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Thursday, March 1, 2012

Occupational Therapy for Sensory Processing Disorder- Part 1

(This is long but I think it's worth reading, especially if you're not sure why OT has been recommended for your child or if you've been told that your child has sensory issues.)

Occupational therapy (OT) is grossly misunderstood and underappreciated. In my humble opinion. :) It's not without good reason. OT and its benefits for children are hard to explain. I was somewhat familiar with OT before Raya started therapy, but I honestly didn't comprehend how much of a difference it would make for her. Not to sound dramatic, but it has been life-changing for her. Usually when people ask me why Raya has OT, my response is something like, "Because she's CRAZY without it!" And that's the honest-to-goodness truth. The last 3 weeks without OT have been a perfect illustration of what a big difference it makes for her, so I decided that I'd try my best to explain what OT is, why she needs it, what it does for her, and what she's like without it.

What is OT?
According to the American Occupational Therapy Association (AOTA), occupational therapy is meant to, "help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations). " This is the definition that I was familiar with but I was only aware of OT for the purpose of restoring activities of daily living (ADLs) in patients who had had some type of injury, such as a stroke. I had no idea what OT could do for children with disabilities/special needs until I had one of my own. AOTA's website states, "Common occupational therapy interventions include helping children with disabilities to participate fully in school and social situations, helping people recovering from injury to regain skills, and providing supports for older adults experiencing physical and cognitive changes."

Sensory processing disorder (SPD) is one of Raya's diagnoses, although I don't think it's actually recognized by the medical/insurance world. It has many names (sensory integration disorder, sensory processing disorder, sensory processing dysfunction, sensory integration dysfucntion, etc.) but they all mean the same thing: the child's body does not process the sensations it receives from his or her environment correctly and as a result, the child is compelled to behave in certain ways in an effort to compensate for what the body is processing incorrectly. Every child with sensory issues is affected differently and there are a lot of manifestations of SPD. There are several different areas of focus for treatment: "Emphasis often is placed on the tactile (touch), proprioceptive (body awareness, body position in space) and vestibular (perception of movement) systems." (AOTA) 

Back when we were in the process of finding an OT and I was researching SPD, I came across a checklist of some of the manifestations of sensory disorders (click here to see it). We already knew that Raya had some significant problems with her oral sensory development due to her total aversion to food and anything in her mouth, but it wasn't until I read through the checklist that I started to recognize some of the other ways that her body was affected by sensory processing disorder. Donny and I read through the list together and couldn't believe how many of them Raya had. The ways she's affected by SPD have changed over time, but here are some of the things we've seen:
  • Avoids touching certain textures (anything light & fluffy) and would cry and try to get away from things of that texture. She had a crocheted blanket that made her cry and panic every time we put it on her.
  • Has to get used to changes in clothing, like wearing long-sleeved shirts when the weather gets cool enough. It takes her several days of having long sleeves on before she can get dressed without freaking out because of the sleeves.
  • She REALLY liked touching rough textures like sandpaper to the point where she actually relaxed and could tolerate touching softer textures as long as her feet or hands were touching sandpaper.
  • She has a freakishly high tolerance to pain and/or absence of typical pain response. Like when she broke her arm the first time and then 4 days later while she still had fresh fractures in both her radius & ulna, she was swinging from the kitchen table and it didn't faze her one little bit. And when she broke her arm the second time and I didn't take her in to get it x-rayed until 5 days later because she wasn't acting like it was THAT hurt.
  • She falls down on purpose sometimes and thinks it's funny.
  • One of the first things she liked having in her mouth was the handle of a battery-operated toothbrush because the vibration gave her strong sensory input.
  • When she does put food in her mouth, she prefers things with strong, intense flavors. Last week she ate a really hot, spicy chili flavored chip that no 2 year old would ever choose to eat but she chewed up the whole thing before spitting it out 20 minutes later.
  • She has difficulty tolerating walking on uneven surfaces, although she's gotten much better. Here's a video of how she used to panic when walking down a sidewalk with a sideways slant. 
  • She is constantly moving and is never really still unless she's asleep
  • She likes to be held & wants to be held but only at arm's length & doesn't like to have her arms & legs touched. Especially her hands. She HATES having her hands touched.
  • She used to vomit almost every time we had a ride in the car. Sometimes it was during the car ride and sometimes I had enough time to park the car, run around to her side, and yank her out so she could puke on the garage floor instead of in the car. :)
  • Now that she's learned how to run and jump, she runs and jumps more than she walks.
  • She seems overly clumsy for her age and runs into things by mistake a lot.
  • She has had mild to moderate motor delays that have gotten much better with PT & OT.
  • She hates to have blankets on her even if she's cold.
  • She's had a love-hate relationship with swinging motions. As an infant, she loved the cradle swing but then she got to where she could only be in it for 10-15 minutes and then she would throw up. When we started OT, she hated the platform swing. She likes it now but she still HATES the cuddle swing. She also LOVES to swing from the kitchen table or anything similar.
  • She loves to carry heavy things and seems abnormally strong for her age. We joke that she's going to be an Olympic power lifter someday. :)
  • She's scared of certain noises (vacuum, blow dryer)
  • She gets overwhelmed in crowded places like church or parties.
  • Oral development. *sigh* yeah, she's got issues. :)
  • She has had trouble discerning between food tastes and non-food tastes. She puts things in her mouth and can't tell whether they're food or not.
  • She LOVES the dark and is probably the happiest/most calm when she's in her crib at night and it's totally dark.
  • She would rather WEAR her food than eat it.

Those are just a few of the ways that SPD affects or has affected Raya. There are more but the list is long enough already. I left out things like how she can be awake all day long and be running around like a wild woman the entire day and never seems to run out of energy or how she has no fear of climbing on the kitchen table, counters, or anything that she should probably be afraid to climb on. She has no sense of danger for the things that she should be afraid of and is afraid of small silly things that she shouldn't be afraid of.

(Click here to read part 2.)

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