Mobility and Functional Assessments while in the EI Program

Tony had (and continues to have) no limitations in joint range of motion. At two years of age, he was physically able to roll, crawl (main means of mobility in class and at home, prior to the power chair), pull to stand, lean on furniture, and sit in a classroom chair with arms and a back when placed there by an adult.

At the age of two years old there was a strong family and professional interest in treating Tony’s mobility impairment through gait instruction. Ankle Foot Orthoses (AFOs) were ordered for foot and lower leg support. Tony was also treated using a gait trainer. He loved the mobility, but only really wanted to push backwards because that was the fastest way he could get around. For Tony the mobility goal has always been to keep up with his peers as quickly as he can.

Daily functional activities at the age of three or four years included using his hand on his left side only. He was in the process of learning to use adapted spoons and forks with much spillage (left hand), when he entered First Grade. He had great difficulty extending his right arm and opening his right hand.

He could hit large switches with a closed fist on the right and one finger isolation on the left (medium to large switches). This was the situation with regard to prewriting skills and mouse use when he was first evaluated by the EI team.

Toileting has been a challenge. At the start of his EI process, he was in pull-ups and stayed dry about half the time. Communication was difficult and the need to transfer to an adapted potty chair resulted in accidents. He now can drive to the bathroom and position his chair in the accessible stall. He does still need moderate assistance from his aide to transfer to the toilet. He now knows the needed timing and has very few accidents. He has expressed the desire to stand to urinate, but that has also been challenging. This had been even more challenging at home where there is a regular child potty seat.

He has always readily interacted during free play with the other children. Once he began the EI program, other children often took his toys and playthings from him and he was not able to get them back; he dealt with this by protesting vigorously. Outside, to use the slide or the swings in the playground, Tony was placed and supported by a teacher or therapist. He was able to crawl up but not down some of the lower playground items.