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Wednesday, May 16, 2012

Raya's OT session

I've said it before and I'll say it again, Raya has been blessed with the most AMAZING occupational therapists. We are SO lucky to have worked with Miss Elizabeth for a year and now Miss Meredith! Before Raya started OT, I only knew about OT for the purpose of developing and improving fine motor skills and for helping to restore activities of daily living (ADLs) after traumatic injuries. I had no comprehension of what sensory processing disorder was or how OT would be beneficial in treating it. I feel like I'm understanding things a little more with each therapy session now. I've gotten into a rut of posting nothing but cell phone pictures on the blog lately so I took my real camera to therapy with us yesterday and thought I'd share what an OT session with Raya looks like. :)

This session was what we do on the days when Raya is having a lot of sensory-seeking behaviors (i.e. climbing on things, falling down without reacting to what should be painful, falling down or bumping into things on purpose, hanging from the kitchen table, toe walking, jumping instead of walking, etc.).

We started with the swing, which Raya was absolutely TERRIFIED of just a few weeks ago. She has had a total meltdown anytime I've ever put her in this type of swing outside of therapy, and up until very recently she couldn't handle it at therapy either.
We start her out gently and then increase the movement as she tolerates it. You would think that a child that exhibits a lot of sensory seeking behaviors would love a lot of motion but as soon as she's not the one in control of the motion, she panics. Yesterday she was doing really well though. Clinging for dear life, but with a smile on her face. :)

After the swing, Meredith blew up the giant inflatable mattress with the opposite corners clipped together to make a tunnel. She put a pile of bean bag animals at one end and a bucket at the other end and had Raya crawl back and forth putting the animals into the bucket. It's a challenge for her to crawl on the uneven surface and an even bigger challenge for her to stay focused for very long. Tunnels used to be terrifying for her too. She's come a long way.

She takes a lot of breaks.


She also likes to tell Meredith that she's all done and try to dive over the edge of the mat after every other bean bag:
Nice try girlie! Keep movin'! Then she protests by crawling to the other end and flopping down to rest.

She looks comfy, doesn't she?


After she gets all the bean bags into the bucket, it's time to jump!

After she bounces for 30 seconds or so, her trunk starts to get floppy. She has really strong legs so she keeps jumping but you can tell when her trunk is getting fatigued because she loses control and goes all over the place. It keeps us busy running around keeping her from flying off of the mat. :) Yesterday she flopped down after a few jumps, threw her arms up and said, "All done!"

But she wasn't. :) We made her jump a little more and then it was time to play "doggie basketball" with the weighted stuffed animal.

After a couple minutes of doing that, THEN she got to be "all done" and sit down in the middle of the mat with the heavy puppy on her lap.
This is Raya's "I'll say 'MEEEEE' for you but I'm too distracted by the light coming through the door to look at the camera" face.

She's never quite sure what to think when the mat starts to deflate while she's sitting on it. :)

After all the hard work, it's time for her massage, deep pressure, and oral sensory program. She chills on a bean bag and listens to relaxing spa music while she gets her legs & arms massaged and has deep pressure done. Tough job but somebody's gotta do it.
Even though it's a little more than she can take sometimes, I think it's her favorite part of therapy. She LOVES Miss Meredith!

On the days when she's not tolerating all the really active stuff, we go into a dark room to remove all of the visual stimuli that she's very sensitive to and easily distracted by and spend more time doing the massage and deep pressure. On those days, she swings in a cuddle swing instead of the baby swing. When there are things to look at, she would rather distract herself by looking than allow herself to be aware of whatever else is going on with her body, which is why she relaxes so much better in a dark room. It's much easier to organize her system when there aren't distractions around. Yesterday, there was a cute little boy doing an obstacle course in the same room and Raya was SO distracted by what he was doing:
Sometimes there is an up side to having her distracted though. When I took that picture, her legs were squirming a little bit which is usually an indicator that she's about finished with letting people touch her. I can guarantee that if it had been me doing her massage instead of Meredith, she would have been off of that bean bag the second I tried to touch her arm. She rarely lets me massage her arms and it's even more rare for her to let me touch her hands. If I can find the right distraction, sometimes she'll let me do the massage but ideally, she needs to get to a point where she can handle being massaged without having to find something to take her mind off of it.
She's a little scary sometimes when we're walking in parking lots and things like that because she really hates holding my hand. More often than not, I end up carrying her kicking and screaming because she throws a fit and refuses to hold my hand. Part of it is just her being 2 but part of it is that she hates the sensation of people touching her hands unless she's the one that initiated the contact.

On Tuesdays, we go straight home from OT just in time to have feeding therapy, so we like to end the OT session with the oral sensory program. Meredith puts on a cherry-flavored glove and goes through a series of pressure points and massage on Raya's face. As long as she's tolerating that, they move on to "cheek hugs" and rubbing Raya's teeth & gums. Yesterday, she had the weighted stuffed animal on top of her while she got her massage. I hope that at some point she'll be willing to try a weighted blanket. I made her one last summer and she HATED it! I finally ended up giving it to her little friend Lily who loves it, so I'm glad somebody's getting some use out of it. :)

Then they do "frog jumps" on Raya's tongue. Some days she lets the "froggy" in and some days she clamps her lips shut. :)

This started out as a lips clamped shut day but then she opened them and let the froggy in. The very last part of the program is having the roof of the mouth rubbed. I'm pretty sure I would gag if somebody tried to do it to me so I'm always amazed when Raya lets her do it.
By the look on her face you can tell that the last step really pushes her limits. She can't really tell me but I wonder if the smell and taste of the glove bothers her at all. I really think I would gag if somebody did all that to me and I'm always really proud of her when she makes it all the way through the program.

She did SO well yesterday with her OT session. I walked in with a hyperactive, bouncing off the walls girl and walked out holding hands with a calm, organized, and worn out girl. :) We are SOOOO thankful to have OTs who understand how important it is to address sensory issues and so glad to have a better understanding of it ourselves.

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