OT Appointment follow-up

We have our follow-up with the occupational therapist and I found the appointment very informative but it was honestly a lot of information to cram into 30 minutes. I felt like I understood everything until I got home and felt really overwhelmed by it. I kept trying to go over what she showed me in my head to recall everything we are supposed to do and I’m not sure I got it really.

So I went through all the handouts I got and then headed to YouTube to look for videos to help refresh me on the techniques I was shown.  The OT decided not to do Wilbarger on him but rather a combination of sensory diet, joint compressions and what are called “squishes”.  “Squishes” involve the application of deep pressure to the muscles in the arms and legs using my hands. This seems to be achieve the same thing as brushing but because he’s so defensive she felt it would be less invasive than brushing.

The primary issues now are implementing this rigid protocol every 2 hours at home with cooperation from a teen. Oh, and also fitting real life in there some where. I do think this is much easier if you have a toddler. We homeschool so that needs to be done daily also.

 

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Sensory Defensiveness 101

Subsequent to my schooled by a OT post, I wanted to explain what I learned about the sensory system in defensive children.

The sensory system has light touch and deep touch receptors. This gives us our input about what is touching us and where our body is in space. These are processed by the brain and responses created as needed. Most of us have a balance between the two types of touch. Kids with sensory don’t.

Deep touch sensors live in our Golgi tendon receptors found in our joints. This is part of proprioception system.  We need this for our brain to know where our body is and where are limbs are. Light touch (somatosensory)  is found all over the skin/body and the signals are processed by the brain. We need this so we don’t burn ourselves and so we can feel what we are touching.

In children with sensory defensiveness, one side of the sensory system, the light touch system is over-stimulated all of the time.   When this becomes an ongoing situation, the light touch system is on high alert. The brain will create automatic avoidance behavior or responses to the unwanted stimuli.  An example of this is a child that flinched before they are even touched when you reach for them.

The reason severity in symptoms can change from day-to-day is because it is affected by how many “sensory diet” activities that child is doing on any given day. Most children with sensory develop coping mechanisms on their own and will do them when they are over loaded.  Every time they do this, this reduces sensitivity for a short period of time. So if my son had been swinging and used a hoppy ball at several points in the day, he might rate his sensory a 7 instead of a 9 that day. It would look like this on a chart:

The key to correcting the defensiveness is to tamp down the light touch system continually before they ever reach the top of that chart! This is accomplished by regular deep touch input through heavy work activities (sensory diet). Over time this settles down the light touch system and leads to lasting improvements. (** work with a OT to set this program up because it is specific to your child**)

I think my most important message to everyone is please don’t attempt to treat a sensory disorder on your own without consulting an occupational therapist that has extensive training in sensory processing disorder and sensory integration therapy. If they suggest Wilbarger protocol, make sure they went to a seminar by the actual Wilbarger people.

I detail our negative experience when it’s not done properly here.

I want to emphasize that we have not self-treated. My son has developed his own coping activities over the years and he uses them when he wants too. While this is better than doing nothing it isn’t a fix, it’s only damage control.

Don’t wait. If at all possible get an evaluation for a sensory child as early as possible. Keep in mind your school may not be able to treat this appropriately.

 

I got schooled by an Occupational Therapist!

Catchy head line, right? It is also true. With as many books as I have read on sensory processing disorder, it isn’t a replacement for an education in occupational therapy or meeting with one.

We finally convinced my son he needs to see an OT (occupational therapist) for his sensory. I was gladly schooled (yes I know educated is the proper word)  by her and happy to learn some things I didn’t know about SPD.(sensory processing disorder)

In the past my son has had OT or what his school liked to call OT which looks nice on paper. Most of the time, either it wasn’t done properly which I’ll get to in a minute or they couldn’t address things because they “don’t interfere with school” or worse yet, things were simply not being done even though they were in the IEP. This happens more than you think, folks. Apparently the complete and total inability to look at, touch or use paper is somehow not relevant in a school setting?! Yeah, ok. So anyway…..

We spent over an hour with this therapist going over all sorts of questions about my son’s symptoms. What helps it? What makes it worse?, etc and so on. The conclusion is that he has a very significant sensory disorder.  I knew that but his other doctors have ignored this issue for years as if it’s normal for a child to refuse to be examined, or refuse sitting on the paper covered exam table, so it’s nice for someone to finally recognize, that yes, it’s bad.

What we learned are:

  • Sensory disorders usually start out fairly mild but when left untreated they become worse. This leads to a child being hyper-sensitive most of the time and that can cause anxiety, problems falling asleep and many other avoidance behaviors.
  • Sensory actually CAN fluctuate from day-to-day which is fairly normal. (Good I can stop driving myself mad trying to figure that one out! see my going mad post)
  • Prior sensory treatment if not done right either doesn’t work or makes it worse.
  • There is help, we can treat this and improve his quality of life! (Yay!)
  • The previous attempt at Wilbarger Protocol was done completely WRONG! (explains why it failed)
  • The sensory diet won’t help if not done properly.

I do want to elaborate on the Wilbarger Protocol problem we had, because I think it’s highly disturbing that so many people try to use this protocol on kids without the proper training. You really can cause more problems and a lot of misery for a child if it isn’t done properly. In fact if you’re doing this wrong, you WILL cause more over-stimulation of the wrong part of the sensory system.  This is what happened to us when school improperly implemented the program.

I did not know that school didn’t implement it correctly. All I knew was that my son got a lot worse pretty fast. He even wet the bed for the first time in his life! I had read enough about the protocol to know that what we were seeing was bad. I contacted school and reported these things and they had no answer for me as to why, so I revoked my permission for the protocol immediately. It was stopped that day.

Why did this happen?

Here is why:

I found out several people at school were taking turns doing the brushing every few hours because the regular OT wasn’t always there. I also learned that they were simply not doing the technique correctly either which means I had also been advised to do it WRONG!

How to avoid problems:

  • NEVER ever try to do Wilbarger on your own. Find a properly trained OT.
  • Find out where they got their training in Wilbarger. Should be from Wilbarger.
  • Find out who will be doing it, it should be the same person every time.
  • The best time is probably during a 2 week vacation when only one parent does all the brushing once properly instructed by the OT.

We should have asked who trained them. We should also have asked if the same person would be doing the brushing each time. We honestly should not have done it at all if the same person couldn’t do it every time, and that person wasn’t trained properly either. We simply didn’t know any better which is why I’m talking about it.  I’ve learned a lot since those early days but it’s now that I’ve discussed it with a private OT, not the school, that we are getting answers.

I also note there are a lot of videos online claiming to give instructions for doing Wilbarger, some of them are actually incorrect which is why you really should work with a properly trained sensory integration therapist to learn the proper method for brushing.

We go back in several weeks to lay out his treatment plan, which will probably include  Wilbarger done properly as well as a sensory diet that the OT will put together for him.

Stay tuned…….