Botox, hips and language school

We have finally heard back from the neurological psychologist from PMH to discuss Cayla’s test results that was sent to us in the post a while ago. It was a great chat and the psychologist pointed out that Cayla’s cognitive development is going ok, being age appropriate but her language development being under which we already knew. She also said that she think it might be good for Cayla to attend a Language development school which is something we had already started to look into a while ago. These type of schools offer an alternative way of learning for kids with severe speech and language delay/difficulty from Kindy up to Year 3. After that they will go back to mainstream schools. It is difficult to get a place and they need quite a few tests to be done and forms to be filled out but we might give it a go anyway, we’ll see.
They also require reports from Cayla’s speech pathologist, her school and the results from the neurological psych test that she has just done. As soon as our speechie from TCCP is back from holidays I will ask her to help us with the application.

A couple a days ago we had Cayla’s first pre – Botox appointment at Princess Margaret Hospital (PMH), it has taken roughly two years for her to get in through the public system. Luckily we have private health insurance and have been able to see a private doctor until now. Or Cayla may still have been walking up on her toes on the left foot and I’m not even sure she would have been able to walk by herself either. She started to walk independently a couple of days after her first Botox when she was 2 years and two months old.
The doctors checked her range on both legs and feet and came to the conclusion that she definitely need Botox in her left calf but nothing in her right. This is so confusing as some specialists are saying that she needs Botox in her right leg as well but hey whatever, I’m just gonna go with what they say at PMH for now. So next Botox is booked in for the 25th March.

Cayla also had her yearly hip surveillance on the same day as our pre-botox meeting. This is done by one of the physio therapists at the hospital and monitors the indicators towards progressive hip displacement. Extreme tightness in the groin and hips can often lead to hip dislocation in children with cerebral palsy. The physio examined Cayla’s movements and flexibility and sent us off for an x-ray. The prime radiological measure for hip surveillance is migration percentage and this x-ray was compared to the one she had done twelve months ago. The x-ray showed an improvement on the right side which is now looking very normal and the left side is still at about 25% which is not great but ok. The x-ray we did when Cayla was 18 months and before we knew she had cerebral palsy showed a migration percentage (MP) of 30% on the left side so we can definitely see an improvement.
Normal hip – MP < 10%
Near normal hip – MP >10% 15%

Dysplastic hip – MP >15% 30%
Subluxated hip – MP >30% <100%
Dislocated hip – MP  > 100%

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