Making sense from our observations

Let me share how I happened to discover the value of observing what goes on around us. This happened about 20 years back, when I was getting more interested in clinical signs of neurological importance in children, to understand and predict the developmental needs of children.

I used to have parents seeking consultations for children who have paralysis or weakness of one side of the body. It was obvious by about six months if a child was using one side more and ignoring the other side of the body. It was rather late to notice the weakness of one side at six months of age as treatment got delayed. I wondered if it could be found out  before three months of age! 

That is when I noticed, while reviewing several photographs of children who preferred to use the left hand, that those who had a weakness caused due to an injury to brian, preferred to keep the fingers or the thumb on the side of paralysis closed over the palm as seen in the first photograph.

Those infants, who have a preference for the use of left hand as the dominant hand, normally demonstrate that only by two years. Till then they use both hands equally. But even those who may use the left hand by choice, while the right hand is fully functional, will keep the fingers of the right hand open, which is what you  observe in the second photograph. They may be natural left handers and not compensating for any weakness of the right hand.

This consistent observation helped me to examine the fingers and thumb more carefully while doing a neurological examination of the infants at six weeks after birth and at three months of age. The flexed  position of the thumb over palm, increased tone of the fingers as revealed by flexed position of the fingers even during sleep and incomplete opening of the fingers when the palm is stroked or when an object is placed over the palm became indicators  of suspicion of  a possible weakness on that side. This  could be observed even before any other definitive signs of weakness or paralysis of the one side of the body could be clinically picked up. On follow up of several children, this was authenticated. 

This was a significant learning experience in my clinical pursuit. Although books have referred to it, it was a new experience when it was possible to authenticate it by observation as early as two or three weeks after the baby was born. This meant that treatment for such children began immediately after birth.

All of us can observe and commend about what is going on around us and when we do so, we discover many surprises which can make a difference! This increases our alertness, and enhances our capacity to see, hear and feel.It promotes staying connected with our environment, and makes us more relational.