A proper pediatric neurological evaluation will better guide PT/OT, as well as if any other necessary treatments if the underlying cause is treatable.
Pediatric question: For an 8mo baby with hypotonia and delayed gross motor milestones, how much could diagnosing the cause impact the PT/OT she is already receiving?We are talking about an IUGR baby who was born 0.03rd percentile at 38 weeks and is now 13th percentile weight, still has low BMI and diagnosed at 6mo with overall hypotonia. Currently working with PT in person weekly and OT via video-chat weekly.Skills being worked on in PT/OT include:rolling front to back (emerging, working on efficiency)rolling back to front (she never does this unassisted)weight-bearing on elbows in tummy time (often lifts arms and arches back)weight-bearing on hands in tripod sitting positionshifting weight and reaching while in prone/various seated posesbuilding lower abdominal strength with targeted exercisessensory brushing and joint compressionsimproving one and two hand grabsreconditioning oral aversion (from extensive craniosacral mouth work and tongue tie revision w/ post-surgical exercises around 4-5 months old)eating solid foods (baby will touch foods, but never bring to mouth, accepts spoon feeding enthusiastically)neck and shoulder stretches for mild torticollisIm probably leaving something out, but this is an idea of our therapy focus. We live in an area with only one pediatric neurology practice, so we cannot begin to diagnose or rule out anything until our scheduled visit in 2 months.My questions are: Is the therapy we are doing appropriate regardless of diagnosis? How could delaying diagnosis until 10 months (or later) affect her long term outcomes? Would there be any reason for us to travel out of state to a larger facility if we could be seen sooner (on our own dime, eight hours away)?TLDR: Is diagnosis of the cause of mild to moderate infant hypotonia urgent when PT/OT is already underway?