← Back to homepageTherapy and small steps
Behind every small step Alex takes are many hours of work. Therapy is not an extra part of our life – it is an investment in his future independence.
Rehabilitation stays
Alex has already completed 14 intensive week-long rehabilitation stays, mainly in Poland. A typical week includes around 15–20 hours of therapy, and some future programmes will be even more intensive. We combine different areas such as physiotherapy, speech therapy, sensory integration and motor development. For Alex, an intensive stay means daily systematic work on skills that cannot be practised this frequently during an ordinary week. We have seen important developmental steps after previous stays, which is why they remain an important part of his rehabilitation. I organise the travel, accommodation, daily schedule, therapy and care of both children on my own. Melanie travels with us because I am alone with the children. Further intensive stays are planned for November 2026, February 2027 and May 2027.
Physiotherapy
Physiotherapy has been part of Alex’s life almost from the beginning. After many operations, long hospital stays and periods of limited movement, his body has repeatedly had to relearn movement. We work on posture, walking, balance, coordination, muscle strength and core stability. Foot alignment is also an important issue, so Alex uses orthotic insoles and other orthopaedic support. Knee and hip pain must be monitored and taken into account when exercises are chosen. The goal is not only to help him move better, but also to protect his joints and avoid reinforcing inefficient movement patterns. Alex currently has a double physiotherapy session every week. We continue recommended exercises at home as well.
Occupational therapy
Occupational therapy helps Alex develop skills he needs directly in everyday life. We work on hand function, fine motor skills, hand-eye coordination and motor planning. These abilities matter for writing, cutting, dressing, eating and many school tasks. Alex also needs support with sensory processing. Therapy therefore includes activities intended to help him organise his responses to touch, movement and the surrounding environment. The main goal is greater independence rather than simply completing an exercise in the therapy room. We try to transfer new skills into home and school life. Alex attends occupational therapy every week.
Speech therapy
Alex’s speech development requires particularly intensive work because the effects of his cleft, many operations and hearing impairment overlap. We practise articulation, sentence building, vocabulary, language comprehension and the muscles of the face and mouth. Breathing, tongue movement and the coordination needed for speech sounds are also important. Alex attends weekly in-person speech therapy. In addition, we work online with a Polish speech therapist so that he can continue developing Polish as well. I carry on the recommended exercises and massage at home. With his hearing impairment, every new sound and every clearer sentence requires many repetitions. The goal is not only clearer pronunciation but, above all, giving Alex more freedom to communicate his needs, emotions and thoughts.
Hippotherapy
Hippotherapy combines motor work with contact with a horse, which gives Alex extra motivation. The horse’s rhythmic three-dimensional movement is transferred to the rider and constantly challenges the trunk muscles to respond. We use this to work on balance, stability, coordination and postural control. Alex also has to adjust muscle activity and plan movements while completing tasks on the horse. The setting is completely different from a traditional therapy room. Contact with the animal can support motivation, attention and confidence. Alex genuinely enjoys these sessions, so demanding work is also connected with a positive experience. He attends twice a month and we pay privately.
Osteopathy
After more than twenty operations, Alex has many scars and areas of his body that have been under considerable strain. We use osteopathy as a complementary approach, not as a replacement for physiotherapy or medical care. The therapist works manually with tissue tension and mobility, including areas around scars. For Alex, the aim is to give his body the best possible conditions for free movement. We also observe whether tension in one area may influence posture and movement elsewhere. After procedures and periods of immobility, this gentle work can be a useful addition to rehabilitation. Alex has appointments twice a month. We cover the cost privately.
SSP, SAS and Johansen
We also use specially processed listening programmes to support auditory processing. During the 2026 summer holidays we completed the SSP (Safe and Sound Protocol) stage. Alex listened regularly in a quiet environment without additional distractions, with me beside him throughout the sessions. Because of his hearing impairment, implants and strong sensitivity to certain sounds, we proceed carefully and observe his responses. The aim is not to “fix” his hearing, but to support regulation, tolerance of sensory input and everyday functioning in an acoustic environment. In October 2026 we move to the next stage and begin SAS. We also plan to use the Johansen programme after the appropriate assessment and individual adjustment. We treat these programmes as an addition to his hearing rehabilitation and other therapies. The video below shows a short part of Alex’s SSP therapy during the 2026 summer holidays.
Cochlear Implant Days and KBO Munich
Alex’s hearing requires ongoing specialist monitoring and rehabilitation. Once a year he attends three Cochlear Implant Days with hearing tests, processor checks and programming, and therapeutic sessions. Music therapy can also be part of the programme, offering a more natural and engaging way to work with sound. For a child with an implant, hearing a sound does not automatically mean understanding it correctly, so systematic learning remains essential. Alex has also completed a four-week rehabilitation stay in Bavaria. Another important step was a two-week stay at KBO Munich focused on augmentative and alternative communication. We are looking for ways that allow him to communicate effectively when speech alone is not enough. We are currently waiting for another stay addressing his emotional difficulties.
Dennison exercises and bilateral integration
We also include selected exercises inspired by Dennison and bilateral integration in our everyday work. They involve both sides of the body, crossing the midline, alternating movements and hand-eye coordination. With Alex, I mainly use them as practical exercises for coordination, body awareness, attention and motor planning. Many can be done at home without specialist equipment. Some look like simple games, but for Alex they can require considerable concentration and conscious control of his body. I observe which tasks seem useful for him and adjust their difficulty. The broad claims made for Brain Gym regarding learning and cognitive function are not strongly supported by scientific evidence. I therefore regard these exercises only as a complement, not a replacement for physiotherapy, occupational therapy or other professionally guided therapies.
Therapy at home
Alex’s therapy does not end when we leave the clinic. At home we repeat elements recommended by physiotherapists, speech therapists and other specialists and practise skills needed in daily life. I try to use ordinary situations such as dressing, eating, preparing school things, playing and small household tasks. This way practice becomes part of everyday life instead of a separate programme. I organise all appointments, trips and consultations and try to make the different therapy elements work together coherently. Alex still needs substantial support at school, with peers and in everyday functioning. Nobody can tell us today how independent he will be as an adult. But every skill he gains now may become one more thing he can do without help in the future. That is why our daily work at home matters to me just as much as regular therapy appointments.
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