Giulietta's Motor Apraxia Required Creative Adaptation of OT Principles

Exploring Therapies: Giulietta’s Journey

Giulietta's low muscle tone was present at birth. By 3 months of age, an OT was

consulted, and craniosacral therapy began. Craniosacral therapy is a hands-on

technique that uses light touch on the skull, spine, and sacrum to release tension and

support the nervous system, potentially helping babies with developmental delays

improve comfort, mobility, and overall function. Giulietta did not benefit from this

approach.

OT was also sought to support crawling, though Giulietta never achieved this milestone. We realized Giulietta, like Benji, also experienced motor apraxia and had similar motor- planning challenges. She did make some progress with fine motor tasks through play therapy, as Giulietta enjoyed table work and could tolerate repetitive practice. A sensory diet was prescribed that included swinging activities, weighted and compression vests, and other sensory modalities. Adapted cutlery has allowed Giulietta to gradually learn to use a fork and eat independently.

While formal OT sessions became increasingly sporadic, the Team took the initiative to

implement OT principles learned from extensive work with Benji and earlier in Giulietta's life. Ultimately, given Giulietta's motor apraxia, standard approaches were ineffective.

The Team customized these principles to create a tailored program that encouraged

Giulietta in developing fine motor skills. Substantial gains have been made over the

years, including her ability to carefully navigate her iPad for communication, requiring

eye-hand coordination and fine motor control to acquire proficiency in augmentative and alternative communication (AAC).