"Chayse-ing" goals and moving forward at MBSH

At a small-town rehabilitation facility like Missouri Baptist Therapy and Wellness in Sullivan, Missouri, therapists are used to being on a first-name basis with their patients. Developing a one-on-one rapport by seeing their patients two to three times a week over the course of three to four weeks is commonplace for them. It's one of many things that set them apart from other rehab clinics. But for Chayse Everhart-Rector and his parents, the connection they've built has been even more important.

Physical therapist Kerri Wallace, MPT, and occupational therapist Cody Ellis, OTR/L, CLT, have seen Chayse almost exclusively from the beginning of his treatment in February 2016. They have worked closely as a treatment team, comparing goals and techniques across treatment plans to get the most out of his time in clinic. They have even gone so far as to take a special course on pediatric mobility to find new and effective ways to help Chayse -- and any future pediatric patients with similar impairments. 

Chayse's road to improvement began just before he turned a year old, when he was diagnosed with a global developmental delay. 

Developmental milestones aren't an exact science, since everyone develops and matures at their own, individual pace. But, generally, when a child approaching his or her first birthday can't sit upright independently, belly crawl or exhibit similar gross motor skills, despite the best efforts of the parents, the pediatrician should be consulted.

Chayse's parents began to get concerned when, at 4 months, he wasn't meeting certain milestones, such as holding his head up on his own. By 9 months, his pediatrician recommended they see a neurologist. 

Further intensive testing came back with abnormal results as well, prompting a referral to Missouri First Steps, an organization that provides in-home services to children from birth to age 3 years to help with development, learning and life skills. First Steps was helpful for Chayse; however, his motor limitations were severe enough to warrant more frequent therapy, so his doctor ordered outpatient therapy. Now, more than four years later, though testing and diagnostics continue, the cause of Chayse's delay remains elusive.

Ashlee Everhart, Chayse's mother, says therapy has been key in helping overcome the obstacles of developmental delay. "The teaching aspect of his therapy has really helped. The therapists are always encouraging and find a way to work with him, even in circumstances that aren't ideal."

She is thrilled that the therapists Chayse began with -- and has stayed with -- have been so adaptable and resourceful. 

"We love Kerri and Cody. That's why we continue coming here after moving. They don't quit. They don't give up," says Everhart. 

She says that other long-term providers who work with Chayse are "astonished" at how much progress he's made, particularly with his comprehension and retention, because of the perseverance and diligence of his physical therapist and occupational therapist. 

Getting him to engage and remain engaged throughout both therapy sessions was the biggest challenge for the therapists to overcome initially. Chayse was rarely responsive to verbal cueing and often required more sensory stimuli to initiate and maintain his attention during treatments. 

The goal from the start, according to his therapists, was to get him functional enough to communicate his needs and reach a level of independence that would afford Chayse and his parents a more functional lifestyle. When he started, he was completely dependent on his parents for every need. Even worse, being non-verbal, he couldn't tell them what that need was.

"Now, he has some functional independence," says Wallace, Chayse's sole physical therapist. "He can move on the floor, roll, crawl and feed himself. He is beginning to understand that he can use his body as a tool now, and make things happen for himself. He can even navigate YouTube, so he can watch his favorite, Mickey Mouse!"

Everhart wants other parents who may share in struggles like hers to know that there is hope and help available in the Sullivan area for children like Chayse. "People need to know that you can get great pediatric therapy locally."

Moreover, Everhart doesn't think that going to therapy closer to their new home in Festus, Missouri, would have been a good fit. "Kerri and Cody care so much and appreciate the little victories with us," she says. 

Chayse and Ellis especially click, Everhart says. Ellis seems to be able to get through, even when teachers have not.

"It's been a pleasure working with Chayse through the years to see him develop and progress in so many ways. It's also been a pleasure working with two parents who not only want the best for their child, but enjoy collaborating and engaging with every treatment to give Chayse the best experience he can have," says Ellis, who has seen Chayse almost exclusively for the duration of his OT treatments, addressing fine motor skills, activities of daily living and other life skills he might need to function independently.

"He's given us some real opportunities to grow as clinicians," says Wallace about her time working with Chayse. "That means more than simply learning a new technique here and there, but also honing communication and co-treatment skills, not just with another therapist, but with a family."

Wallace works with improving mobility and strengthening, as well as some gross motor skills.

Other Therapy and Wellness Center staff agree that their colleagues are committed to getting all of their patients better, but the teamwork practiced with Chayse in particular is evident. 

Everhart reiterates that perseverance is key for this treatment team to succeed. 

"Chayse has proven that all kids can be taught. He's teachable as long as you're patient and don't give up," she says. "He's smart, unstoppable and he's not going backwards."