CHILD: Jill 1month 3 months 9 months 12 months 24 months 36 months

Motor Hypertonia:
floppy baby
lacks flexor
tone
Still cannot
hold head
steady when
sitting
Sits alone Walks alone
Feeding/Swallowing Low muscle
tone presents
challenges
with latching
on to the
breast
Dysphasia due
to
oropharyngeal
hypotonia and
small mouth in
relation to
tongue size

Weight gain is
slow
Neck and
head support
is still limited
Milk is often
regurgitated
Not ready
for solid
foods,
transport of
the bolus
difficult due
to small
mouth/large
tongue
Food
sensitivities
and allergies
present
additional
weight gain
challenge

Cognition and
Emotion
Smiles when
talked to (avg .2
mo)
Plays pat-a-cake,
peek-a-boo (avg. 11
mo)
Responds to simple
instructions (avg. 16
mo)
Building a tower of 2
blocks (14-32 mo). 2
Dry by day,
Bowel control (on
avg.)
word phrases. Pointing
to pictures.
Speech seldom
vocalization
before 5 mo.
Begin to
babble
around
10mo.
(12-15 mo.)
Spoken words are
about to form if
the child shows
signs of trunk
support and
ability to blow
bubbles, although
first words arent
likely.
May or may not be
intelligible, and first
words emerge, can
repeat sounds, but
poor oral motor
skills become
evident.
Produce
around 150
words,
however there
are a lot of
speech
errors(slushy-
sounding
fricatives and
omitted
sounds),
produce 2
word
sentences,
Language responds to
sound, smile
when talked
to
responds to
simple
instructions re
12-24; avg. 16
months), respond
to simple
requests,
peek-a-boo,
responds to simple
instructions (range
12-24; avg. 16
months), can point
to pictures, name
body parts
first words
spoken with
meaning
(range 13-36;
avg. 18
months),
2-word
phrases (range
18-60; avg. 30
months)
Overall
communication
responds to
sounds
Follows
objects with
eyes, smiles
when spoken
to
reaches out
and grasps
objects
passes objects
from hand to hand,
plays patty cake or
peek a boo (11
months)
first words spoken
with meaning (18
months)
builds a tower
of two cubes

-slowing down in comparison to normal development
-pathological feedings due to hypotonia.
-Insufficient core stability causes difficulty with motor development (due to hypotonia)
-hypotonia: abnormal tone
-***not only slow in development but also differences in development due to that hypotonia*** depends how severely motor system is impaired, on
the hypotonia, and on MR)
-risk of mental retardations from mild-severe
-weakened/reduced/absent reflexes
-weak rooting reflex can cause problems in feeding/swallowing
-Jill has a good caregiving team and good sensory input