AFO Casting

More new stuff.

Earlier this week, Asher was fitted for his AFOs (ankle foot orthotics). Often, in a child with spasticity, AFOs can be used to help keep the foot in flexion instead of extension, and the child wears them all the time. They are usually hinged at the ankle, to allow the child to take steps, kneel, sit, and engage in all transitional movements.

Asher is not dealing with spasticity, so his AFOs are being used solely to help him stand. Asher loves to stand, but lacks the strength in both his legs and his core. His AFOs will not be hinged so his feet will be kept in a flat, standing position, preventing him from straightening into extension. Hopefully better foot position will allow him more ease in standing.

Because of his AFOs being in a fixed position, he will not be able to make transitional movements. In his case, that is totally acceptable (for now) because of the goal being only standing. It would only be a downside if Asher was meant to wear his AFOs all the time, which he is not. So he will wear them in his stander/eventual walker, and not wear them any of the other time. 

The addition of AFOs to his repertoire is the first time our therapists have been at odds. Asher's physiatrist (MD of rehab medicine) and PT are big advocates for this and how much it will help Asher stand. Asher's Feldenkrais practitioner (a former PT herself) is totally against them because he is not battling spasticity and they will restrict his natural movements. 

We have given a lot of credit to what both sides are saying. We had a thoughtful discussion with the physiatrist and orthotic technician. They completely understand our Feldenkrais practitioner's concerns and agree that restricting Asher's transitional movements is NOT in his best interest, hence why they will only be used for standing.

Jordan and I are of the mindset that if it could possibly affect Asher positively, we will try it. If something doesn't work, at least we tried and can tick it off the list of 'things to do' (which is incidentally huge). If it does make some sort of positive impact, all the better. A year down the road, when he's outgrown these, we will assess whether we will replace them or not.

As for our Feldenkrais practitioner - well this is going to be our little secret. We think the world of her and what she does for Asher, but we really want to try this and don't want to be met with disdain from her. Because it doesn't affect anything she does with Asher, there is no reason for her to know. 

Always so much to consider! Anyway, onward ho!

To make the AFOs, Asher needed casts taken of his legs, then they create the AFOs specifically shaped for him. He was so amazingly good and patient (of course he was):

Wearing the "sock" that provides the first layer of the cast, along with a long strip that provides protection when the cast is cut off...

Wrapping the cast. When it is completely bandaged she massages his leg and his foot to have it at the angle of flexion she wants, then waits a few moments for it to set....

Molded and cut off, all in a matter of about 5 minutes per side. 

Now we wait a couple of weeks until they are ready and we go for his first of a few fittings in early September. I am anxious to see how reacts to them but I'm sure he will do very well. (Again, of course he will. When doesn't he?).