Asymmetrical gross motor development in preschooler? - Mothering Forums

Forum Jump: 
 
Thread Tools
Old 07-25-2010, 07:30 PM - Thread Starter
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,388
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 17 Post(s)
Not sure whether I am in the right forum, mods please move as appropriate or suggest a crosspost...

I am worried about DS’ gross motor development, but am not sure where to start here.

DS was 5w premature, gained weight very quickly despite having reflux but was very limp and, depending on your favorite chart, at the slow end of normal or slightly delayed in gross motor development during his first year: crawled at 11m adjusted, sat independently at 12m adjusted. More importantly, he had torticollis (head tilted to the right and turned to the left) and would turn over on his left much sooner (5m adjusted) than on his right (I think 7m, but was in rehab myself for spine surgery, so am unsure about that particular milestone) and kept developing asymmetrically, favoring his left side and retracting his right arm when creeping and crawling – no biggie, but definitely noticeable.

Our ped (who I am happy with in all respects but this one) felt there was not really need for concern because the asymmetry was so slight but at my insistence we were referred for several PT sessions. However, the exercises designed to make him lift his head up towards his left side and move his right side more did not seem to make any difference at all. And the PT wasn't really concerned either - did see the asymmetry, but again, like with our ped, made me feel like it wasn't a big deal - I felt they see so many worse cases I come across as this overly concerned overeducated mom.

At 12m, we went to see a torticollis specialist who had a reputation for working miracles with manual therapy, on the theory that torticollis is due to blocked vertebrae which need to be adjusted (very contraversial in the medical establishment, I understand – both the man and the method, I mean). The specialist pronounced him to be low in muscle tone - which he said would persist but could be compensated for - and blocked in his neck, did something on his neck vertebrae (turned away from us to do it so we couldn’t see!) and prophesied improvement in development within 6 weeks, asking us to come back for a second visit within the next few months if we felt the issue hadn’t resolved completely...He did straighten out very noticeably in that time frame and walked at 16m adjusted, which I think is decidedly on the normal side, so we never went back (the treatment itself is covered by insurance but it’s a four-hour-trip...).

However, I felt that even with learning how to walk, he was favoring his left side eg when climbing stairs, but we encouraged symmetrical stair-climbing and the issue resolved. He did appear to develop normally if continuing to be on the limp and slow side, eg with hopping on both feet (he does not have the most athletic and graceful parents, I have to say). For a while I really felt we were sorted. And his head looks fine! Though physically cautious, he does enjoy moving, climbing, running, riding his balance bike, sliding etc and has great stamina, so I am pretty sure it is not a sensory issue. He’s also happened to be assessed by a ped neurologist because he kept complaining about backaches but nothing was found and the complaints went away – they think he was copying me...

But it is his running that is concerning me again. He is often still skip-running and when skipping, will skip left foot forward unless encouraged to try the other side, which he will do awkwardly and stop soon, complaining it hurts his legs. Today he was running around like a maniac in short pants in the sun after sitting still for a two hour theater show, and we had a chance to really observe, and he is ever-so-slightly, but clearly, favoring his left side- pushing just a little more with his left leg and holding his right arm a little more stiffly and backwards.

I live in Europe, so am not asking for places to go, but thoughts, experiences, maybe websites to look at – could this still be torticollis, even though there is nothing noticeably wrong about the way he holds his head? Can hypotonia cause this? I haven’t found anything about hypotonia causing asymmetry – you’d think it’s just low muscle tone an both sides on his body, why would it make a difference? What else might be causing this? There is a well-baby-visit coming up as he turns four and I need to speak to his ped about it, but am unsure what to ask or look for, or which specialist I should ask for a referral to. We should probably just have sucked it up and gone the miracle specialist again, but I will not be able to make the trip myself for a while now, as you can see from my siggy...

MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
Sponsored Links
Advertisement
 
Old 07-26-2010, 01:35 AM
 
greenmom17's Avatar
 
Join Date: Oct 2008
Posts: 291
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
My 9m DD is being evaluated by a PT and OT this week for asymmetrical reflexes, and we've also noticed that she is weaker on that side as well.

I'll post everything I can learn from those evaluations, maybe it will help a bit.

Mom to:
DD (1/03) , DS (9/05) , DD (10/09)
greenmom17 is offline  
Old 07-26-2010, 06:34 AM - Thread Starter
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,388
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 17 Post(s)
Thanks in advance!
I tried to search for our issues but couldn't find anything. Then I saw your thread after I'd posted myself and your issues did strike me as possibly similar. Good luck with your evaluations!

MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
Old 07-26-2010, 01:05 PM
 
by-the-lake's Avatar
 
Join Date: Jul 2008
Location: Northern Wisconsin
Posts: 1,134
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Your DS has alot of similarities to mine. My DS is 9.5 months, diagnosed with central hypotonia, asymetric reflexes, and possible weakness, but not sure. Definetly ask for a physical therapy eval. I saw you had one when your child was younger. Can you get a different one? Also, you know your child the very best. Good luck. Your child is lucky to have you as his mother.

Wife to DHluxlove.gif DS 98thumb.gif DD 03flower.gif DS 09 babyf.gifwinner.jpgcd.gifnovaxnocirc.gif

She is here!!! Oct 5th!!!joy.gif

 

by-the-lake is offline  
Old 07-26-2010, 02:29 PM
 
cdahlgrd's Avatar
 
Join Date: Sep 2002
Location: Seattle, WA
Posts: 2,155
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
You might also want a neru or at least a developmental pediatric eval. 1 sided weakness is often a brain issue (but not always).

Courtney wife to geek.gif and mom to 4 boys: chicken3.gif   . I need caffix.gif !
They're not typos. . . I can't spell!
cdahlgrd is offline  
Old 07-28-2010, 01:56 AM
 
greenmom17's Avatar
 
Join Date: Oct 2008
Posts: 291
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Well we had our OT and PT evals, and I don't really have any further information to share, as far as what the asymmetrical reflexes could be a symptom of...but they are starting both therapies right away and recommending a MRI and a visit to a ped. neuro.

I'm sorry I don't know much about torticollis, but if you see asymmetry in your little one I'd push for further evaluation. Did the neuro do a MRI or just physical exam? You mentioned backaches - was he tested for scoliosis? Just a random thought.

Trust your gut - hope you get some answers mama!

Mom to:
DD (1/03) , DS (9/05) , DD (10/09)
greenmom17 is offline  
Old 07-28-2010, 02:07 AM
 
That Is Nice's Avatar
 
Join Date: Jul 2007
Posts: 6,798
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by by-the-lake View Post
Your DS has alot of similarities to mine. My DS is 9.5 months, diagnosed with central hypotonia, asymetric reflexes, and possible weakness, but not sure. Definetly ask for a physical therapy eval. I saw you had one when your child was younger. Can you get a different one? Also, you know your child the very best. Good luck. Your child is lucky to have you as his mother.
What is central hypotonia as opposed to just a general diagnosis of hypotonia?
That Is Nice is offline  
Old 07-28-2010, 10:31 AM - Thread Starter
 
Tigerle's Avatar
 
Join Date: Jan 2009
Location: Europe
Posts: 1,388
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 17 Post(s)
I have now scheduled our well-baby-visit for mid-August, which is sort of the earliest they will do it, as he will be four in October only, but the nurse-midwife at the ped's office I talked to agreed that I might want to get it over with while I can still focus on one child and while my husband is still on vacation, as it's quite a lengthy examination consisting of hearing, vision and speech testing and a full physical eval (hope no more pressing concerns will interfere in the meantime...). So I will bring this up and maybe we can come up with a plan for further testing or another PT or OT eval.

Unfortunately, I wasn't there for the ped neuro eval appointment due to work conflicts and my husband isn't that great at remembering medical details (that's why I am usually in charge of this in our family!). At the time, asymmetrical development wasn't a concern of ours so he did not mention it and he is sure it didn't come up. I have actually no idea whether his reflexes might be asymmetrical, I imagine that would have come up though, also I trust that something like scoliosis would. Maybe we can have reflexes checked by the ped, too. I know there was no MRI scan involved, just a physical examination and some tests, and DH reported at the time that the doc and our little boy had a lot of fun together! Apparently he said that the next step would be an x-ray but he really did not want to go into more invasive diagnostic measures as DS struck him like a perfectly healthy child. I wonder whether whether a very mild CP would have been picked up? He really does not have any other symptoms of anything being "wrong" than what I have described.

MeDH DS1 10/06 DD 08/10 DS2 10/12with SB and
Tigerle is online now  
Old 07-28-2010, 01:13 PM
 
by-the-lake's Avatar
 
Join Date: Jul 2008
Location: Northern Wisconsin
Posts: 1,134
Mentioned: 0 Post(s)
Tagged: 0 Thread(s)
Quoted: 0 Post(s)
Quote:
Originally Posted by That Is Nice View Post
What is central hypotonia as opposed to just a general diagnosis of hypotonia?
From the way the neuro described it, she says the central hypotonia is driven from central nervous system depression, so his whole body is affected. She says he will not ever NOT be hypotonic. Anyways, I gather this as a premature dx to CP or some other. We see a developmental peds in August who could maybe be more specific and answer our questions, and perhaps dx him.
Not sure what the difference is between the two diagnosis.

Wife to DHluxlove.gif DS 98thumb.gif DD 03flower.gif DS 09 babyf.gifwinner.jpgcd.gifnovaxnocirc.gif

She is here!!! Oct 5th!!!joy.gif

 

by-the-lake is offline  
 
User Tag List

Thread Tools


Forum Jump: 

Posting Rules  
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are On
Pingbacks are On
Refbacks are Off