So many people have had questions about Ryan’s physical therapy since he started in at the beginning of the year, so I thought it was time to share some details. It’s been an enlightening + emotional process for all of us. Lots of hard work, lots of discouragement, lots of proud moments, lots of prayer.
Here are some of the most common things people have asked us about our family’s experience with physical therapy:
Why does he need physical therapy?
Ryan never learned to crawl. He never tried pulling to stand. In fact, he didn’t even want to bear weight on his legs. While most babies will stand while supported at only a few months old, Ryan refused. He would either stick his little legs straight out or let them go limp and collapse. He was a little late learning how to sit unassisted too. Once he mastered sitting, he had even less desire to do tummy time. He stopped rolling over. If he tipped over while sitting, he was stuck and wouldn’t try to right himself.
He was frustrated. We were frustrated.
Eventually he figured out his little sidewinder bum scoot. With his newfound mobility, he was much happier, but he also didn’t want to go back and work on skills he’d skipped or was missing. If he couldn’t reach something, he either yelled for help or decided it wasn’t worth the effort and moved on.
I had discussed all of this with our pediatrician at every appointment, but he told us to give Ryan more time. Then he had his first birthday and still wasn’t bearing weight on his legs or attempting to crawl. At his one year checkup, the doctor and I decided it was time to give this a closer look.
Won’t he just “figure it out?”
I have heard countless times, “My kids were late walkers. He’ll be fine.” Or, “My niece scooted like that and she figured it out.” Lots of kids do! And perhaps Ryan would have, eventually.
But when he scooted, he strongly favored his left side. His feet were beginning to turn sideways, his muscles on one side were stronger than the other, and if he continued along those lines he could have faced bigger issues than not crawling. I have some pretty major crookedness in my feet, hips, and back; I’d like to help my children avoid the pain and problems that has caused me. Consequently, I wasn’t willing to “wait until he figures it out” any longer than I needed to.
Is he delayed in other areas? Is he disabled or “special needs?”
That’s a tough one. Maybe?
His initial evaluation showed that he was right on track with his development other than gross motor skills…which were SEVERELY delayed. He didn’t qualify for help through the state Department of Developmental Disabilities, as he didn’t seem to be at high risk for anything they cover. However, he’s been much slower to learn to speak than his sisters were. Part of that is just that every kid is different. However, his PT mentioned that we may begin to notice a delay in other areas (like language development) because he is working so dang hard on his gross motor skills right now to catch up.
For the moment he doesn’t seem to need additional help other than physical therapy. That could always change. We’ll assess as we go, just like with any other child.
How did you find a physical therapist?
Our pediatrician referred us to a pediatric therapy group for an evaluation. Even with his referral, though, our insurance didn’t cover much (if anything). The eval cost $200 out of pocket, and they recommended weekly therapy, which would’ve cost $600 per visit. Choke.
Luckily my mom was with me at the evaluation and asked if there was another, less expensive option available. The PT said she would refer us to AZEIP–Arizona Early Intervention Program–for an evaluation. They contacted us and we set up an in-home eval. It took a couple meetings to determine that Ryan did qualify for their services. And since he qualified, they assigned us a PT (who we love!) and we now make appointments directly with her.
How much does it cost? Does insurance cover it?
Because we are using a state-subsidized program, it costs our family nothing. AZEIP provides all the services we need free of charge. (If you don’t count the taxes we already pay, that is. That money comes from somewhere, you know.) They did take our insurance information, though. Since these services are not cheap, they try to get funding through insurance in order to stretch the state funding farther. I honestly don’t know if our insurance is covering anything, but I know AZEIP at least attempted to get payment through them.
For us, though, it hasn’t cost a cent. I cannot tell you how grateful I am for that.
What does he do during physical therapy?
Short answer: he plays!
Long answer: we try to distract him into trying new things. His PT uses toys, snacks, even this stupid video (which he’s OBSESSED with) to get him to kneel, do pushups, climb up and over things, stand while supported, reach while on hands and knees, etc. She and I discuss any progress he has made throughout the week, and she gives me suggestions for things to try until our next session. We work on his muscle development, sensory issues, and resistance to bending his knees. Most of our sessions are at our house but we’ve gone to the park a few times as well.
How long will he need physical therapy?
I don’t know. At one of our initial meetings, we set goals for six months out. He has almost met those goals, which means we’ll need to meet again to assess and set new ones. I expect we’ll continue therapy until he is walking normally. For now, we’re taking things one week at a time.
Tomorrow I’ll share more of the less practical, more emotional stuff. For now…did I cover everything? I’m happy to answer any other questions you might have!
**All photos by Kylie Pond Photography