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Saturday, December 10, 2011

A smile in the ball pit

When we first started talking about OT at Raya's first neuro appointment, I totally didn't get it. I vaguely remember the neurologist mentioning that she thought Raya would benefit from OT, but she didn't write anything down or make a referral or anything, and I was trying really hard to remember the BIG things we'd talked about so that kind of went out the window. Not to mention that at the time, Raya wasn't on her secondary insurance through the state and didn't have OT as part of her early intervention therapies (we hadn't even started the EI therapies yet at that point) so it would have been yet another out-of-pocket expense. There were a LOT of expenses then since we were seeing GI every couple of weeks & paying higher Rx copays. I didn't understand how much of a difference OT could make and I felt like I was pretty much maxed out on appointments then so I didn't pursue OT for her.
Anyway, at the appointment when the official CP diagnosis was made, her neuro brought up OT again and kept talking about sensory processing disorder, which I didn't really know anything about. When her services moved over to the Department of Developmental Disabilities instead of Early Intervention, we started OT. I still didn't quite understand it then. It's taken me almost a year, but I am finally seeing the connections between some of the activities we do frequently and the issues Raya has.
Sometimes we play with toys as a distraction while we're doing things she doesn't like. This applies more to our PT appointments (during stretching & soft tissue work which she hates) but sometimes she needs a distraction in OT as well. Other times Raya plays with a certain toy because it motivates her to do things that are difficult for her and also offers a welcome distraction so she can focus on something she likes doing to take her mind off of whatever she's doing that's difficult or unpleasant. As she's focusing on things that she likes while doing things that are difficult or unpleasant, she's also learning to cope with the sensations that her brain doesn't process correctly.

For example, on Friday there was a toy that Raya had been playing with through most of her appointment. It was a plastic case with different shaped animal blocks in it, and since it kept her attention pretty well, Miss Elizabeth more or less set up an obstacle course for Raya and put the blocks at the end of it. Raya would climb over mats to get the block and then climb back over to bring them to me and put them in the case. The blocks were the motivator and at the same time, they gave her something to focus on to keep her from losing interest in climbing over the mats. After she had gotten really comfortable with that, we went to the ball pit.
I don't remember how long it's been since the first time we tried putting Raya in the ball pit but it's been several months. We've tried SO many times to get her in it but she's always been terrified of it. It's complete sensory overload for her. They surround her body, make noise when they move, make it hard for her to move, and it's just a really difficult situation for her. This time, she did really well with it. Elizabeth put the case at one end of the pit and the blocks on a chair at the other end and then helped Raya go back and forth to take the blocks to the case. And for an added sensory experience, Kaida was flopping around in the ball pit the whole time. It was very helpful. :)Raya stayed right at the edge and was hanging onto the rail for dear life the whole time, but she kept going. When you find the right motivators and have the patience to allow things to move on their schedule instead of trying to make them fit the timeline you have in mind, great things start happening. :) (now somebody please remind me of this in 6 months when all she wants to eat still is sour cream :)
I think having long pants, a shirt and a jacket on helped a little because the balls weren't really touching any skin except her hands & feet. She was still uneasy but she had a task to focus on so she did it. No sooner had she placed the last block in the case than she said, "Ah-out." and tried to climb over the side. :) She's been doing much better with telling me she's done with something instead of freaking out like she used to.
Well, that was long & rambly as usual, but my point is that OT is just plain amazing. We love OT & we love Miss Elizabeth and we love days like Friday when we see progress like getting in the ball pit without a meltdown!

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