Tag Archives: lefty

My Last Daycare Check

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My last daycare check is in the mail. I reach this milestone with a mix of emotions.

In the first picture above, Zoe was visiting Mia and me in the hospital. Mia was just thirty-six hours old. It was a dozen hours before she had her first seizures which meant she had to be sent alone with medical staff by ambulance from the hospital where she was born to a bigger one across the river, with a full NICU, and the ability to diagnose her stroke.

In the second picture above, taken last week, Mia and Zoe are goofing around, far too big to be in the bike trailer, but asking me to take them for a ride for fun. Zoe is seven. Mia is nearly five.

In both pictures, their sisterhood is so present. It’s ironic to me now to see Mia sucking her left thumb and Zoe studying her right thumb. This was before, before we knew that Mia would become a lefty for sure.

It’s a leap of faith to have a child, perhaps a blind leap of faith to have a second as a single mom. I leapt twice and somehow we have all made it, not just surviving nearly five years as a family of three, but really thriving even in the face of some daunting challenges.

Last year, I actively participated in Pediatric Stroke Awareness Month, blogging daily through the month of May. That effort has had many benefits, new contacts with families and professionals interested in pediatric stroke, sharing information broadly that seems to benefit others, and most personally, helping me affirm how far Mia has come with my support. It was cathartic and healing to be able to share more details of our journey. And, we raised significant funds for Children’s Hemiplegia and Stroke Association.

This year, I considered repeating my blogging streak. I could easily have written updates on all the topics of a year ago, showing Mia as an even more competent kid, now almost five. But, I made an active choice not to blog. I am investing more this year in my own self-care. Blogging that intensively last year meant lost sleep. And, this spring, we are in a big transition. I wanted some space to feel my way through the changes.

To work full-time outside the home as a single parent requires tremendous logistical support. Zoe was in a family daycare in our neighborhood her first two-and-a-half years, but even before I was pregnant with my second child, I had visited the daycare/preschool where I would later send both girls. I loved it then and still do now. Some of the teachers have been there more than twenty years. They care for infants all the way through pre-K. Both girls started there when my maternity leave ended. Zoe was in the youngest preschool class and Mia was in the infant room. For three years, both girls went there full time. For the past two years, Mia has been in preschool there and on Monday she goes for kindergarten orientation at the bilingual school where she’ll join Zoe in the fall.

Mia has just three weeks left at this beloved school. Today, she hosted me as her special guest in her class brunch. I’ve been feeling nostalgic as the end of this era approaches. I’m putting some of that energy into making a special gift for the school and cards for the teachers.

Of course, my budget will be easier without having the expense of daycare. I look forward to seeing my bank balance when my mortgage payment exceeds my childcare expenses again. That has not been true since before I had my second child. I feel grateful to have been able to afford such excellent care, to have had the amazing continuity so that both children have had many of the same beloved teachers, and that we’ve been there long enough to feel like they are part of our family, certainly part of the village supporting me in raising these beautiful girls.

When I signed us up for two spots in this daycare, even before Mia had been born, I had no idea that she would have any special needs. And then she did, and I took a lot of time in the beginning to orient the caregivers to exactly how to handle Mia when picking her up, not to prop her in sitting but to let her lie down and find her own way there. As a toddler, she went to school wearing a splint on her unaffected left hand to give her time every day to practice with righty, modified constraint therapy. The teachers followed my suggestions for sensory play with my promise that whatever was good for Mia would be great for other children too. Mia played with shaving cream, sand, water, rice. And then, after eating snack with righty, the teachers could help her take off her splint so she could go outside to play and she could use both hands and arms to master the playground by climbing, swinging, traversing the monkey bars, and sliding.

Each year that Mia has transitioned, I have met with the new teachers to orient them to her needs. I have written up a one or two-page set of suggestions for how to best support Mia’s development. Remarkably, this year, both of Mia’s teachers have marveled at her curiosity, eagerness to participate, persistence and independence, and self-care skills that are on par or ahead of some of her peers. It’s through their eyes that I have come to see Mia as so ready to take the next step, to leap from the early childhood years into elementary school with her big sister leading the way.

And, it is nearly time for me to make that transition too, to escort Mia to kindergarten orientation, to believe that we made it, not just through the financial hurdle of getting care for two kids from birth to five while working full time, but through the developmental hurdles put in our path by Mia’s stroke.

Here are my girls in action recently, Mia on her 16″ bike, confidently making a turn, Zoe joyously swinging on the trapeze swing.

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I will close with gratitude for making it to this transition with the love and support of many. Here’s one of Mia’s recent pieces of art, where she so clearly affirms her left-handedness.


Occupational Therapy – October 4

Mia has her weekly half-hour occupational therapy session on Friday mornings. Tighter school security means I can no longer observe. Fortunately, Mia’s therapist takes time to describe what they did together, sometimes using pictures as she did this past Friday. The sequences are so compelling that I want to share them.

Mia chooses where she wants to start and the therapist goes with Mia’s preferences while still keeping her goals in mind.

On Friday, Mia wanted to start in the gross motor area, throwing balls from inside the ball-pit Jump-o-lene into an inner tube with righty.

Here, Mia is carefully using her right hand to pick up a ball. Notice how she is concentrating.


Really beautiful extension with her right arm as she throws a ball.


Cleanup time. Mia spontaneously used both arms to help put all the balls back in the ball pit!




Fine motor practice next. Mia was feeding the ball pennies. She initially tried to pick up the ball and squeeze it with her right hand but that was too challenging so she switched hands and held the ball with her stronger left hand while practicing pincer grasp with righty.



Picking pennies up off the table with pincer is tricky so you can see in the final picture that Mia got creative using righty pointer to slide the penny to the edge of the table.


Constraint Induced Movement Therapy

This may be my longest post so far as part of my streak in the month of May to spread awareness about pediatric stroke. Please consider donating to support Children’s Hemiplegia and Stroke Association, an organization that has helped our family tremendously with support and information.

When Mia was nearly 12 months old, her physical therapist suggested that a splint might help her right thumb abduct better. She tended to keep it tucked in next to her hand. With my Feldenkrais orientation, I was really opposed to any kind of stretching for Mia’s right hand, wrist, or arm. I didn’t want to splint her right arm. From what I knew, that would only cause her brain to work harder against the resistance of the splint. So began a research project that led me to Children’s Hemiplegia and Stroke Association (CHASA) which helped me discover Constraint Induced Movement Therapy (CIMT), and make my own conclusions about what to try with Mia.

Here’s Mia on her first birthday, chewing on a watermelon rind that she’s holding with lefty. You can see that her right hand is in a fist and her right thumb is tucked in between her index finger and her middle finger. This was a common position for Mia at that age.


When Mia was first diagnosed, I think I did find CHASA but I didn’t want to sign on to the support group there. I don’t know if it was because I was in shock, denial, or just didn’t want to fully identify with the group. I was doing everything I could to ensure Mia’s recovery. In any case, after a year, I was on a mission to avoid the recommended splint for righty, and needed to search the archives of posts of other families who were dealing with similar challenges, similar decisions. I found many discussions of splints for the affected hand and also for the unaffected hand in the context of CIMT. So what is it?

Constraint Induced Movement Therapy is an approach where you restrict the movement of the unaffected hand and arm, usually through casting or splinting it, so the person is given the opportunity to learn to use the affected hand and arm, of necessity. Intensive therapy is given at the same time so progressively more challenging tasks can be mastered over a period of days or weeks. Often, significant improvement can be seen over an intensive period of a few weeks. This work was pioneered by Edward Taub in controversial research with monkeys but later accepted for adult stroke patients and more recently adapted for kids.

I found all the articles I could on pediatric CIMT, took them with me on vacation, read The Brain That Changes Itself, and went to the pharmacy for self-adhesive ace bandages to use to fashion my own constraint for Mia who was just starting to walk but still crawling quite a lot. I wanted a constraint that limited her ability to use her left fingers but allowed her to crawl and pull to standing. I covered the bandage with a sock. Mia’s vacation was spent with her left hand and wrist in this constraint for all her waking hours except if we went swimming. She played on the beach like that, she ate like that, she seemed to adapt.

Here she is at 12 months old, working hard to get a blueberry into her mouth.


I had some tough conversations with family members and strangers. Everyone wanted to know why I was taking away her “good hand.” Strangers wanted to express empathy that my baby had broken her arm. But, then if I replied that she’d had a stroke, they were in shock. I was learning too, dancing between sharing our truth, and just getting on with helping Mia. In that week, Mia gained some skill with her grasping and releasing. I brought out new toys and fun finger foods. Food is highly motivating so if she was successful in eating with righty, she’d keep at it.

Sometimes we took the wrap off because it was hot or annoying. Mia started to spontaneously open her hand a lot more to do things like grab a sand shovel while playing in water.


Over the next few months, I got more professional resources to help support our experiments. We saw a physiatrist, that is a doctor of rehabilitative medicine. She connected us with an occupational therapist who specialized in CIMT at Spaulding Rehabilitation Hospital. Another parent on the Hemi-Kids mailing list referred me to a fabulous orthotist who made a hot pink neoprene splint for Mia to wear on lefty.

Here’s Mia playing with a magnetic monster with righty and sporting her new splint on lefty. She was 15 months old.


Once we had that splint that was easy to put on and take off, we tried a new routine where the splint was just another thing that Mia had to put on each morning while getting dressed. She wore it from about 7 am until 10:30 am so she ate breakfast at home with righty and snack at daycare also with righty. I oriented her daycare teachers about good activities to do in the classroom – lots of sensory stuff like sand, rice, beans, water and shaving cream, puzzles, toys, balls.

Mia could point well with her right index finger by the age of 2 years.


The splints that Mia has had all stopped below the elbow so she could always do bimanual things too. That helped cut down on frustration. Mia eventually outgrew the pink splint and by then she was old enough to request her own color – green! By the time she was 2.5, she had developed both the ability to point and a decent pincer grasp. She had also developed the ability to take off her splint and she started to protest wearing it every day. So we stopped.

By then, Mia could respond to verbal prompts to, “Give righty a turn.” Or, “Use both hands.” Or, “High five with righty!” Try asking most 2-year-olds to do something with righty or lefty and they won’t know what you’re talking about. Typically, handedness doesn’t develop until age 3.

Here’s a video of Mia working hard to do a puzzle, she’s practicing her pincer grasp and doing a nice palmar grasp and working on supinating too, that is to rotate her arm so her palm is up.

Monkey Mia

There is a place on the west coast of Australia called Monkey Mia. It’s famous for the dolphins that come ashore. I was there in about 1995 after a research cruise that ended in Perth. But, we never saw any dolphins.

“Monkey Mia” is a good nickname for my Mia now who seems utterly determined to master the monkey bars as soon as she can.

This evening, we went to the park. Zoe is a pro at the monkey bars, so fast that I couldn’t get any pictures of her on them. I was also trying to help spot Mia. Little did I know that Mia had moved on and no longer wanted my help.

Zoe is trying to master her next challenge with climbing trees  with branches that are kind of hard to reach.


So, here’s Mia in a series of action shots. Her focus and motor planning are palpable. She makes the riskier big reach with lefty as she knows that’s safer for her and then she’s able to reach and extend her fingers to grasp with righty.



Every occupational therapist who has worked with Mia has focused on helping her extend her right arm, hand, and wrist. This shot below is an incredibly clear view of how well she has to do that to succeed in her goal of mastering the monkey bars.





And, here’s a video of Mia putting it all together on the monkey bars.

Earlier this week, Mia figured out how to get started on her bike on her own. She’s been riding it well for a few weeks but still needed a tiny push to get going. No longer. It’s almost as if each new motor skill she masters drives her to find the next challenge. In the last picture above, she’s reaching for the fifth bar. There are only two or three after that. And, she wants to go back to the park to practice so she can go all the way across. She did the monkey bars so many times this evening, dropping to the ground each time her arms gave out. She’d get up and say, “I need to try again.” I started to worry that her determination was so intense she might keep trying past the point of fatigue and injure herself. I gave my 5 minute warning and we biked home for bedtime snack.

This post is part of my streak of posts in the month of May to spread awareness about pediatric stroke. Please consider donating to support Children’s Hemiplegia and Stroke Association, an organization that has helped our family with support and information.

Update on September 3, 2013

Here’s Mia yesterday at 4 years 2 months old (four months after her early forays shown above) showing me that she has been practicing and can go all the way across the monkey bars. Note how confident and nonchalant she is. She just knows she can do it and she does. You might also notice that she consistently reaches first with her left arm (unaffected) and then with her right arm (affected by stroke). She does this for every one of the seven bars, reaching first with lefty, then with righty. She happens to be wearing the same lucky butterfly shirt she wore in May when I first captured her learning to swing on the monkey bars in the still and video images above.

Preschool Brunch Tradition

Mia goes to a preschool (that Zoe also attended for the past 3 years) where they celebrate seasons but not holidays. One of the highlights of the year is when each preschool class hosts a brunch. Each child gets to invite one special guest. They go all out to prepare decorations and food and to welcome their special guests.

Here’s Mia this morning, all ready for starting her brunch day.


I was honored to be Mia’s special guest.


Just to include a little stroke-related observation, here’s Mia eating her yogurt parfait. Note how she is using the spoon with lefty and keeping the cup from tipping over with righty in her own style. It’s challenging for her to open her right hand wide enough to hold a cup of that size so she sort of braces her thumb and other fingers to keep it from tipping over. I read a really interesting essay today on Adaptation versus Innovation by a college student who is a stroke survivor.  It’s on the Children’s Hemiplegia and Stroke Association blog. Last summer when Mia would eat ice cream from a cup, she would get her right hand really messy before she had refined this strategy she is using in the picture below. I suggested that she switch hands and use righty to hold the spoon while holding the cup with lefty. That was much tidier and she has enough control to use righty to scoop ice cream and eat it. But, recently when I suggested the same strategy, she had an emphatic, “No, mommy. I don’t want to do it that way.” After reading the essay on Adaptation versus Innovation, I’m more inclined to let her continue to figure out what works for her as she’s the expert on how it feels. And, so what if we have messy clothes for a few more months or years while she sorts it out.


For historical reference, here are shots of Zoe from her brunches in May of 2010, 2011, and 2012.




This post is part of my streak of posts in the month of May to spread awareness about pediatric stroke. If you’re able, please consider donating to support Children’s Hemiplegia and Stroke Association.