood that clearly and was perfectly fine with

it. Some parents don't like the CP dx if their child doens't have

it, but for me it wasn't an issue, it was more about what extra

services can I get through my insurances. Definitely ask your dr.

what her intentions were for that statement, don't be afraid to speak

up and ask questions.

Hope that helps.

Lori

>

> Hi !

>

> I have heard that any of our children with hypotonia or low tone in

the

> body that have hypertonia in the extremities 'could' be diagnosed

as

> having cerebral palsy -but they don't have to use that diagnosis as

> it's probably very mild. Some pediatric neurologists however use

CP to

> help a child secure services which may be why in this case -but

some

> know that the diagnosis name will upset a parent and since CP is

not

> degenerative -they don't use it. There are probably quite a few

> children here who could have been diagnosed with CP -but were not.

Yes

> I'd ask the doctor why she said it now as she may have used it to

help

> your child secure more services? Also I always say second opinion -

and

> some go for more than that.

>

>> =====

>

[Guest guest]

Thanks for sharing Lori as I forgot to mention that too. Yes many

times it's a therapy reason and at times even when it's not CP since

some don't know how to secure services for apraxia.

=====

[Guest guest]

My daughter has apraxia and hypotonia, maybe some dyspraxia (global

motor planning problems) as well as some feeding issues. We've seen 2

neurologists and a neurodevelopmental Ped. None has made a definitive

diagnosis as her case is not severe and she is young (22 months) but

one suggested she may have a mild form of CP, however he would not put

that in the report and didn't want to alarm us, but explained how her

symptoms COULD be a result of very mild CP. Another doctor explained

to me that many docs are leary of the CP label as so many lawsuits are

involved with CP cases (malpractice- delivery complications, etc.)

We're just beginning the battle for services. If a CP label will get

her what other labels won't I wouldn't be concerned. I think we all

just want to get help for our kids.

>

> There are things that were NEVER, NEVER, NEVER said to US (Ian and

> I, husband and I) about Brenden. The Developmental Pediatrician (head

> pediatrician) says that her IMPRESSION of Brenden is: hypotonic

> cerebral palsy, developmental delay, speech and language delay, weight

> & height in the 90th percentile.

>

> Hypotonic cerebral palsy?! This was NEVER, like I said before, NEVER

> NEVER NEVER said to us at ANY of the appointments we have had with her,

> her nurse(s), or anyone. We've heard hypotonia and global development

> delay.

>

> It says nothing about her DIAGNOSIS, just her impression.... what

> should I do? Do I call her and demand and explanation, and further

> evaluations/appointments? I'm a little... shocked...

>

[Guest guest]

Bonnie,

Good for you! It is tough to hear that something may be wrong with your

precious child. I wish that some of the people we had seen when Mark was a

little guy would have 'clued me it' as to what was ahead....

I had absolutely no idea and was completely blind-sided..... he was 'supposed'

to grow out of it, wasn't he? Stupid me! Keep up the good work and I apologize

in advance for all of the parent(s) in denial that may eroniously abuse you for

your good work. We wouldn't mean to but we just don't know any better and your

words frighten us.

Cheers to you!

Janice

Mother of Mark, 13

[sPAM][ ] Re: Proposed IEP report includes things

we've NEVER heard of...

, I have a child in my classroom with apraxia whose outside

(private) SLP said she thought he has CP and told the parents to get

him tested. This really upset the parents. I am not a SLP, nor an

expert in the area of apraxia, but after everything that I've read

about it b/c of my own son (w/ apraxia) I was thinking that this

student is probably one of those kids w/ dyspraxia. He has very low

tone and since he's been in my classroom, I've gotten him PT, OT and

APE (adaptive gym) along with his ST w/o having the dx of CP. Good

luck to you. By the way, this child's reg. dr. has never mentioned any

concerns with his motor skills or lack of language. When I first

approached the parents for the OT, mom immediately shouted at me that

her son wasn't autistic. I've had to take baby steps with them and now

they are very comfortable with me and realize we all want what's best

for their son.

If I were in your shoes, I'd probably call the dr and ask why he/she

never shared their " impression " before.

Bonnie

[Guest guest]

I can imagine you were shocked! I had never really heard of this (CP and

apraxia) before

this thread. I am aware of OT used to treat hypotonia -- and I know

hippotherapy is

supposed to be really good for it as well. Janice also gave out a great

exercise with a

weighted ball that we've been using with great results.

But, what exactly is hypertonia -- and how does one remedy that? Our dance

teacher

once said something about this issue to me, but as none of our professionals

ever

mentioned it, I just blew it off. Now, I am wondering -- is there something

that can be

done for hypertonia? She's had OT (a lot) and evals, but no one ever said a

thing. But, I

don't want to miss something major.

>

> Hi !

>

> I have heard that any of our children with hypotonia or low tone in the

> body that have hypertonia in the extremities 'could' be diagnosed as

> having cerebral palsy -but they don't have to use that diagnosis as

> it's probably very mild. Some pediatric neurologists however use CP to

> help a child secure services which may be why in this case -but some

> know that the diagnosis name will upset a parent and since CP is not

> degenerative -they don't use it. There are probably quite a few

> children here who could have been diagnosed with CP -but were not. Yes

> I'd ask the doctor why she said it now as she may have used it to help

> your child secure more services? Also I always say second opinion -and

> some go for more than that.

>

> Let us know how it goes- and please know it's OK. He's still the same

> child. It's obviously very mild too or you wouldn't need to be told.

> She probably just again wanted to help him secure services.

>

> For the MDs in the group as well as from those of you with children

> diagnosed as CP- please correct me if I'm wrong as I don't know as much

> about this.

>

> =====

>

[Guest guest]

Thats very true . Tara got her Mild CP diagnosis going from Early

Intervention to preschool and the Physiatrist told me its more for

services than anything else. CP is now a very broad term that covers a

lot of conditions. Than it was the Apraxia dx that came at 4yrs old

for going into K...it never ends.

>

>

> > For the MDs in the group as well as from those of you with children

> > diagnosed as CP- please correct me if I'm wrong as I don't know as

much

> > about this.

> >

> > =====

> >

[Guest guest]

I didn't know if it happens as much today. But when Tanner was first

diagnosed apraxic at 3 in 1999 - most didn't have a clue what that

was in regards to pediatrics -it was fairly common then for parents

to be given that diagnosis to secure speech and occupational therapy

services. I was told this by some parents as well as MDs at that

time.

=====

[Guest guest]

Personally, in hindsight, I can see that mild CP and dyspraxia as being so

similiar with regards to the way the body works as to be almost

indistinguishable. Is there a specific brain injury that occurs in CP that a

MRI would pick up?

I remember when Mark was little before we had a firm diagnosis, I would take him

to the pool and this one gal who I worked with would always come sit by me. Her

daughter had very mild CP. In reflection, I can see how she was trying to

'hint' politely that Mark's condition might be more than a simple speech

disorder. I was so blind that one needed to bash me over the head with a

baseball hat to see what was looming. But she knew.....

If I truly am honest, Mark's dyspraxia was far worse than her child's mild CP.

Her daughter did not have any of the fine motor issues that Mark was later to

experience.

This stuff is really subjective..... I think that diagnosis could vary from

professional to professional. In some ways, it is simpler to focus on the

symptoms or senses, ie. low muscle tone, tactility, lack of binocular vision,

tonal auditory processsing issues...... In this way, we really start to 'nail'

what is actually going wrong with the child's development and work to stop it.

Janice

Mother of Mark, 13

[sPAM][ ] Re: Proposed IEP report includes things

we've NEVER heard of...

Thats very true . Tara got her Mild CP diagnosis going from Early

Intervention to preschool and the Physiatrist told me its more for

services than anything else. CP is now a very broad term that covers a

lot of conditions. Than it was the Apraxia dx that came at 4yrs old

for going into K...it never ends.

>

>

> > For the MDs in the group as well as from those of you with children

> > diagnosed as CP- please correct me if I'm wrong as I don't know as

much

> > about this.

> >

> > =====

> >

[Guest guest]

I just got off the phone with our neuro, and he said he does not believe our

daughter has

CP -- he thinks she has apraxia, along with some mild hypotonia. I asked him

about

hypertonia in her legs, and he said that he did not show that in his evaluation.

He said I

could come back in, or he would feel comfortable referring to a PT. So, I guess

I feel

better it was not right there in his report as a major concern, but . . .

I told him we had done therapy for hypotonia, and asked what the treatment would

be for

hypertonia, and he said that would be best discussed with someone else. I spoke

to our

pediatrician, and he said he never noticed the hypotonia or hypertonia.

So -- has anyone's child had hypertonia in the legs? If so, is it correctable

with therapy?

My daughter is 7! Have I waited too late to correct this?

[Guest guest]

Em,

Don't worry...... I only started 'earnestly' working with Mark when he was 11

and it finally dawned on me that he 'wasn't' growing out of it!

So.... working on hypotonia is a strength issue. The best way to beat it is to

build core body strength. We all talk about it..... hipotherapy, horse back

riding for some; Mark does squats and lifts with a 10lb medicine ball.

Our children with hypotonia need a lot of DAILY weight bearing exercise.

Whether this means carrying in groceries when you shop, pushing around a vaccum

cleaner, shoveling snow, raking leaves.... you got it! The stuff that tires our

children out the most is what they desparately NEED the most!

So.... our kids don't want to do it because it's hard but they need to do it to

get better and to develop whole body core strength. So the way we work this is a

little bit of weight bearing activity or strengthening exercises spread out

throughout the day..... this helps to 'build' the muscle.

In addition, the kids with the best prognosis are without a doubt..... the kids

who become runners. Kids with neurodevelopmental delays should all be on the

cross country team at school. I always chant jokingly to Mark (he gives me a

slug for this).... Run Forest.... Run!

You should have seen Mark the first year of cross country.... poor guy hardly

could lift a leg by the end of his first race. But I started him running around

the block each day and slowly progressed it. Now, I just dump him out of the

car about a mile from home when we are driving and he runs the rest of the way.

It has really been an important key for him... Running is a cross-pattern

activity so it works the mid-line and thus keeps the brain agile and it develops

the respitory (our kids tend not to get enough oxygen to their brains for some

reason); the benefits are too great to mention. So if it takes little tykes

soccer to get your daughter running... go for it! Just keep in mind that

throughout her life, she will really need to do this type of work. Today, Mark

is one of the fastest kids on his basketball team! Running has served him in

too many ways to mention. Thus, running needs to become part of our kids'

identity and whatever we can do to foster this within them at a young age.....

we should do for they can run throughout their lives.

Fitness needs become an essential component of who she is..... we need to turn

our weak little scrawny (Mark is definately scrawny) dyspraxic kids into jocks!

Well... that's new one, eh?

I am slowly beginning to put a 'used' weight room together for Mark because as

he ages, I see the need for more and more lifting. He NEEDS it to keep up. He

NEEDS it to thrive and work those muscles.

Note: this is how we are 'beating' (or trying to) the dysgraphia as well;

Hand-strengthening. The hands of our children are notoriously weak and by the

time they reach grade 3, they cannot write fast enough or well enough to keep up

with their peers. For a kids with hypotonia, we need to strengthening the small

muscles of their hands. This takes an incredibly long time (apraxia of speech

x 2) so you need to begin working it as soon as you can. Dysgraphia is the true

limiter at school; because the hands are so weak, our kids really begin to fall

behind.

For this..... I highly suggest that all hypotonic kids learn to type as young as

is reasonably possible so that their education is not compromised while they

build up strength in their hands. Had I gotten Mark typing younger, he would

not have needed to go to special education. Because he simply could not write

fast enough to keep up with the class (not evident in grades 1 or 2)..... he

just couldn't stay in mainstream.

The goods news is.... I 'hear' that this greatly improves with puberty and with

the development of greater muscles.

Let me know if you have any questions with this.

Janice

Mother of Mark, 13

[sPAM][ ] Re: Proposed IEP report includes things

we've NEVER heard of...

I just got off the phone with our neuro, and he said he does not believe our

daughter has

CP -- he thinks she has apraxia, along with some mild hypotonia. I asked him

about

hypertonia in her legs, and he said that he did not show that in his

evaluation. He said I

could come back in, or he would feel comfortable referring to a PT. So, I

guess I feel

better it was not right there in his report as a major concern, but . . .

I told him we had done therapy for hypotonia, and asked what the treatment

would be for

hypertonia, and he said that would be best discussed with someone else. I

spoke to our

pediatrician, and he said he never noticed the hypotonia or hypertonia.

So -- has anyone's child had hypertonia in the legs? If so, is it correctable

with therapy?

My daughter is 7! Have I waited too late to correct this?

[Guest guest]

Em you say hypotonia in the body and hypertonia in the legs? Did you

mean to say that or do you wonder about hypotonia in both?

http://www.ion.ucl.ac.uk/library/patient/hypo.htm

My son was diagnosed with mild hypotonia in the truncal area which is

pretty typical -but he clearly had hypotonia in his legs too because

he would stop walking and sit on the ground crying waiting to be

picked up when he was younger -and then when he was older and able to

communicate a bit more (than crying) he would stop walking and hold

his legs with tears in his eyes and say " burn "

While hippotherapy is one approach some embrace as an alternative

therapy -there are so many traditional and other alternative

therapies that are effective it would be hard for me to choose just

one. It also depends upon the child's age of diagnosis. A few here

will have children diagnosed from infancy -and there are approaches

that are appropriate for that age. One would hope that you didn't

have to wait until your child is older to learn of this diagnosis so

that you can address it during preschool years which is why a neuroMD

exam is highly recommended.

Some of us may be fortunate in that either we can afford hippotherapy

or have a horse or two in our yard when our children are growing up

as we used to - but many here in the past didn't go this route due to

lack of resources availability or financially speaking. Yes I agree

that many children enjoy horseback riding or hippotherapy -and we

haven't talked about it in awhile but there are other animal assisted

therapies that are also embraced by some -such as one of my favorites

to talk about - dolphin therapy or should we now call it echolocation

therapy?

" The more recent one comes from a Japanese group, published in the

Journal of Veterinary Medical Science in 2006. The scientists found

that dolphins increase their vocalizations when interacting with

people and that this form of sonar, called echolocation, can

penetrate the human body. This complements work by a German group,

published in the Journal of Theoretical Biology in 2003, which found

that echolocation could have an effect on biological tissue under

some circumstances if repeated over several days or weeks. "

As of yet -no strong clinical evidence to support this therapy -but

many are strong believers in " DAT " . My son's mainstream school even

took a class trip to swim with dolphins here

http://www.dolphins.org/ But here's one I've posted about for years

http://www.islanddolphincare.org/ the history behind Island Dolphin

Care start with (of course) a Mom! (Deena) Like hippotherapy -

dolphin therapy if you can afford it is fun and worth exploring.

" Ms. Deena Hoagland, LCSW, after witnessing the remarkable recovery

of her son, Joe, after he began swimming with dolphins at the age of

three. Deena and her husband, , brought Joe to Dolphins Plus, in

Key Largo, FL in the hope that the dolphins might motivate Joe to use

the left side of his body-weakened from a stroke which occurred

during his third open-heart surgery. Joe had not responded well to

traditional physical, occupational, and speech therapies. At Dolphins

Plus, Joe began to make progress physically and psychologically in a

natural, non-threatening, fun setting. He took pleasure and

satisfaction in completing his exercises, assisted by the

unconditional support from

the dolphins. Joe responded extremely well to this " new " therapy,

increasing muscle tone and flexibility, as well as increasing his

self-esteem. With the support of the dolphins, especially his dolphin

friend " Fonzie, " Joe was able to normalize his young life. Deena

hypothesized that if dolphins could help Joe feel better about

himself, and motivate him to try new tasks, then the dolphins might

also help others.

A variety of children with special needs could experience therapeutic

success in an environment less threatening than standard medical

settings.

Since 1990, Deena has worked with many children from around the world

with various educational, emotional, and physical needs. The dolphins

are catalysts that provide unconditional love and support. The

program also provides unique educational experiences that often

allows children to become more expressive and develop closer bonds

with parents, doctors, and therapists upon returning home.

http://www.islanddolphincare.org/nonflash/about.htm

For preschool children there again are a host of activities to

increase strength -and you want to concentrate on the upper body.

For example something as simple as having the child lay on his

stomach while playing a game or watching TV so he or she has to

support her upper body on her elbows. Grabbing their feet or legs

and having them do the " wheelbarrow " as I just posted in the archives.

/message/77374

The best time to address hypotonia is during early intervention time -

however it's true that lack of knowledge to secure appropriate

diagnosis will delay appropriate therapy until down the road.

From the National Institute of Health website

'

What is Hypotonia?

Hypotonia is a medical term used to describe decreased muscle tone

(the amount of resistance to movement in a muscle). It is not the

same as muscle weakness, although the two conditions can co-exist.

Hypotonia may be caused by trauma, environmental factors, or by

genetic, muscle, or central nervous system disorders, such as Down

syndrome, muscular dystrophy, cerebral palsy, Prader-Willi syndrome,

myotonic dystrophy, and Tay-Sachs disease. Sometimes it may not be

possible to find what causes hypotonia. Infants with hypotonia have

a floppy quality or " rag doll " appearance because their arms and legs

hang by their sides and they have little or no head control. Other

symptoms of hypotonia include problems with mobility and posture,

breathing and speech difficulties, lethargy, ligament and joint

laxity, and poor reflexes. Hypotonia does not affect intellect.

However, depending on the underlying condition, some children with

hypotonia may take longer to develop social, language, and reasoning

skills. When hypotonia develops in the adult years, it may be due to

diseases associated with cerebellar degeneration (such as multiple

sclerosis, Friedreich's ataxia, or multiple system atrophy) in which

neurons in the cerebellum -- the area of the brain that controls

muscle coordination and balance -- deteriorate and die.

Is there any treatment?

Treatment begins with a thorough diagnostic evaluation, including an

assessment of motor and sensory skills, balance and coordination,

mental status, reflexes, and functioning of the nerves. Diagnostic

tests such as a CT scan of the brain, an EMG to evaluate nerve and

muscle function, or an EEG to measure electrical activity in the

brain may also be necessary. Once a diagnosis has been made, the

underlying condition is treated first, followed by symptomatic and

supportive therapy for the hypotonia. Physical therapy can improve

fine motor control and overall body strength. Occupational and

speech-language therapy can help breathing, speech, and swallowing

difficulties. Therapy for infants and young children may also

include sensory stimulation programs. "

http://www.ninds.nih.gov/disorders/hypotonia/hypotonia.htm

=====

[Guest guest]

Em,

I got rid of this at 11-12 so please don't worry about being late..... just make

sure that you do some weight bearing exercise daily from now on. Fit it into

your day and begin to slowly work up your daughters stamina.

Core strength will really help her sit in a chair all day at school. This is

very, very tough for kids with dyspraxia. Mark never got diagnosed until he was

about 7 so.....

We do what we can.... and you know.... It works!

Janice

Mother of Mark, 13

[sPAM]Re:[ ] Re: Proposed IEP report includes

things we've NEVER heard of...

Em you say hypotonia in the body and hypertonia in the legs? Did you

mean to say that or do you wonder about hypotonia in both?

http://www.ion.ucl.ac.uk/library/patient/hypo.htm

My son was diagnosed with mild hypotonia in the truncal area which is

pretty typical -but he clearly had hypotonia in his legs too because

he would stop walking and sit on the ground crying waiting to be

picked up when he was younger -and then when he was older and able to

communicate a bit more (than crying) he would stop walking and hold

his legs with tears in his eyes and say " burn "

While hippotherapy is one approach some embrace as an alternative

therapy -there are so many traditional and other alternative

therapies that are effective it would be hard for me to choose just

one. It also depends upon the child's age of diagnosis. A few here

will have children diagnosed from infancy -and there are approaches

that are appropriate for that age. One would hope that you didn't

have to wait until your child is older to learn of this diagnosis so

that you can address it during preschool years which is why a neuroMD

exam is highly recommended.

Some of us may be fortunate in that either we can afford hippotherapy

or have a horse or two in our yard when our children are growing up

as we used to - but many here in the past didn't go this route due to

lack of resources availability or financially speaking. Yes I agree

that many children enjoy horseback riding or hippotherapy -and we

haven't talked about it in awhile but there are other animal assisted

therapies that are also embraced by some -such as one of my favorites

to talk about - dolphin therapy or should we now call it echolocation

therapy?

" The more recent one comes from a Japanese group, published in the

Journal of Veterinary Medical Science in 2006. The scientists found

that dolphins increase their vocalizations when interacting with

people and that this form of sonar, called echolocation, can

penetrate the human body. This complements work by a German group,

published in the Journal of Theoretical Biology in 2003, which found

that echolocation could have an effect on biological tissue under

some circumstances if repeated over several days or weeks. "

As of yet -no strong clinical evidence to support this therapy -but

many are strong believers in " DAT " . My son's mainstream school even

took a class trip to swim with dolphins here

http://www.dolphins.org/ But here's one I've posted about for years

http://www.islanddolphincare.org/ the history behind Island Dolphin

Care start with (of course) a Mom! (Deena) Like hippotherapy -

dolphin therapy if you can afford it is fun and worth exploring.

" Ms. Deena Hoagland, LCSW, after witnessing the remarkable recovery

of her son, Joe, after he began swimming with dolphins at the age of

three. Deena and her husband, , brought Joe to Dolphins Plus, in

Key Largo, FL in the hope that the dolphins might motivate Joe to use

the left side of his body-weakened from a stroke which occurred

during his third open-heart surgery. Joe had not responded well to

traditional physical, occupational, and speech therapies. At Dolphins

Plus, Joe began to make progress physically and psychologically in a

natural, non-threatening, fun setting. He took pleasure and

satisfaction in completing his exercises, assisted by the

unconditional support from

the dolphins. Joe responded extremely well to this " new " therapy,

increasing muscle tone and flexibility, as well as increasing his

self-esteem. With the support of the dolphins, especially his dolphin

friend " Fonzie, " Joe was able to normalize his young life. Deena

hypothesized that if dolphins could help Joe feel better about

himself, and motivate him to try new tasks, then the dolphins might

also help others.

A variety of children with special needs could experience therapeutic

success in an environment less threatening than standard medical

settings.

Since 1990, Deena has worked with many children from around the world

with various educational, emotional, and physical needs. The dolphins

are catalysts that provide unconditional love and support. The

program also provides unique educational experiences that often

allows children to become more expressive and develop closer bonds

with parents, doctors, and therapists upon returning home.

http://www.islanddolphincare.org/nonflash/about.htm

For preschool children there again are a host of activities to

increase strength -and you want to concentrate on the upper body.

For example something as simple as having the child lay on his

stomach while playing a game or watching TV so he or she has to

support her upper body on her elbows. Grabbing their feet or legs

and having them do the " wheelbarrow " as I just posted in the archives.

/message/77374

The best time to address hypotonia is during early intervention time -

however it's true that lack of knowledge to secure appropriate

diagnosis will delay appropriate therapy until down the road.

From the National Institute of Health website

'

What is Hypotonia?

Hypotonia is a medical term used to describe decreased muscle tone

(the amount of resistance to movement in a muscle). It is not the

same as muscle weakness, although the two conditions can co-exist.

Hypotonia may be caused by trauma, environmental factors, or by

genetic, muscle, or central nervous system disorders, such as Down

syndrome, muscular dystrophy, cerebral palsy, Prader-Willi syndrome,

myotonic dystrophy, and Tay-Sachs disease. Sometimes it may not be

possible to find what causes hypotonia. Infants with hypotonia have

a floppy quality or " rag doll " appearance because their arms and legs

hang by their sides and they have little or no head control. Other

symptoms of hypotonia include problems with mobility and posture,

breathing and speech difficulties, lethargy, ligament and joint

laxity, and poor reflexes. Hypotonia does not affect intellect.

However, depending on the underlying condition, some children with

hypotonia may take longer to develop social, language, and reasoning

skills. When hypotonia develops in the adult years, it may be due to

diseases associated with cerebellar degeneration (such as multiple

sclerosis, Friedreich's ataxia, or multiple system atrophy) in which

neurons in the cerebellum -- the area of the brain that controls

muscle coordination and balance -- deteriorate and die.

Is there any treatment?

Treatment begins with a thorough diagnostic evaluation, including an

assessment of motor and sensory skills, balance and coordination,

mental status, reflexes, and functioning of the nerves. Diagnostic

tests such as a CT scan of the brain, an EMG to evaluate nerve and

muscle function, or an EEG to measure electrical activity in the

brain may also be necessary. Once a diagnosis has been made, the

underlying condition is treated first, followed by symptomatic and

supportive therapy for the hypotonia. Physical therapy can improve

fine motor control and overall body strength. Occupational and

speech-language therapy can help breathing, speech, and swallowing

difficulties. Therapy for infants and young children may also

include sensory stimulation programs. "

http://www.ninds.nih.gov/disorders/hypotonia/hypotonia.htm

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