Brielle is a 3-year-old girl with a diagnosis of spastic quadriplegic cerebral palsy who was born at 27 weeks and remained in the NICU for five months after birth.

“When we were given her diagnosis, we were at a loss,” Brielle’s grandfather, her primary caregiver, said. “All we were told is that she would basically have no memory, no control of her muscles not be able to eat or speak and have no future.”

Brielle’s grandfather said there was mention of possible therapies after she was released from the NICU, but that he did not know what to expect.

“We were blessed,” he added. “We began working immediately with Green Apple Therapy and THERAPY 2000. From the beginning, it just felt right.”

Brielle began Speech Therapy when she was six months old in order to develop feeding skills. Physical and Occupational Therapy began shortly thereafter. At the time of her admission, Brielle was unable to hold up her body or control her head; she had very limited movement. Because Brielle couldn’t use her arms to participate in play and she struggled greatly with sensory regulation, therapy initially focused on her ability to calm herself, participate in sessions, and build strength so she could begin playing and learning. Brielle struggled with being able to participate in activities with new people and she took a great deal of time to build rapport with her therapists.

“It was important to reduce her defensiveness to different sensory input because this impacted her exploring pureed foods by mouth, or reach for different objects,” Vanessa Reynolds, MS, CCC-SLP, said.

As she progressed, therapy focused on developing Brielle’s ability to visually scan to locate and track items, decrease her defensiveness to touch or tactile input, and improve her motor control so she could keep her head up and her body upright for feeding and communication with others.

“From the beginning, it just felt right.”

-Brielle’s grandfather

Brielle’s family has played a pivotal role in her success. They have been highly creative and very involved in her treatment plan.

“All of Brielle’s therapists have guided us to everything we need for Brielle and have done an amazing job in each session,” Brielle’s grandfather added. “She is NOT her diagnosis, and we believe it’s thanks to her wonderful therapists.”

Brielle is making huge leaps in her speech, fine motor, and gross motor skills. She has a wheelchair that allows her the best positioning to access her new eye gaze communication device, which she uses to name her therapists, request her favorite songs, call her ‘Grand Daddy’ and her ‘Mimi,’ ask to go outside, or tell others when she is ‘all done’ with an activity.

Therapy for Brielle has allowed her to be included in social situations and has helped reduce her frustration when she does not want to do a task.

“She is one of the happiest little girls you will find, and she smiles constantly,” Jessica Rossman, PT, DPT, said.

Rossman and Brielle’s family have incorporated the pool into physical therapy sessions, which is something Brielle now loves. Her family can also take her on bike rides since her positioning and head control has improved so greatly.

Through Occupational Therapy, Brielle can now engage in functional play with her family and therapists. She can now track objects and focus her eyes down or to the left/right to find others. This has allowed her to participate and be successful in social settings and her teletherapy sessions.

Brielle has been seen through teletherapy since March 2020. Her family worked with her Occupational Therapist, Taylor Zalesky, OTR, MOT, to develop a system of setting up an iPad, cell phone and Brielle’s communication device so that Brielle can see and communicate with her therapists, and so her therapists can see her face and eye gaze device simultaneously.

“Her family has been involved in each teletherapy session, and I believe that is why she continues to make strong progress, despite not being seen in person,” Zalesky said. “Coordination between all three disciplines, as well as her family’s involvement, has been absolutely necessary to make teletherapy successful.”

Brielle in a telehealth session with her Physical Therapist, Jessica Rossman, PT, DPT

Brielle is expected to continue being treated mostly through telehealth until her family, doctors and therapists believe it is safe for her to transition fully back to in-person treatment.

“Brielle is a joy and is always surprising others with what she is learning,” Reynolds added.

When it is safe for her to venture out of her home, the family is most excited to include Brielle and her communication device in their weekly, Sunday-night bowling activity.