Health Update: Leila Edition

I have been thinking, over the last couple of weeks how different the third child is from the first child. When Benjamin was little I posted about his health progress all the time. I'm not sure I've even mentioned some of our challenges and milestones with little Miss Leila! So, I decided it is time for a Leila update.

For the past year we have had Leila in physical therapy for a significant gross motor delay. (If this sounds vaguely familiar it's because Talia was in the same program at the same age for the same issue, although the reasons behind Leila's delay are completely different from the reasons Talia was delayed--go figure.) When Leila was still not crawling (or giving us any idea that she would soon begin) by 13 months we decided to pursue physical therapy. So last June we started the process to get Leila qualified for early intervention, aka the "First Steps" program. She did qualify, testing in at about the level of an 7-8 month old for her gross motor skills. We began physical therapy shortly after.

This has been a completely different road than we traveled with Talia. She needed a little extra help and encouragement, but basically progressed very quickly and caught right up within a few months. Talia's issues were mostly due to balance (because of her frequent ear infections), which improved once she had her tubes put in, and low muscle tone, which improved with some basic strengthening techniques. Leila has been a little more tricky to figure out. Early on our therapist noticed that Leila had some "gravitational (or positional) insecurity," which is a fancy therapy term that means her muscle receptors had a hard time communicating to her brain where her body was in space. Practically speaking, this means that if she was tipped backward suddenly, or moved in a new way, or pushed too high in a swing she became very, very afraid. As a result she was extremely cautious and timid about movement. Working on a new body-movement skill usually involved a death grip onto any part of me she could reach and/or a complete jelly-legs meltdown. It was super fun.

Another complicating factor became evident about 6 months into our therapy when we discovered that Leila had a leg-length discrepancy. Her right leg measured 2 cm longer than her left leg, which converts to .78 inches. That's quite a big difference when your legs are only 11 inches long to begin with! This, of course, was a factor in her balance and ease of movement.

Leila, by the way, began crawling at 14 months, the day I signed the papers for her therapy plan to begin. But she still had plenty of work to do to come to anywhere near age-appropriate skills. The task then became to give her the balance and strength skills she needed to walk. She was compensating well for her longer leg and for several months both the therapist and I knew that she was on-track with her skills--she could walk, but she wouldn't. The fear factor was really the dominant issue. We made little progress for 3-4 months. By this time her problem solving skills had become another obstacle. If something we were asking her to do seemed too hard she would just figure out another way to accomplish it. And of course, she became more an more conscious of our strategies to encourage that "W" word, which she expertly thwarted. She didn't want to walk! Finally, at 21 months, with the help of an ingenious little device called "walking wings, " Leila took the plunge and (literally) stepped out into the unknown.

Since that time she has made some remarkable strides, especially in the area of her fear. Her gravitational insecurity seems to have mostly disappeared. She has conquered her fear of falling down the stairs (two big tumbles set us back for a few weeks), her fear of crossing a threshold, her fear of the big, scary, uneven terrain of the backyard, and her fear of standing on a raised surface (such as a stool or a chair). She even recovered quickly from her first skinned knee last week.

Lastly, I asked our therapist to update me on her leg-length discrepancy this week. She remeasured Leila's legs and they were exactly the same! She explained that this is probably due to the increased stimulation her left leg has gotten over the past few months as she has been walking consistently. Bone growth, apparently, is caused, at least in part, by impact so when her left leg began receiving more consistent impact it began to grow (whereas her right leg was receiving the same amount of impact since she stood with most of her weight shifted to the right since she learned to stand.)

So, overall, Leila is doing very well! She still has some skills to catch up on (such as walking up & down stairs, throwing, climbing, and balancing on one foot), but I think we have crossed the threshold of willingness to learn them, which seems like a very positive step.