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Thursday, July 12, 2012

SPIO Compression Vest for Sensory Processing Disorder

This week is Circus Week at OT, so Raya got to dress up as a butterfly and play carnival games. She was irresistably cute with her little butterfly wings, tutu skirt and pigtails. Her therapist wanted to try out a SPIO compression vest on her again today so we decided to make an experiment out of it. On Tuesday when Donny took her to therapy, they put it on at the beginning of the therapy session and took it off towards the end. They thought there was a difference but it was hard to tell because it could have also been fatigue from working hard during her session. This time, we decided to leave it off for the first part of therapy and then put it on and see if anything changed.

WHOA...back up...what the heck is a SPIO?? According to the SPIO website, "Stabilizing Pressure Input Orthosis (SPIO™) assists patients with stability and proprioceptive deficits through deep pressure. Since deep pressure appears to be an important somatic input for balance and movement control, SPIO is designed to provide and enhance deep pressure sensory input around and toward the midline of the body to improve dynamic stability and postural activation."
SPIO compression garments are made out of Lycra and come in a variety of colors and products. They have vests, long and short sleeved shirts, pants, and shorts. According to the website, they're recommended for kids with sensory processing disorder, cerebral palsy, hypotonia, hypertonia, Rett syndrome, autism, pervasive developmental disorders, brachial plexus injuries, Down syndrome & other syndromes, and other developmental delays. There are some contraindications, such as neurological impairments that would affect the child's ability to regulate body temperature and heart or lung defects that could be affected by the pressure of the garment compressing the chest cavity but from what I've been told, these things are evaluated on a case-by-case basis.

So remember how Raya is a very sensory-seeking kid who is easily distracted by anything and everything, lacks core trunk stability, etc.? The SPIO vest provides constant deep pressure input and that compression allows her to focus and helps engage her core muscles to give her more trunk control. I'll explain more about what her specific benefits have been later.

For the first few minutes of therapy, she was on the upside down "T" swing. After a minute or two, I noticed that she had a very serious look on her face. There was a lot going on in the room and she was really interested in what the other kids were doing. I don't know if it's because she was looking around so much or what but I'm pretty sure that the serious face was really a "if you don't get me off this thing right now, I'm gonna puke!" face. So I told her therapist and she stopped the swing and Raya jumped off and ran to hug my legs. She does that ALL.THE.TIME when we're at therapy now. And she's on a kitty-cat kick this week and won't use words at therapy. She just meows. Sounds cute but rather irritating after a few days.

After the swing, she moved on to the inflatable jumpy thing. She LOVES LOVES LOVES jumping. We let her jump for a few minutes before putting the SPIO on her. As usual, she was pretty well controlled for the first minute or so. After that, her core muscles start to fatigue and she gets floppy. She bounces all over the place, falls down a lot (sometimes on purpose, sometimes not) and she stops a lot. Enter SPIO. It's supposed to be worn in place of a shirt and without pants under it but we left her pants on anyway since we were only using it for a few minutes. It's actually rather cute on her, in my personal and completely biased opinion. :)
See what I mean? Completely and totally irresistable.

As soon as we put the SPIO vest on her, we could see an immediate difference. She instantly had more trunk control and her jumping was more controlled and calculated. Instead of just flying all over the mat in whatever direction her body happened to bounce, she was able to stay in the center of the mat. She decided that she wanted to jump to me, so she jumped to me.

She was very much in character as a butterfly too, hence the flapping arms and blurry picture. :) It was very interesting to see how much things changed instantly once we put the SPIO vest on.

After the jumping, it was time to play the OT version of a ring toss. Instead of tossing the rings, she wore them on her head, scooted across the room on the scooterboard and put them over the pegs. Everything is cuter with butterfly wings on. There were three big differences that I saw with the scooterboard activity.
1. She seemed to be more aware of her position on the scooterboard and only fell off of it once, where normally she slides off several times in one OT session.
2. Her posture looked AMAZING. She sat up SO straight and tall, which again illustrates how the SPIO helps to engage the core muscles and helps with trunk control.
3. She was much more focused. She did still stop a couple of times to look at other people who were walking past her or working in a nearby area but all it took was her therapist saying her name once or twice to remind her what she was doing and get her moving again. Such a far cry from the girl we had a week ago who spent 2 minutes picking lint out of the carpet while we tried uselessly to get her attention and remind her what she was supposed to be doing.

Okay, so look how tall she looks in this picture:
EEK! My baby is a big girl!!
Isn't that crazy?? She's sitting up so straight. I was impressed.

When we finished with the scooter board, she got to play the milk bottle game where you throw something at stacked up milk bottles and try to knock them down. (circus week, remember? :) This was pretty amazing with the SPIO too. Her therapist had her sit straddling a big bolster. She would hold a bean bag out to her and Raya had to reach across midline and grab it and then throw it at the milk bottles.
When she was wearing the SPIO, she sat still on the bolster, grabbed the bean bag with the correct hand, looked at the milk bottles, and chucked the bean bag at them. More often that not, she hit them. It was pretty impressive. Then she switched directions and had her use her right hand and she performed about the same.

Then we took the SPIO vest off. INSTANTLY we had the Raya that we know and love back. :) She immediately went back to jumping, spinning, bouncing on the bolster, rocking back & forth on it, meowing at us, looking around the room instead of paying attention to what she was supposed to be doing, and only being able to focus for a few seconds at a time. Her balance was less stable and her movements were choppy and jerky instead of being a little more smooth and fluid like they were with the vest on. When she did reach for the bean bags, her therapist had to verbally cue her to use the correct hand about half the time. When she threw them, they went all over the place and she only hit the milk bottles once or twice out of all the attempts with either hand. (In the picture below, you can see the orange bean bag she had just thrown over next to the blue mat.)
 HUGE HUGE HUGE difference. As I'm thinking back on it, the more I think about the before & after, the more disturbing it is to me that there could be such a drastic change just from putting on and taking off a compression garment.

At that point, we were ready to go home so Raya bounced across the room to get her flip-flops on. When she got to them, she picked them up and then instead of sitting down to put them on, she jumped up and seat dropped flat on her butt on the floor, completely on purpose, and didn't even flinch. I'd say that after that we walked to the car but it was more like I walked and Raya bounced, spun, tripped over herself, and jumped to the car. I felt like I was holding hands with a little bouncy ball. As we were leaving, her therapist said, "If she's still like that when you get home, do her massage and that should calm her down. Hopefully. I'm sorry. Good luck."

Thankfully, once I had the bouncy ball contained in her carseat and started driving, she relaxed a bit and calmed down. Not enough for a nap though. She decided to poop at naptime. Why is it that a toddler who poops at naptime can't go to sleep after they poop?

So back to the SPIO vest, we have discussed possibly getting one for Raya, but there are a lot of things to consider. One is cost. These things aren't cheap. There's a good reason for that and if I had the money to do it right now, I would. Another factor we're considering here is that a primary reason to get this for Raya would be to help her focus at school. She's not in school yet and possibly won't be until kindergarten, so our money would be better spent by waiting another year or so before we invest in it because if we get it now she'll outgrow it by the time she's in school. The third consideration is that because she has a G tube that would need to be accessed during the day for feeds, she would need to have the garment modified to accomodate that. If we wait another year, maybe...MAYBE...she won't need that modification. Maybe. If we were at least to a point where she was only needing a couple of tube feeds per day and taking in calories orally during school hours when she would be wearing the SPIO, then we wouldn't need to modify the garment because her tube is so low-profile that I don't think it would bother her. And last but not least, some of the behaviors that seem to be modified by putting the SPIO vest on her are also things that typically come with the age that she's at so it's possible that a few months down the road, some of these issues will have resolved due to maturity. (but I'm not totally convinced of that. just sayin')

All things considered, this is definitely something that I would like to get for her when she gets into school. It's pretty amazing to watch your child who is normally all over the place sit still and focus on an activity. This wasn't our first experience with the SPIO vest. We used it several months ago with Raya's previous OT and had very similar results. That was honestly the first time any of us had ever seen Raya sit still in one place and play with something for more than a few seconds at a time. One of my biggest concerns looking ahead with Raya is whether or not she'll be able to pay attention in school, sit still when she's supposed to sit still, and focus on her work. After seeing what the SPIO vest does for her, I can honestly see us utilizing it when she gets into school if any of those things continue to be problematic for her.

(FYI, this is NOT a paid advertisement. That would be lovely, wouldn't it? I'm just kind of excited about a cool product that we tried out so I thought I'd share it. :)

1 comment:

  1. Any idea if a weighted vest would do the same thing for her? If so, you could ask someone to make one for you; they're really easy, and the materials are CHEAP--all available at your local craft store.

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