Simon’s incredible progress after neonatal stroke

simon shows off the orange cast on his arm
Simon shows off his cast, part of therapy for the neonatal stroke he experienced. (Michael Goderre/Boston Children's)

Simon Lieffers is “a very busy boy,” says his mother, Cara. At 2 1/2 years old, he’s obsessed with trucks and tools like many kids his age — but he’s also fascinated by things most grownups don’t consider fun. “He wants to mow the lawn and vacuum the house with us,” laughs Cara. “He really wants to help and please.”

Simon has been surprising his family since he was born. After 37 weeks of a normal, healthy pregnancy, Cara noticed that her previously active baby had stopped moving. “Something just didn’t feel right,” she remembers. After being rushed to the hospital, she learned that her placenta had begun to die. Yet when Simon was successfully delivered with a Cesarean section, he “seemed fine,” she says. “We thought we’d gotten a happy ending.”

mri scan of simon's brain after pediatric stroke
This MRI scan of Simon’s brain shows the extent of damage from the stroke he experienced (dark area on right of slide).

Getting answers and moving forward

But at his 4-month checkup, Simon’s pediatrician was concerned that the baby favored his left hand and recommended that the family see a neurologist. “We were panicking and tried to stay off Google,” says Cara. When the inevitable lure of the internet proved too hard for Cara and her husband, Andrew, to resist, “We worried that his symptoms meant he might have cerebral palsy,” she says.

An MRI scan at Boston Children’s Hospital revealed that Simon, then 6 months old, had experienced a significant stroke while he was still in his mother’s womb. While the news was shocking, it provided the family with answers about their son’s health — and gave them the encouragement to keep moving forward. “We had to accept that we would never know exactly why this happened, but that Simon is here now and he’s healthy,” says Cara.

simon writes on a chalkboard with his hand that was affected by neonatal stroke
Constraint-induced movement therapy pays off as Simon writes on a chalkboard with his affected hand.

Being optimistic about stroke recovery

And there has been much to be optimistic about, according to Dr. Miya Bernson-Leung, a neurologist in the Stroke and Cerebrovascular Center. “Dr. Bernson-Leung told us that Simon’s abilities didn’t match the damage shown in his MRI images,” says Cara. “We didn’t know what to expect because he was so young, but he was doing really well.”

Along with Dr. Bernson-Leung, Simon benefits from regular visits with occupational therapist Julie Malloy and physiatrist Dr. David Fogelman. “We don’t think Simon would be doing nearly as well without his team at Boston Children’s,” says Cara. Because Simon never crawled, his parents weren’t sure that he would ever walk — but today he’s toddling around, as active as can be. “He keeps us on our toes,” says Cara.

simon plays with julie malloy, his occupational therapist
Simon knocks a magnetic toy off the wall as his occupational therapist, Julie Malloy, looks on.

Making strides after neonatal stroke

Simon’s greatest challenge is with his right hand, which was affected by the stroke. Constraint-induced movement therapy with Malloy — which involves placing his unaffected left arm in a cast to encourage him to use his weakened limb more often — has helped him make what his parents call incredible progress. And while he’s still receiving speech therapy, he’s speaking in complete sentences. “He’s on track with his milestones, if not a little ahead of his peers,” says his mom, who attributes his progress to the power of prayer and his dedicated clinical team.

simon lies on the floor laughing
To Simon, occupational therapy feels like playtime, but it’s having fantastic effects on his recovery from stroke.

Indeed, at a recent visit with Malloy, Simon can’t stop beaming as he works to push a ball through a basketball hoop, grasp a colorful rubber frog, and knock magnetized animal heads off the hallway wall. “He’s just improving so much,” Cara marvels as she and his paternal grandmother, Deb, cheer him on.

But Simon takes it all in stride. “Hey, buddy, can you make the frog bounce?” asks Malloy.

“Sure!” he grins, reaching for it. “No big deal!”

Get more answers from the Stroke and Cerebrovascular Center.

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