Simona DeMarchi Paediatric Therapy
220 Duncan Mill Road Unit 608 M3B 3J5 Toronto, ON, Canada

Goals In the weeks since Antonio began transitioning from crawling to standing independently, he’s been reverting to this whenever he’s in a squatted position. For example, when now attempting to get up from a low chair or a stair, he’s been leaning forward and placing his hands on the floor, unable to make this further transition without the additional hand support. While we had been working on having Antonio move from squat to standing for months, and I was SO pleased when... he achieved it on his own (see post from Nov 16th ), his parents and I didn’t want to see him reverting to using hand support all the time now that he had mastered this transition. Hence, was born the further progression of his goals to include getting up independently from sitting on a step. This video is just a small sample of the work we did in his CME sessions to achieve this goal. And, watching it, I can’t help but realize that Antonio is now even one step closer to his day from SDPT. As thrilled as I am to see him continue to flourish in response to CME, I also can’t help but think of the (happy) tears that will be shed that day. We’re not quite there yet, but the tissues are ready in anticipation @toniyoyosmom #thisiscme #functionalgoals #everydaylife #motordevelopment #transitions #hardworkpaysoff #practicemakesprogress #proudpt #paediatrics #pediatrics #paediatricphysiotherapy #paediatricoccupationaltherapy #pediatricphysicaltherapy #pediatricoccupationaltherapy #specialneeds #specialneedsmom #specialfriendship #cuevasmedekexercises #cuevasmedek #cme #sdpt

I think 2021 will be your year, Mr. Trouble Mode . But until you are ready to take flight from my hands, I will be here for you. And your mom will be sure to keep the tunes running at your request on your beloved iPad! #nextyearisyouryear #2021herewecome #wellonyourway #hardworkpaysoff #practicemakesprogress #cuevasmedekexercises #cmetherapy #ipadlover #twin #prematurebaby #nicubaby #nicuwarrior #thatface #cerebralpalsy #cerebralpalsyawareness #sdpt

I’m so grateful for the opportunity to continue to instruct CME I tutorial courses during this global health crisis we are facing. The interest in the new live virtual CME I Certification course at SDPT has been phenomenal and the engagement from therapists truly inspirational. While it’s certainly not easy, therapists are stepping up to the challenge of virtual learning and, by their efforts, CME is reaching more and more children around the . A further acknowledgement of t...he impact which Ramon’s work is having and I am truly grateful for the opportunity to share my knowledge of and passion for CME with my colleagues. The above being said, I also miss teaching in person. I miss moments of connection with therapists that only in person learning can bring. Moments such as this where, in June 2019, the PT behind @pediatricphysicaltherapy visited from NY and joined our team as a CME I Certified Practitioner. Here, Marissa and my daughter, Mira, are having a stand off of sorts and they both did very well managing their babies - who are not easy to work with . Marissa, I look so forward to the day when international travel becomes easier and we can come back together for your CME II course! In the meantime though, I am so honoured to continue to welcome therapists to the CME team via virtual instruction. #cmecourses #cmeinstructor #cuevasmedekexercises ##cuevasmedekexercise #cme #standoff #virtuallearning #thenewway #missingtheoldway #wellbeback #teamworkmakesthedreamwork #patience #peristence #perserverance #findinggratitude #sdpt

Although Antonio is walking independently, his parents are committed to continuing with #cmetherapy. We are now working on the acquisition of further motor skills by continued refinement of his postural control and balance. Here we are working on just one of those skills (and stay tuned in the days ahead to see just what we’ve been focusing on most recently!), while we also connect eye to eye as trusted friends #cuevasmedekexercises #cuevasmedek #cme #hardworkpaysoffs #practicemakesprogress #hardworkingboy #trustedfriends #specialfriend #letthebraindoitsjob #globaldevelopmentaldelay #hypotonia #specialneeds #specialneedsfamily #sdpt

Future CME practitioner x2?? OT @hannahvyh will soon join the CME team as a CME I Certified Practitioner, but perhaps Izzy also has some plans to join us with time #whosteachingwho #futureinstructor #chatterbox #newfriends #meetingpeoplefromallovertheworld #cmeinstructor #cmecourses #cmeteam #welcometotheteam #cuevasmedekexercises #cuevasmedek #thisiscme #sharingiscaring #virtuallearning #thenewway #signofthetimes #sdpt

The application of CME in everyday life. Pretty incredible for a child who was completely blocked with extensor tone and unable to dissociate his body when we first met. At that time, Antonio was unable to get into 4 point so was scooting on his bottom as his primary mode of mobility, or making some steps using his walker, but with significant support and effort. One year later and the results are clear. The power of a very dedicated family, a determined little boy, and a br...ain which is responding to every challenge #cmetherapy presents it with #thisiscme #cuevasmedekexercises #cuevasmedek #cme #thisiscme #theresultofhardwork #strongereveryday #practicenotperfection #inspirationalkids #itsnoteasybutitsworthit #geneticdisorder #hypotonia #motordelay #organizedbrain #letthebraindoitsjob #familytime #independentmobility #proudboy #proudfamily #proudpt #morethanajob #sdpt

During a CME intensive block last week, Hudson was struggling with completing this exercise independently. In order to give his brain some experience with the configuration, we completed some repetitions with distal support. After this, with just a little help to slow down the velocity of the tilt in the panel, he was able to complete the exercise independently. And with all the determination - and resulting joy - as we #letthebraindoitsjob #cuevasmedekexercises #cuevasmedek #cme #thisiscme #cmeintensive #intensivetherapyintensiveresults #progressnotperfection #strongereveryday #hardworkpaysoffs #determination #cerebralpalsy #cp #cerebralpalsystrong #yougotthis #itsnoteasybutitsworthit #hardworkingkids #motordelay #paediatrics #pediatrics #paediatrictherapy #pediatrictherapy #pedipt #sdpt

Exciting News to Share In the face of the global pandemic and associated travel restrictions, SDPT is very pleased to announce that Ramon Cuevas and the CME International Center has authorized Simona DeMarchi, CME IV certified practitioner, to offer CME certification in an online format. As the CME teaching team continues to work towards our goal of increasing accessibility to CME for families in need around the world, while also continuing to do our part to keep therapi...sts and families safe, this alternate teaching method has been created. Yet, given the nature and complexity of CME, the program will begin at SDPT with CME I certification only. While in person instruction will always be considered optimal and strongly encouraged, direct learning is simply not possible for many at this time. So, if you are a physical or occupational therapist working in paediatrics and you would like to learn more about this exciting opportunity, please contact SDPT directly. Inquires will be received by email at [email protected]. And, for parents, please feel free to share this exciting news with your local therapists #cmecourses #cuevasmedekexercises #cuevasmedekexercise #paediatriccourses #pediatriccourses #continuingeducation #continuinged #virtuallearning #mentorship #inthistogether2020 #spreadthenews #cerebralpalsy #cerebralpalsyawareness #downsyndrome #nothingdownaboutit #rettsyndrome #rettsyndromeawareness #seizuredisorder #geneticdisorder #nicubaby #globaldevelopmentaldelay #sdpt

Joy comes in many forms. For Sonali’s family and I it came today in the form of seeing Sonali achieve the ability to roll independently, a skull which she was previously unable to complete fully. Sonali began having CME sessions just 3 months ago and she is already able to sustain independent sitting and now to roll in all directions. And, best of all, as this video clearly shows, she’s quite pleased with her progress #cuevasmedekexercises #cuevasmedek #cuevasmedekexercise #cme #thisiscme #fuelforthebrain #letthebraindoitsjob #practicemakesprogress #strongereveryday #abilitynotdisability #motorstimulation #independentsitting #shesrolling #motorcontrol #organizedbrain #developmentaldelay #specialneeds #nicubaby #nicuwarrior #cerebralpalsy #cvi #paediatrics #pediatrics #sdpt

Distal Support In CME, distal points of contact are used in each exercise. Whether the CME practitioner is working on provoking development of further head control, trunk control, sitting, standing, or stepping control, the goal is to give the child the least amount of support possible at each point in their therapy program. In standing position, distal support may include contact at the child’s thighs, below their knees, or at their ankles, just to mention a few examples. B...ut, as is the case in this video, it may also mean offering support higher up on a child’s body with the goal of provoking independent control below. In this exercise, Vaso is experiencing standing without any contact on his legs. In fact, I am using the straps to not only provoke further development of standing control, but also in an attempt to provoke the initiation of an independent step, which is something that we continue to work on in Vaso’s CME program at this time. Watching the video closely, especially Vaso’s response with his knees, one can see that he is exploring this freedom, which is a very positive signal toward him developing the confidence and control to one day initiate steps without direct contact on his legs. Plus, I dare anyone to attempt to resist those gorgeous eyes of his - it’s difficult to do and the reason why he now gets a chocolate from me at some point in many of his therapy sessions #distalsupport #willworkforchocolate #aboyaftermyownheart #wrappedaroundhisfinger #cuevasmedekexercises #cuevasmedek #cuevasmedekexercise #cme #thisiscme #truetotheprinciples #truetothepractice #letthebraindoitsjob #fuelforthebrain #organizedbrain #itsinourgenes #nicubaby #nicuwarrior #nicugraduate #cerebellarhypoplasia #hypotonia #lowtone #uniquelyabled #differentlyabled #specialneeds #sdpt

Charlie has become a highly anticipated visitor at SDPT. He doesn’t come to the office every day so, when he does, he certainly creates quite a level of excitement for many of the kids...and some of the parents and grandparents also . #hesloved #charliethelabradoodle #willworkfortreats #trickandtreat #hemakestherapyfun #bestdistraction #motivation #rewardforhardwork #sdptpup #sdpt

August 21 Sept 18 These videos were taken exactly 4 weeks apart. Vaso continues to improve month by month, week by week, session by session. What changes do you see? Comment if you’d like ... #cuevasmedekexercises #cuevasmedek #cuevasmedekexercise #cme #thisiscme #fuelforthebrain #letthebraindoitsjob #motorstimulation #motorcontrol #organizedbrain #itsinourgenes #genetics #geneticdisorder #geneticcondition #cerebellarhypoplasia #progressnotperfection #strongereveryday #differentlyabled #uniquelyabled #specialneeds #specialneedsfamily #ptforkids #otforkids #sdpt

Brock was so happy to be jumping out of therapy and into the weekend, that he insisted on jumping by his car - while I was concentrating on cleaning the floor #helloweekend #bringontheweekend #notquiteyetforme #stillsomeworktobedone #seeyoulateralligator #untilnexttime #productiveweek #cmeintensive #cuevasmedekexercises #cuevasmedekexercise #cuevasmedek #cme #cerebralpalsy #cerebralpalsywarrior #cerebralpalsyawareness #therapycanbefun #paediatricphysiotherapy #pediatricphysicaltherapy #pedipt #sdpt

Some sessions are a bit messy and I make mistakes at times - lets see if any CME practitioners can catch it?? And, if you do, feel free to call me out in the comments - but we always try our best and, for the most part, do so with a ! #thisiscme #cuevasmedekexercises #cuevasmedek #cmeintensive #cme #weallmakemistakes #learnfromyourmistakes #hardworkpaysoffs #practicemakesprogress #strongereveryday #cerebralpalsy #cerebralpalsystrong #hypertonia #hypotonia #highmuscletone #lowmuscletone #keepworkinghard #proudpt #sdpt

As a paediatric physiotherapist, I strive to foster as much independence as possible in the kids that I work with. For some, this may mean ultimately walking independently without assistance while, for others, it may be gaining sufficient head and trunk control to sit independently or to require less support when participating in their daily activities. Each child is an individual with their own unique strengths and challenges and each family has their own goals for their chi...ld. But, ultimately, as I think any parent would agree, the overarching goal is to support and encourage their child to develop to their fullest potential. Fostering independence...with a little side of help and a lot of love. #fosteringindependence #uniquelyabled #differentisbeautiful #imhereforyou #cuevasmedek #cuevasmedekexercises #cuevasmedekexercise #cme #thisiscme #fuelforthebrain #letthebraindoitsjob #practicemakesprogress #strongereveryday #motorstimulation #motorcontrol #specialneeds #nicubaby #nicuwarrior #cerebralpalsy #cerebralpalsyawareness #paediatrics #pediatrics #paediatricphysiotherapy #pediatricphysicaltherapy #sdpt

Novel Experiences One of the principles of CME is that the child is presented with novel exercises such that their brain is provoked to create responses which are not yet within their control. Applying this principle in clinical practice, this video of Antonio shows us working on the transition from four point to standing. When Antonio began CME at SDPT less than one year ago, at the age of 3, he would NOT tolerate four point position, let alone attempt crawling or even usin...g this position for any other transitional movements such as getting into sitting. At the time of his initial CME assessment, these were all considered absent motor functions for Antonio. However, as this video shows, he is now tolerating four point and is working on getting into standing with just minimal support! He is also using four point as a way to transition into sitting and is now four point crawling at will. Along with staying true to all other principles of CME, by exposing Antonio to novel motor experiences, his brain has been provoked to develop motor control that was, previously, not only absent, but also thought impossible for him to achieve even with active therapy. That is, until CME became a part of Antonio’s life #cuevasmedekexercises #cuevasmedek #cuevasmedekexercise #cme #thisiscme #truetotheprinciples #truetothepractice #letthebraindoitsjob #fuelforthebrain #organizedbrain #itsinourgenes #genetics #geneticdisorder #geneticcondition #differentlyabled #uniquelyabled #neuroatypical #specialneeds #specialneedsfamily #paediatrics #pediatrics #paediatricphysiotherapy #pediatricphysicaltherapy #sdpt

Variety Given the breadth of CME exercises to choose from, the clinical choices grow with a therapists experience. While I certainly may choose to return to particular exercises, whether for consolidation of the response or simply to check progress, no two sessions with any given child who attends therapy at SDPT are the same. It is this variety of motor challenges which enriches the experience for each child and provokes the optimal outcome possible. Izzy continues to respon...d well to each of the obstacles I present her with in therapy and, as her parents share with me from session to session, they are in turn seeing an exponential growth in her confidence and willingness to walk independently at home #cuevasmedekexercises #cuevasmedek #cuevasmedekexercise #cme #thisiscme #fuelforthebrain #letthebraindoitsjob #practicemakesprogress #strongereveryday #motorstimulation #motorcontrol #organizedbrain #developmentaldelay #specialneeds #nicubaby #nicuwarrior #nicugraduate #26weeker #twinsister #paediatrics #pediatrics #balance #stability #independentwalking #sdpt