1 |
Parents’ main complaint: "My child has difficulty standing and does not take steps, even when supported." |
- Mutually agreed goals: “get the child to stand up from sitting on the floor and increase the time in orthostatism.” - The family established moments in the routine to stimulate the child. - They suggested games that encourage the child to reach the goals, such as placing toys at different heights so that the child tries to move to standing from sitting on the floor. They also encouraged the standing position during the bath. |
- Main difficulty for parents: failing to support the child during position transfer. - Main facilities for parents: they allowed the child to try and make mistakes during the process. They understood that the child needed less support than was provided for position transfer. They motivated the child. The activities were varied and in different contexts. The parents built and acquired toys that helped to stimulate the achievement of goals and showed more autonomy in care and greater understanding of the child's condition over the weeks. |
- In the evaluation shared with the parents, an improvement was observed in the child’s ability to pull himself to a standing position from the buddha sitting position, in addition to greater interest of the child in playing in the standing position. - Parents recognized advances in their child's motor performance. - Parents stated that they were less overprotective and more patient in waiting for the child to respond to activities, in addition to having a better understanding of their child's health condition. |
2 |
Mother's main complaint: “I would like my child to have an improvement in sitting balance and stay in that position longer.” |
- Mutually agreed goals: make the child stay in the sitting position longer, with as little support as possible, and improve alignment in the position. - The mother established moments in the routine to stimulate the child during daily care activities and during play. -The students helped the mother to think about how to overcome the limitations she presented so that she could have ideas for games to be developed with her child, until the mother suggested building a sensory mat for the child and suggested encouraging her to sit on a step, with her feet supported. |
- Mother's main difficulty: maintaining the child's alignment in the sitting position. Due to low visual and auditory acuity, the mother reported difficulties in stimulating the child. - Main facilities of the mother: very attentive to the child’s routine and in the implementation of stimuli as she learned more about the child’s health condition. She made rugs with different textures so that the child could be stimulated in the position of all fours, on the mother’s legs, and, thus, improve the activation of the spine muscles and the child's head control. - Over the weeks, the difficulties initially reported ceased to exist and the mother was more empowered and assertive in playing with her child. |
- In the assessment shared with the mother, there was an improvement in the child's balance in the sitting position, which enabled him to considerably increase playing time without becoming destabilized, going from a few seconds (in the pre-intervention assessment) to a few minutes (in the post-intervention assessment). - The mother stated that she was more confident in the decisions made in relation to her son and easily perceived his greater interaction with her and with his younger sister, who was being involved in the games developed with her brother. |
3 |
Mother's main complaint: “I wanted my son to firm up his body more and put food in his mouth by himself.” |
- Mutually agreed goals: to provide opportunities for the child to feed himself, giving him the necessary time. Play with the child on more stable surfaces to encourage better head and trunk control. - The mother was initially afraid to make suggestions as to moments in her routine when she could stimulate her child. - The students conducted the visit/treatment in order to eliminate hierarchies. - After understanding that the one who has the most knowledge about the child's health is herself, the mother was able to define, together with the students, the games to be played to stimulate the child and the best moments within the routine. A board with the routine was fixed on the wall of the house to help the mother remember. |
Main difficulties encountered by the mother: she was initially unable to develop activities, which made her feel discouraged with the approach. Main facilities: the mother was able to see the child's progress as she overcame the difficulties in giving him time to perform the tasks, so she became more participative and more motivated during the following sessions. The child's older sister was included in her brother's routine in order to contribute with games that stimulated him. - A clothesline of photos with the child in different positions and with encouraging phrases was prepared by the group of students to give visual stimuli to the family. |
- In the evaluation shared with the child's mother and sister, it was observed that he spent more time in the sitting position with the support of his hands and presented better control of the head and trunk (from 5 seconds to almost 2 minutes). When stimulated, the child began to pivot to reach objects. As for putting food in the mouth, it was agreed with the family that the child needed more opportunities to explore food and be able to put it in his mouth. - Over the weeks, the mother and sister were more participative in activities with the child and more open to talking about their anxieties with the students. - The family was motivated not to give up encouraging the child in the first attempts at a new game, since the child needed trials and errors, and training was necessary for the proposed task to be carried out. |
4 |
Parent’s main complaint: “My daughter moves her legs little compared to other children.” |
- Mutually agreed goals: reach the feet in the supine position. Stimulate the child in the absence of the ecological cloth diaper to facilitate performance in the activity, since it was previously observed that the volume of the diaper made it difficult for the child to move.3232 Cole WG, Lingeman JM, Adolph KE. Go naked: diapers affect infant walking. Dev Sci. 2012;15(6):783-90. DOI DOI...
- Moments were established within the family's routine so that the child was stimulated, including during diaper changes, as suggested by the parents. |
- Parents' main difficulty: the child's irritability in some postures made it difficult to carry out certain activities designed by the parents. - Main facilities: parents engaged in relation to different ways of stimulating the child. To overcome the child's irritability, the parents introduced musical resources, which enabled the daughter to remain calmer and stay longer in the postures defined for stimulation. - As the weeks went by, the child showed progress in motor development and new goals were set with the parents, such as playing longer in the prone position and, subsequently, stimulating the child in the cat position and to pull herself to a standing position. |
-In the evaluation shared with the parents, there was an improvement in the child's gross motor performance with improvement in active movement of the lower limbs in all postures, good performance in rolling over, sitting without support, and in the use of the hands to reach and manipulate toys in the position. - Parents were even more engaged and assertive about ways to stimulate the child. - The mother stated that she was calmer about the child's condition, as she began to understand her condition better, and said that she understood that it was necessary to allow time for the daughter to respond to stimuli, which greatly reduced anxiety and fears about the child's future. |
5 |
Parents' Chief Complaint: “We want our child to take his first steps.” |
- Mutually agreed goal: make the child pull himself to his feet, encourage the child to stay longer in orthostatism, promote anterior gait with the help of toys. - The parents, with the help of the students, identified factors that facilitated and hindered the performance of activities by the child. - The parents determined moments in the routine when they could play with the child, in order to achieve the goals and use facilitating elements to carry out the activities. |
- Main difficulties for parents: establishing, within the routine, a time to play with the child during the week that could be effectively accomplished. They reported difficulty in meeting the goals agreed with the students. - Main facilities: as the sessions progressed, the parents became more creative in stimulating the child and began to try to overcome difficulties. |
- In the evaluation shared with the parents, they mentioned that they realized the importance of letting the child play on the floor longer and how much their participation in games made the child more motivated and made him/her stay on his/her feet longer. - The parents, despite leaving the child a little freer to play on the floor, remained overprotective until the end of the visits. At the end of the treatment, the environment had more stimuli for the child and the parents adapted a stroller so that the child could push it and steps were encouraged. |