Juliette is a fun, little 3 year, 4-month-old girl who receives Speech Therapy, Physical Therapy, and Occupational Therapy. Juliette always has a smile on her face and everyone at the clinic loves to say hi to her when she’s here!
When Juliette was born, she was diagnosed with failure to thrive. She was oxygen dependent and spent 40 days in the NICU. She started receiving services from Medical Support Services just before she turned 2 years old.
Juliette started receiving Occupational Therapy in June of 2023. When she first started OT, Juliette had decreased overall strength, which led to difficulties sitting upright and putting weight on her arms. She also had decreased hand strength and stability, which affected her dexterity and fine motor skills. Her play skills were affected by her sensation seeking for oral input as she would frequently mouth objects. Her decreased motor planning and grasping affected her ability to help during activities of daily living. Since starting OT at MSS, Juliette has been a rock star! Juliette has made so many gains in her attention, motor planning, fine motor skills, dexterity, and strength. These gains have led to increased mobility skills, ability to get around her environments, play skills, and dressing skills. Juliette is now able to sit upright by herself. She is spontaneously putting weight on her arms. She uses her arms to climb and pull up to stand. Juliette has been interacting with toys/objects as she is now putting balls into a ball drop toy, rings onto a stacker, coloring with a marker, and helping with her socks and shirt. In addition, her attention to tasks and ability to follow directions has greatly improved. Way to go, Juliette! We are so proud of you!
Lately, Juliette has also been meeting all of her Physical Therapy goals. A few examples include: getting up from the floor without support, standing without support, climbing on and off surfaces, and taking independent steps! During physical therapy, Juliette is able to walk with and without her ankle braces on. More recently, she has taken over 30 consecutive steps without falling! Juliette’s determination, curiosity, and support from her loving family has led to her success in therapy. She also just had a pretty significant surgery and bounced back like a champ! She is getting faster, stronger, and more adventurous each day and we can’t wait to see what goals she will crush next!
Juliette started in Speech Therapy, as eating has always been a struggle for her. She had a hard time gaining weight so her feeds needed to be supplemented. This was difficult to do when she stopped taking bottles and only wanted to breastfeed, so she received a gastrostomy tube (GT) around 13 months of age. Due to ongoing GI struggles, she only wanted to breastfeed and required very frequent small GT feeds otherwise she would throw up. She also continued to have difficulties sleeping due to severe sleep apnea, which was treated with surgical removal of her tonsils and adenoids as well as a laryngoplasty -procedure to help open up her airway. Despite all of this, Juliette has always been very interested in putting things in her mouth, but she didn’t know what to do with them. The food would go in and it would be pushed right back out. Now, she is actually chewing and swallowing some foods and can take drinks from a cup!
Initially, Juliette didn’t respond very much when people would talk to her. Caregivers weren’t quite sure what she could see. Family learned some sign language and we started to explore some tactile signing, providing visual models of signs, as well as our faces close up to her face so she could have access to visual information. She loves music and is very motivated by her family members. Ultimately, she was found to have high intracranial pressure and, after a long road to figure out what she needed, she had a shunt placed in her brain that would help drain the fluid in her brain to relieve pressure. This has significantly improved her ability to function. Juliette has come such a long way over this past year. She has increased vocal play, follows directions, imitation of speech and non speech sounds, imitation of gestures in play and signing to communicate and starting to answer yes/no questions, and waving hi and bye.
Her parents’ calm perseverance and dedication in advocating for their daughter’s medical care, making the hard family sacrifices to pursue all the medical appointments/therapies and persistent carry over of therapeutic activities every day has made all the difference in Juliette’s abilities across the board. We are blessed to be a part of her story and super excited to watch her grow in the future!
“We are so incredibly pleased with Juliette’s progress over the last year and a half of therapy at Medical Support Services. Everyone is so supportive, celebrating both small and large milestones, and navigating various medical procedures along the way. Juliette has really blossomed over the last several months, first taking steps, now walking and climbing ALL over! She is following simple instructions, participating in her early childhood classroom, and using signs such as “more” and “all done”. Way to go Juliette! We are so proud of you and cant wait to see what amazing things you will do next!” -Stephanie Foege, mother of Juliette