After nearly eight years working toward his goals, 10-year-old Christian Smith graduated from his therapy program this past March. “We miss him around here,” occupational therapist Macy Freeman remarks fondly, “but we are so happy to seem him thriving.”

Graduation (pictured below) was a super day for this motivated superhero fan. Like the “good guys” he’s fond of from his favorite comic books, he worked persistently to get the job done. According to his therapy team, he never lost his sense of humor along the way – or his willingness to tell jokes – despite the continuous hard work required of him. And each day he brought an attitude that spread joy to those around him.

“Christian’s determination is amazing to me,” his mom Jessica says, reflecting on watching him work through the years. “Also his consistent joyous mood. He never complains that he can’t do something, and doesn’t use his disability to say he can’t.”

Maximizing motion and movement

Christian was diagnosed with cerebral palsy as an infant. His care is monitored by our cerebral palsy team, which has specialists in orthopaedics and rehabilitation.

Cerebral palsy affects how the body moves and functions. Exactly how a person is affected can vary, and in Christian’s case, the muscles, movement and motor skills in his limbs – most significantly his legs – are affected. There is no cure, but CP doesn’t worsen over time, and treatment can help a child improve their functioning to the highest level possible and maintain that improvement.

As part of his treatment program, Christian had surgery when he was eight that lengthened the muscles behind his knees (his hamstrings) to help his leg movement and knee positioning for walking. He wears leg braces to help with stability and walking patterns and at times uses other assistive equipment. When he was one and a half, he began coming to our Petersburg Therapy Center, our closest location to his home in Sussex.

“We enjoyed the patience, motivation and encouragement offered by the whole staff,” Jessica says. “They always made sure he was comfortable and that any questions I had were answered.”

With Christian’s form of CP (diplegic cerebral palsy) muscles tend to be stiff or stay in a tightened position and over time this can limit how far joints in the legs and arms are able to bend and move. Through exercises and activities, physical therapist Katy Smotrys helped Christian work to loosen and strengthen his affected muscles to help improve the motion in his legs so he was able to reach full movement potential. She also worked with him on balance and related physical needs.

One of Christian’s favorite activities was the half-kneel exercise. “He would balance on one knee and we would either hit a beach ball back and forth or play a game on the iPad while he was in that position,” Katy recalls.

Exercises like these require significant effort and sharing jokes with therapists was often a reward for Christian at the end of his sessions. (Knock-knock jokes were their favorite.) Reaching his goals was motivating too. When Christian first began walking, he needed the support of a wheeled walker. He graduated to forearm crutches at the end of first grade and by second grade no longer needed them: “I still bring them to school, but only because I have to,” he happily points out. “I can walk without them.”

Coming to sessions without the crutches, then not needing them at school were huge milestones. “Christian feels a great sense of independence not having to use them,” Jessica says. Long distances can still be challenging and he sometimes uses a walker for those. He keeps up his progress through physical therapy at school.

In occupational therapy, Macy led activities focused on helping Christian acquire motor skills and muscle strength required for the things he needs to do to function in his daily life. “He made great strides with dressing skills,” she says, “and with taking off and assisting with putting on his leg orthotics (braces).”

Working with Macy, Christian tried supports like a “talk to text” phone app to assist with written communication. He has an aide in school to help with his work and his writing, among other tasks, but he’s doing more on his own each year. This progress continues with his school’s occupational therapist, and his continued improvements allow him to focus even more on his favorite subjects, Reading and Virginia Studies.

Katy and Macy agree that Christian’s spirit, and his family’s positive attitude, teamwork and dedication to his therapy sessions, contributed to Christian meeting his therapeutic goals. “They never look at his disability as a setback and always give him the confidence and resources he needs to be as successful as possible in all areas,” Macy praises.

Inspired plans, inspiring smile

With fewer appointments and a little more time to himself, Christian’s been enjoying special outings with his mom. They’ve done “movie and lunch” a few times already this summer, visited the Children’s Museum with his sister, Cali, and plan to hit some parks, play areas and restaurants they haven’t tried before.

Christian is excited to start 5th grade this fall and already has big future plans. Inspired by his experience, he hopes to be a physical therapist one day, or possibly a chef. A self-described “eating machine,” he enjoys working with his father, Jason, in the kitchen. Christian recently tried his hand at making a breakfast pizza (it turned out really well) and his mom says he loves all types of foods.

Whatever Christian does as he moves forward in life, he’ll bring the infectious smile and personality our therapy team had the pleasure of getting know so well through the years. “It’s one of the reasons I nominated him for a photo in our hospital calendar,” Macy shares. “I knew Christian would make others smile because he always kept his smile and sense of humor, despite his challenges.”