TUESDAY 1/4 FROM LAURA

THURSDAY 1/6 FROM JAI JAI & LARRY

Progress Notes from Pat's OT, ST, PT and PCP's

It is amazing how quickly Pat seems to be progressing. In just a week, Pat is walking more balanced and smoothly, showing improvement in her communication abilities and needing less and less assistance in her daily routine. Earlier she had some difficulty in her yes/no responses but as time progresses, the yes and no's are increasingly more accurate. Her speech is increasingly more meaningful, e.g. "No but we want (to)" As to be expected from Pat, she is getting more independent each day fixing dinner, setting the table, clearing the table…etc. She signs her own name on forms for Bristlecone, traces fairly accurately over letters in her book, with slight hesitation on the small letters since it has to stay below the dotted lines, and word search puzzles seem to still be a little difficult. However, Pat does especially well on mazes and seems to thoroughly enjoy this particular activity; this seeing and looking with her eyes will improve her fine motor skills and ability to think ahead.

To improve spasticity, Pat is to do as much weight-bearing activities as possible, on right hand. On "Ready To Read Activity Box" Pat can look at the words on flashcards - read them & place letters on top of the card.

Pat generally gets up around 7am, making her own breakfast and putting away her dishes in the dishwasher afterwards, with little or no assistance. She continues to improve with her speech. Today (Jan 1st ) she was able to say a few full sentences at different times while talking to different people on the phone. She practiced arranging the alphabet and writing names and copies letters really well with slight difficulty with s, e...curvy letters. Pat decided she wanted to send a gift to her friend Julie; Laura helped her wrap it and Pat wrote a note to enclose with it.

Pat is using more and more speech that is meaningful. Looking at books from Austria and photos in albums are helpful. Tapping finger on table for multi-syllable words helps Pat in repeating words.

Jan 4th - Pat counted in unison with hand tap on left shoulder for each numeral with 90% accuracy. Daily practice is critical.

Some Words Pat is Currently Practicing On:

Hello Yeah, uh, huh Oh, yeah Where's Larry Please How are you ? OK Yes What? Help me No, I don't Thank you I know I was (good)

Practice Exercises per PT: Balance and Coordination

 Touch each finger to the thumb, put fingers straight up between each touch  Walk on tip-toes (hold Pat's hands)  Walk on heels, (hold Pat's hands)  Keep right foot pointing straight ahead, walking and doing steps, side step  Sideways: step, cross, step, cross (in front)]  Backwards walking  On hands and knees each arm straight out in front, each leg, R arm, L leg, reverse  Shoulder exercise - touch hands overhead, RH touch left shoulder, then cross LH over RH to touch other shoulder  Spider pushups - strengthens stomach  Do Not use ball without PT

Eye Exercises

1. Outdoor activities are good because it's necessary to change your focus from far to near 2. Mazes probably enlarged 3. Word find puzzles 4. Might try eye patch to experiment

Handwriting Practice - large for now

Possibilities: 1. Pat can trace letters and numbers on top of your highlighter letters or numbers 2. Write letters in a pan of (dry uncooked) rice 3. Give Pat something to see, structures to follow 4. Practice letters and numbers that are familiar, i.e. birthdate, today's date, letters in her name, etc… 5. Dry erase board 6. Say, "Watch me. Start here."

Pat's schedule is still quite full here at home. With Speech therapy 1 hr a day 5 times a week, Occupational therapy 1hr a day 3 times a week, Psychical therapy 1hr a day 5 times a week. Pat's first class is 9:00 am and finishing at 4:30 p.m. unlike at Craig the classes start time and order of the discipline always change. Today, Friday Speech started at 10:15, with psychical therapy at 1:00. Psychical therapy will be at the pool today with Bunny. Occupational therapy this morning with Brianna (1 of 4 PCP's) , breakfast, cleaning up the kitchen, vacuuming the living room and then watering all before 10:15. We will have a quick lunch that Shirley (Larry's mother) is working on, then off to the pool by 1:00 p.m. This afternoon we will take a short nap then a walk and finish the day with writing and other homework. Who knows what the weekend has in store.

Jai Jai and Larry

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