End of Constraint...

Annabelle ended up doing so well with the cast on that we left it on for a week and a half. Our limiting factor was not wanting to send her to daycare without a functioning arm/ hand and my ability to take time off from work. We saw huge improvements in her ability to supinate her arm and once we got the cast off her spontaneous use of lefty helping righty has been much improved. Generally you see some back-sliding of skills once the constraint is over (just hopefully not enough to put you back where you started so that you are at least a little bit more ahead). As far as her arm goes we have continued (now 2mos later) to see her spontaneously use lefty more on its own and to help righty, improved supination and reaching out to grab. Her motor planning also continued to improve throughout the week... in the video she got REALLY fast at grabbing objects and handing them over, even across midline. I don't think this is still as good as it had been with the cast on but overall it has remained improved.

Her walking and going upstairs (so basically lefty leg) took a hit. I think it was a combination of focusing on her arm and a growth spurt.  Her gait is pretty terrible and she struggled to walk up the stairs again for a while after the cast was off (we were allowing her to crawl up with the cast on).  Her leg did not respond as well as her arm, or as well as it has in the past, with this round of botox. Bummer.  We are 2 mos out from our next round of injections and the poor kid is already getting mad at stretching her hamstring. She has also lost a few degrees off her popliteal angle (at the knee) according to the rehab doc at follow up. Despite that we are totally planning on doing the constraint casting for her again.  Rehab and OT actually suggested that we do it with our next botox round in June but given work we are planning on doing it with every other, so we are shooting for October at this point.


A hit to lefty leg still doesn't slow
this girl down!

We also have our regular eye follow up coming in another month which I am happy for because her left eye is hardly focusing at all. I told the ophthalmologist it was getting worse last time but he liked the way she looked in the office so we didn't do anything. Now it's not just when she's tired but frequently throughout the day, she focuses on you with her right eye while the left one is just sliiiightly off and kinda glazed over.  With her birthday coming up we also have our regular meeting with her pedi. I'll be interested to see how she feels about Annabelle's verbal skills, I think her vocabulary is great but her pronunciation and grammar are a bit behind, maybe ~6mos is all.  And of course with an upcoming birthday comes visitors and planning for a celebration! No real party this year but Annabelle has informed me that she would like Minnie and Mickey cupcakes that are strawberry just like her daddy's were... Does this girl know what she wants or what?

Still such a typical toddler