Milestone Achiever of the Month
Milestones help measure the healthy development of a child. When a child continues to miss a milestone, Bryan Pediatric Rehab Services is here to help. Our team of physical therapists, occupational therapists and speech language pathologists provide children and their families with guidance, therapies and steps to reach their milestones. Not only that we find a way to make reaching milestones fun for each child! Each month we celebrate a patient that has made great strides due to their efforts and the care and support of our therapists.
3-year-old Elias is finding his voice at Bryan Pediatric Rehabilitation. He was born with DiGeorge Syndrome which is caused by the deletion of a segment of chromosome 22. Symptoms include heart issues, specific facial features and developmental delays. At 14 months he was referred to speech therapy because he was not talking or attempting to babble.
As he made progress in play and interaction, he was still not imitating sounds. Next, he began physical therapy to strengthen his stomach muscles to support his speech, which made a huge difference. In occupational therapy he also works on his strength, specifically for fine motor skills and hand-eye coordination.
Elias is still working on sounds and vowels, he has found his voice with the help of his speech generating device. He understands very well and uses the device to communicate at home, school and therapy. Below are the goals Elias has achieved followed by his new goals going forward.
- Imitating vowel sounds.
- Activating whistles to move air out of his mouth.
- Making more verbal attempts to communicate with word approximations.
- Using his speech generating device to communicate during play with some help.
- Adding more consonants and vowels.
- Using his device with peers and adults more effectively.
- Use scissors to cut across a piece of paper.
- Increase fine motor control by fastening buttons.
When Owynn started physical therapy he was unable to stand with his feet flat on the ground. Most of us naturally walk putting our heel down first then our toe. His toe walking was due to extreme tightness in his Achilles tendons. Now Owynn is making progress using his whole foot in a heel to toe pattern.
He’s working hard in therapy, but there’s also time to play. Some of his favorite things are the platform swing, playing on the Wii and Uno Attack.
Below are the milestones Owynn has achieved, followed by his new goals going forward.
- Owynn demonstrates appropriate standing posture with heels on the floor.
- While performing a squat, Owynn keeps his heels in contact with the ground with toes forward.
- Owynn can now walk on a line for 8 feet using a heel toe pattern.
- Owynn will improve his active ankle dorsiflexion range of motion to at least 10 degrees bilaterally.
- Owynn will descend a standard set of stairs with an appropriate step over step pattern with correct alignment while barefoot.
- Owynn will maintain a squatting position for at least 15 seconds with appropriate alignment.
Three-year-old Collin works with a Bryan physical therapist, speech language pathologist and occupational therapist.
When Collin started physical therapy at 13 months old, he was unable to sit or crawl and tired out quickly. Now Collin is running all over, up and down stairs with lots of energy. Collin is currently working on jumping, kicking a ball and riding a trike.
Collin already knew signs for communication when he first started speech therapy at Bryan, but had less than 25 spoken words. His therapy initially focused on increasing his verbal and sign language together. Now Collin is speaking in words, phrases and short sentences, while continuing to use sign language as well. One of his favorite activities in therapy is to sing songs and e loves the Wheels on the Bus, Baby Shark and the ABC’s.
Collin continues to work hard each day in therapy and at home. He has some amazing support at home, and his best friend/sister, Eden, is always pushing him to work harder and learn more!
Meet Libby. She works with a Bryan physical therapist, occupational therapist and speech language pathologist. We celebrate Libby as she increases her vocabulary and continues to strengthen her core. For Halloween, Libby dressed up as Rainbow Brite’s sidekick Twink, which is very fitting because she is an adorable ball of sweetness and silliness. Some of her favorite activities in therapy include singing songs, walking on the treadmill and climbing onto everything.
Below are the milestones Libby has achieved, followed by her current goals going forward.
- Libby moves from a sitting position to a tall kneeling position.
- Libby increased her functional vocabulary to five words.
- Libby demonstrates at least one age appropriate gesture (e.g., waving, clapping, blowing kisses).
- Libby will crawl on hands and knees for 10 feet to increase strength and coordination.
- Libby will increase her functional vocabulary to 10 words.
- Libby will use at least one exclamatory expression (e.g., uh-oh, no-no, oh-no).
Aviana is on a roll! Two months ago she was timid and did not want anything to do with standing. The only walking she did was to get back to her mama, and that was only if someone helped her. Now she’s walking all by herself!
Aviana loves to play! Kitchen is her favorite, but she also likes blocks and farm animals.
She really likes her physical therapist and even brought her a shirt for National Physical Therapy Month. With the progress she’s making, she’ll soon reach her goals and complete physical therapy. Great work Aviana!
Below are the milestones Aviana has achieved, followed by her current goals going forward.
- Aviana maintains standing still for up to 10 seconds.
- Aviana walks forward 10 steps with two hand hold assist.
- Aviana cruises five to six steps.
- Aviana will walk independently for up to 20 feet.
- Aviana will transition from sitting on the floor to standing without help to improve strength and increase gross motor skills.
- Aviana will stand still for up to 30 seconds to improve balance and increase gross motor skills.
Leah Jo Gillispie
"Leah does tremendously well and continues to make progress weekly," says Bryan speech language pathologist Ashley Yates. This month we celebrate her progress as our Milestone Achiever. Leah was 2 years and 3 months old when she had her first session with Ashley. At that time, she could only make typical vowel sounds and did not imitate simple sound combinations or words. Now Leah is almost four years old and speaking in sentences.
After her first few sessions, it was clear she had Childhood Apraxia of Speech (CAS). This is a motor speech disorder that does not allow messages to get from the child's brain to the mouth, but the child knows what they want to say. Often times we do not know why children have CAS because nothing shows up on an MRI or CT scan. Although it is a very common diagnosis in children with brain injuries or genetic conditions, this is not the case with Leah, she is a typically developing child in all other areas.
Leah is very motivated during sessions and loves to play. Her therapist utilizes a very structured approach to her treatment but mixes it up with play so she gets to have fun. Her parents have done a great job of working with her at home. Therapy is instrumental to progress, but the family plays a huge role in getting the child to the therapy sessions and with any home program!
Below are the milestones Leah has achieved, followed by her current goals going forward.
Most recent goals achieved:
- Leah will imitate single syllable words in phrases and sentences with models or cues.
- Leah is able to produce all developmentally appropriate consonants (i.e., m, b, p, h, w, d, n, k, g, t, f).
- Leah will use 2-3 word phrases to communicate.
- Leah will imitate two syllable words at the phrase level with models or cues.
- Leah will use the sounds /k/ and /g/ in words with minimal cues.
- Leah will consistently demonstrate use of 3-4 word sentences during play.
Annabelle was born at 31 weeks and began therapy shortly after leaving the NICU to work on advancing her bottle feeding skills. As she grows, she continues therapy to improve her feeding and swallowing of more age appropriate food textures and drinks. She is able to get most of her nutrition needs, but uses Boost drinks to help meet these needs due to limited intake of solid foods.
Although, she has a great time throwing food on the floor. We are working on keeping the food on the table so she can learn more about food by being able to look, touch and smell it! Below are the milestones Annabelle has achieved, followed by her current goals going forward.
- Annabelle will bite foods 75% of the time.
- Annabelle shows at least 3 chewing attempts before spitting food out.
- Annabelle brings new foods to her mouth for at least taste in 90% of the time.
- Annabelle will show at least 5 chewing attempts before spitting out her food 60% of the time.
- Annabelle will transfer and swallow age appropriate bites of meltable solid textures, such as veggie straws.
- Annabelle will be able to drink from a cup without a lid with little help.
Anai Ortega Garcia
3-year-old Anai was born at 25 weeks and stayed in the Bryan NICU for over three months. She works with Bryan physical therapist Brandy Escamilla and occupational therapist Kindra Fox. We celebrate with Anai as she improves her strength, balance and coordination. Her favorite activities in therapy are playing with the toy food and kitchen set, bubbles and dolls. Below are the milestones Anai has achieved, followed by her current goals going forward.
- Anai can now walk up to 25 feet on her own.
- She can now stand up in the middle of the floor through a squatting position.
- Anai now matches puzzle pieces 60 percent of the time.
- Anai imitates vertical lines or gestures to prepare for prewriting skills.
- Anai will increase visual motor skills to string beads onto a pipe cleaner.
- Anai will imitate circular and vertical motions to prepare for prewriting skills.
- Anai will descend steps with the use of one handrail and step to step pattern.
- Anai will stand on an uneven surface reaching for objects for up to 10 seconds without losing balance.
3-year-old Ezekiel works with Bryan physical therapist, Brandy Escamilla. We celebrate with Ezekiel as he improves his strength, balance and coordination. His favorite activities in therapy are playing with potato heads, cars and bubbles. Below are the milestones Ezekiel has achieved, followed by his new goals going forward.
- Ezekiel can now transfer from one surface to another that are slightly more than an arm’s length apart.
- Ezekiel can step over a balance beam with only one handhold assist.
- Ezekiel can climb a standard set of stairs step by step with a handrail and contact assist.
- Ezekiel will stand up from a sitting position on the floor three to five times during a therapy session.
- Ezekiel will step over four balance beams with only one handhold assist.
- Ezekiel will climb a standard set of stairs step by step to show improvements in his strength, coordination and balance for daily activities.
Kasen is a twin and a former Bryan NICU baby born at 36 weeks gestation. At 21 months, Kasen had very few consonant sounds and only one intelligible word. His limited vocabulary made it difficult to communicate basic wants and needs to his parents. After his evaluation he began working with Bryan speech pathologists, Ashley Yates and Julie McDaniel. They not only work with Kasen, but also teach his mother how to model for him and encourage the use of his words. Kasen's therapy happens while he plays and he loves to play with animals, cars, bubbles and playdough. His increase in vocabulary has decreased some of his communication frustrations. Below are the milestones Kasen has achieved, followed by his new goals going forward.
- Kasen has shown increased sounds that imitate adult speech.
- Kasen increased his vocabulary to 25 words.
- Given two options, Kasen will use his words to choose 80% of the time.
- Kasen will increase vocabulary to greater than 50 words.
- During a therapy session, Kasen will put two words together 10 times.
- Kasen will increase his social language skills for daily interactions, such as answering yes/no, asking for help, labeling, gaining attention, requesting an action.
Xavier is an energetic young man who is always smiling. His occupational therapist, Kindra Fox, helps him improve his focus, coordination and organization. Kindra shows Xavier full body exercises to exert just enough energy so he is able to sit at a table and focus. These exercises help with his attention, strengthen his core for good posture and develop gross motor skills. To improve fine motor skills, Xavier uses tweezers to place small pom poms into the mouth of a tennis ball. Xavier loves to make up games and have competitions during therapy. Below are the milestones Xavier has achieved, followed by his new goals going forward.
- Xavier can hold a prone extension for 1 minute. This has helped increase his shoulder stability for handwriting and fine motor skills.
- Xavier can manage buttons through jean material and small buttons 80 percent of the time.
- Xavier is able to tie his shoes, 75 percent of the time with verbal cues.
- Xavier will identify when he needs to use the skills he's learned to increase his ability to attend to tasks 80 percent of the time.
- Xavier will be able to state three activities to increase a calm, alert state as needed 80 percent of the time.
- Xavier will continue to develop his trunk strength by completing a prone extension for one and a half minutes.
Jaylee was a former Bryan NICU baby born at 29 weeks gestation. After leaving the NICU she struggled taking in adequate nourishment by her bottle. The placement of a feeding tube has helped her get the necessary nutrition and calories she needs to grow. Now she works with Bryan therapists Julie McDaniel, MS, CCC-SLP, and Stacey Anderson, OTR/L, CPST, to eat appropriate table foods. Below are the milestones Jaylee has achieved, followed by her new goals going forward.
- Demonstrates appropriate biting of preferred food textures 80 percent of the time.
- Moves tongue side to side inside the mouth to manipulate food to be chewed and formed into a ball before swallowing.
- Shows the ability to touch wet textured foods without signs of distress.
- Jaylee will demonstrate confidence to bring new food textures to her mouth.
- Jaylee will move ball of food towards the back of her mouth and swallow.
- Jaylee will demonstrate up to three chewing cycles before spitting it out.
Tyson’s physical, occupational and speech therapists help him improve his balance, develop his fine motor precision and increase his vocabulary skills. He works with Brandy Escamilla, PT, Kindra Fox, OT and Ashley Yates, SLP. This six-year-old knows how to have fun - making up silly stories and playing games like Pop the Pig, Candyland and Perfection. Below are the milestones Tyson has achieved, followed by his new goals going forward.
- Tyson is able to sit up while reaching for objects without loss of balance.
- Tyson is able to cut paper in half with a little help holding the paper.
- Tyson identifies similarities and differences for word use with 75 percent accuracy.
- Tyson will walk with forearm crutches for 20 steps.
- Tyson will increase his motor skills by cutting a square and staying within 1/2 inch of the line.
- Tyson will generate concrete sentences provided with pictures with 50 percent accuracy.
Two-year-old Niam works with a Bryan physical therapist, NaTosha Siemek and speech pathologist, Julie McDaniel. We celebrate with Niam as he increases his vocabulary and improves his walking with greater speed and balance. His favorite activities in therapy are playing with cars and balls. Below are the milestones Niam has achieved, followed by his new goals going forward.
- Niam increased his vocabulary to 20 words.
- Niam points to target picture in a simple group of four pictures with 75% accuracy.
- Niam walks up and down an incline surface by himself without losing his balance.
- Niam demonstrates improved walking speed, keeping up with his mom or physical therapist.
- Niam will combine two words and/or signs together in 75 percent of opportunities.
- Niam will increase functional vocabulary with word/sign combinations to 50 words.
- Niam will walk up four stairs with one handrail assist.
- Niam will pedal a trike for 10 feet without assistance.