I need someones suggestions about my daughter please

[sport0425]

My daughter is now 3. She was born at 36 weeks, labor was induced due to her irregular heartrate.  Her heartrate went down to 7.  When she was born she did not cry for 6 minutes.  She never crawled but walked at 10 months.
At age 2 I learned she had a speech delay, assumed to be apraxia, also a fine motor delay.  A year later her fine motor is fine but she has a gross motor delay and is weaker in her arms than her peers.  She still has a speech delay, and while it is assumed it is apraxia, she doesn't fit the general requirements.  She is slow to learn colors and numbers, but after much effort remembers some.  She is very attentive and enjoys learning.  She has always been a very mello but fun child.  She runs and jumps, and plays normally, but is slow on the stairs.  She is also unable to climb on the toys at the park, that children younger than her can.  She has always just sat there when picked up, never holds on, and her hugs are weak.  She is very social.  Since birth she has had some kind of spasms, with a look of pain on her face, in her lower back and thighs.  This happens while sitting 75% of the time at least. Her back goes forward and back, and her legs go up and down over and over.  It isn't restless leg, she is fine while lying down or standing.  It is so bad that she will sit to color and end up with a death grip in her crayons, and her arms jammed into the table just struggling to sit.  I often have to let her eat standing because she cannot function when this happens.  She doesn't cry, but like I said she has always had this problem so she is probably just accepting of it.  She has a neorology appointment, but I was wondering if anyone has a clue what might cause these symptoms.
I know I should have taken her before, but the doctor said RLS, and I know it is not that, it is all the time, not worse at night, and not when lying down.  Another doctor said ADHD, but she is not hyper at all and is very attentive.    

[Akbari]

the position of the arms is called laxity as I understood, it is a position is caused genetically in some people and children that can be improved by aging by itself. but sometimes it is caused by sensory problems. close her eyes and touch a point of arm by the tip of a pencil, then ask her to show the exact location of the stimulation by the other hand. I don't know the position of the leg but I guess the same position of the arms is in the legs too (laxity). maybe this is co morbid with low muscle tone and muscle weakness that makes it difficult to climb the stairs. do the mentioned assessment of sensation and tell me the result pls, also tell the diagnosis of the physician.

[sport0425]

I mentioned the elbows and the muscle tone in her upper arms, just to let you know of other symptoms.  If her arm is pulled, even if she pulls against it herself her elbow comes out.  It has happened a lot of times.  The doctor just said some kids are like that and she would outgrow it by age 5.  I think that is why she lacks muscle, she knows it will happen.  Walking on her hands is a good idea.  I never thought of that.  I don't know what to call what she does with her legs when she is sitting, it's a repetitive motion that she does continually when she sits.  Both legs together and her lower back goes kind of in and out i guess you could say.  I used the term spasm, but I don't know that is the right term to use.  There is something wrong there.

[Akbari]

hi again, by your report I'm confused between spasticity and low muscle tone, I think you should wait for the neurologist diagnosis. but it is recommended to doing weight bearing exercises on the arms. walking on hands if possible for him is suitable.
I didn't get your mean by no muscle on the upper arms! and also elbows coming out of joints. do you mean joint laxity? is it so severe? and are you sure about the spasticity in the trunk? or it may be a kind of hypotonia and muscle weakness.
ask the neurologist about the diagnosis, and these information and also about indications and contraindications. I should know these information to prescribe exercises.
regards!

[sport0425]

Thank you for your comment, it is greatly appreciated.  If you can offer any excercises that would be great.  She apears to function normally with her forearms and hands after therapy for 1 year.  She does not however have any muscle in her upper arms.  Her leg movement appears to be fine while walking and standing, but going up or down stairs is slow, she kind of falls onto one leg, like the other can only stretch so far in her thighs, then does the same with the other.  Her elbows both come out of joint very easily.  The biggest concern I have though is the difficulty sitting, some sort of spasms, or nerve reaction maybe.  It is hard for her to learn to draw and color when she can't sit.  Also she loses her balance a lot, when turning while walking, but usually catches herself.  She does have the problem of not being able to open things that require her hands to twist like doorknobs, and loose jar lids.

[Akbari]

hi, I'm an occupational therapist. it is not possible to diagnose exactly from your report. I think after a neurologist an occupational therapist should evaluate your child, even the exact diagnosis is not made at this time the OT therapist can help her to get better by her practice. It seems that there is a kind of psycho motor delay that has made some learning problems. in these cases the problem is associated with coordination problems as learning. this incoordination can be in gross and fine motor movements.
if you tell me more signs, and the diagnosis of the neurologist, and after some other question, I think it is possible to give you some exercises if you couldn't go to OT.
but it needs you to be patient and exact!
good luck!