Walking & doing shots

(this is a follow-up to the entry below, about India - I wrote them both today)

(shifting gears)

Speaking of learning things slowly, whoo this walking thing is so much more complicated than I ever had to consider before. I wrote on David’s Caring Bridge site about this book we have, Gross Motor Skills For Children With Down Syndrome. I discussed all the “post-walking skills” they describe: walking on uneven surfaces (gravel, sand, grass), kicking a ball, walking up (& down) inclined surfaces, stepping off (& onto) curbs, walking up & down stairs, fast walking and running, balance beam skills, jumping, and riding a tricycle. Each of these skills has a separate chapter devoted to it. The exercises/activities in the book were chosen because they: increase strength in the trunk, leg, and foot muscles; improve balance in standing and walking, improve foot posture, and increase speed and endurance. And, there are guidelines to dealing with “various factors that affect the development of post-walking skills,” such as: physical problems (hypotonia, decreased, strength, increased joint flexibility due to loose ligaments, short arms and legs, and poor balance); temperament, attention (span); and readiness and motivation to learn a skill. And there are 12 listed “guidelines for practicing post-walking skills.”

I greatly apologize for this blasphemy, but: jeeeeeeesus.


But this week I was reminded that before we get to the post-walking skills, David has to learn to, um, walk. Walking is broken down into the following milestones: walking with 2-hand support, walking holding a push toy, lunging steps (1-3 steps), walking with one-hand support, independent steps (from 2-3 steps to walking 15 feet), walking within the house (even surfaces) and walking outside (uneven surfaces).

But, David has long-ago mastered Cruising (broken down into 7 different steps) Learning to Stand (5 steps), and he can do four of the 8 steps in Climbing. And Matt initiated the “lunging steps” the day after I read about it, but without me having told either of them about it. So who needs this lousy old 236-page book, anyway? We are to about page 120, and perhaps I will continue to do exactly what I have done so far, which is pull it out once every six months or so, get slightly upset when thinking about all this stuff, and then forget about for the next six months.

His physical therapist says he will probably be done with PT once he is walking fairly well. She said all the post-walking stuff, he will just learn on his own when he is ready. She said she sometimes works with kids later if there’s a specific problem, but usually walking is it.

David’s nutritionist came out on Friday; he has not gained any weight since her last visit (he should’ve gained about 12 ounces and he lost 1.5), but she does not seem to be too worried. I shared with her some of the difficulties we have had in determining how much to feed him – obviously we want him to get everything he needs, but he will eat whatever is put in front of him, and kids with Down syndrome are at risk for obesity due to their lower muscle tone, so we are trying to strike a balance. She asked us to keep a little food journal for a couple of days and fax it to her; she can feed the info into her computer and figure out how many calories he is getting (she calculated he needs 1050, I think). I might buy a little kitchen scale to make it a little easier, but I’m really not too worried – his weight gain has always been pretty erratic, and every time the (other) nutritionist has been concerned, we’ve taken him to the pediatrician or the endocrinologist and neither of them is ever worried about anything, so I’m not going to stress.

Regarding eating, David is still making slow but steady progress on drinking from an open cup. We are still holding the cup for him most of the time, because he will take 2 really beautiful sips and then dump it out. We have eaten the first corn on the cob of the summer, and David was really interested in what we were doing, so we’ve been sharing with him. He’s not too skilled at getting it all off the cob yet, but it’s really cute. And tonight, he pulled the cob out of Matt’s hand and wanted to do it all himself.

While the nutritionist was here, David was busy standing on the couch, reaching over the back of it, and playing his new favorite game, which is to (very loudly) bang a shot glass on the sofa table. I felt the need to explain why there was a shot glass out, at 9:30 in the morning, and why he seems to be so familiar with it. I told her we use it to hold his nebulizer cup upright, so none of the medicine spills out while we’re making all the final preparations. It was Matt’s idea, and it’s really the perfect size. She got a kind of funny look on her face when I first started explaining, and I thought it was all toddler-playing-with-a-shot-glass related, but then she said she had just visited another family yesterday and the kid had knocked over the cup and spilled the medicine while his mom was trying to get the treatment going. The mom told her this happens frequently, so the nutritionist is going to pass along the tip. Other mom of a kid with breathing problems: you’re welcome.