Sensory Stuff and OT Awesomeness

I've known Kiddo had some sensory processing issues for a while, and I read a few books on it.  The books say to take your child to an OT (occupational therapist) for an evaluation and treatment, and so I did.  I told them that I knew Kiddo had SPD (sensory processing disorder).  But they (and I say 'they' because we've worked with two different OTs) both focused only on his fine motor skills.  Which I realize is an aspect of OT, but not really what I wanted help with.  OT #1 we worked with for 6 months.  She worked on finger and hand strengthening (using tweezers, clothespins, playing with theraputty, etc) and finger dexterity (stringing beads, playing games, etc).  We then switched to OT #2 which I did not have to pay for anymore, as we saw her through the school system and we see once a month.  She has been working with him on scissor skills (Kiddo can cut a piece of paper in half) and writing skills (he can now draw circles, crosses, and several letters, including most of the letters of his name independently.)

Now, don't get me wrong, this is all good stuff.  But Kiddo cannot do a lot of physical things like jump and climb and pedal a bicycle and walk up a curb without needing to hold on to someone's hand.  And all the physical therapy we've been doing hasn't really been helping a lot with that but I've read that OT could.  So I knew we needed to find an OT who could help us.

And then, my apraxia mom friend in the area told me about a new OT clinic.  And so I got the referral from our pediatrician and scheduled the appointment.  And then we went and I was BLOWN AWAY.

The eval was very thorough.  I filled out a packet of info about how Kiddo responded to certain situations and when he met certain milestones (all of them late except for stacking blocks. Sigh) while the OT watched how Kiddo did certain things in their sensory clinic.  The next week she gave me a copy of the eval: a whopping 7 pages, even longer than our speech eval at GWU where he got the official diagnosis of severe apraxia.

Anyway, here's the results of his evaluation based on each system that effects Kiddo:

Tactile system: Responsible for interpreting touch.  Kiddo is undersensitive: he doesn't notice when he has a messy face, and has poor grasp on utensils, crayons etc, as well as difficulty dressing and undressing due to this undersensitivity.  He also has a fairly high pain tolerance--he's had blood drawn multiple times and he doesn't even flinch when they do it.  He watches fascinated, the nurses and I are always amazed.  But Kiddo is oversensitive when it comes to his ears.  He doesn't like water or wind in his ears.  Washing his hair isn't the most pleasant experience, nor is driving with the windows down.  But he no longer covers his ears and starts crying whenever the wind starts blowing.  OT diagnosed him with moderate tactile issues.

Auditory system: Responsible for interpreting sound.  Kiddo is oversensitive, despite his hearing loss.  Vacuum cleaners, blenders, leaf blowers, weed whackers, etc used to terrify him.  He's gotten much better about that if he has warning that they are about to start.  OT diagnosed him with mild auditory issues.

Proprioceptive system: Responsible for understanding body position without using eyes.  This totally explains why Kiddo has such a hard time climbing things and on the playground.  Also explains why he dislikes swings and slides and when Daddy picks him up and swings him around.  OT diagnosed him with severe propioceptive issues.

Vestibular system: Responsible for discriminating movement in space--works with the proprioceptive system to regulate muscle tone, balance, postural control, bilateral movement (side to side) and eye-hand coordination.  Again, explains why playing is such hard work for him.  OT noticed the way he transitions from sitting to standing, from lying to sitting, and from standing to sitting all indicate severe proprioceptive issues.  The way the OT described it to me was that his vestibular system was very immature, like that of a 22 month old, and so the way he moved around would look like that of the average 22 month old.  Talk about a punch in the gut, but it really does explain so much.  Little Brother, at 20 months, will soon be passing him in both speech and gross motor skills, but that is another blog post for another time.  The following picture I found on Pinterest really helped me understand the vestibular issues better.  Kiddo is most definitely a vestibular avoider.

Our awesome OT now works with Kiddo once a week for thirty minutes, and they're the most amazing 30 minutes I've ever witnessed.  Finally, I feel like we're on the right track and getting him the help he's been needing for a while regarding his gross motor delays.  Here's a pic of the sensory clinic where Kiddo works with his awesome OT.

There's a huge ball pit she has him wade through, bringing pillows from one side of the ball pit to the other.  Then he climbs out, stepping through each of those big tires.  Then he swings for a little while on a little platform swing, which you can't see in the picture, then he climbs up the tires and wooden steps to get a hanging monkey and brings it down.  Then, he goes over to the ramp, climbs up it, walks across the suspended bridge and down the slide.  Most exhausting obstacle course ever for him, but he's getting so much better each time and I've seen such good progress.  She also works on different things with him once the obstacle course is completed until our time is up.  It goes by too quick for me, but Kiddo is chatty but exhausted by the time the 30 minutes is up and he takes a good long nap afterward.  I love OT days. :)

As if finally addressing all these issues isn't awesome enough, we've had a little bonus.  Kiddo's talking more often, and the OT says that usually happens as a child's sensory system regulates.  She says in her experience, a lot of children with speech delays and disorders have a speech explosion after they start OT.  I'll gladly take it.  Finding this therapist has been such a blessing and I truly praise God for bringing her into our lives.

I'll leave you with a video of the boys playing.  I honestly don't think Kiddo would have attempted "jumping" into the ball pit like this before OT.  He probably would have crawled over the pool and played a little bit and then would be done.  But he and Little Brother did this over and over and over again, for about an hour. :)

Multi-Word Phrases

Kiddo is in what I call a "speech surge" again and I am not complaining!  I am so proud of this kid and the progress he is making.  Some of the things he said today honestly shocked me, and so I wanted to record them here so I wouldn't forget them.  He is now officially in the multi-word phrase.  Pretty much everything he said today, was two, three or even four word phrases, though he did occasionally say a few one word phrases, such as pointing out a circle ("circo" as opposed to the "cako" he used to say), or that he wanted an orange ("or!") Starburst rather than the red I gave him.

So, without further ado, the fun and surprising things he said today:

• "I wa pho peeze."  Probably unnecessary translation: I want phone please.  Normally in that case he would just say "pho peeze" and then with lots of prompting I can get him to expand to the four word phrase.  But twice today he came up to me saying that phrase completely on his own. 
• "Los o egg"  Translation: Lots of eggs.  Today I located our Easter eggs in the garage, which for some reason were in the trick or treat pumpkin bucket.  So we played with both.  (Didja notice the Christmas cookie cutters in the picture above.  We played with the play-doh on Saturday.  A little variety in holiday traditions never hurt anybody, right?)  Anyway, I've never heard Kiddo say there was lots of something before, though I've heard him say egg several times lately and hence the reason I pulled out the Easter eggs early.  
• "Cady i kukin"  Translation: Candy in pumpkin.  Apparently he remembered that you can get candy in the pumpkin and he wanted some.  So I obliged, and went to get him some.  Remember the "orange" comment I mentioned?  Yeah, that was related to this experience.  
• "Two Cady." No translation needed.  Apparently the one orange Starburst was not enough for the kid.  He's gotten demanding, now that he knows the power of words (and that his mother is a sucker, giving in to most of his requests because she's so proud of him using his words).
• "I di i"  Translation: I did it.  We were playing with his bowling set and after he knocked over all the pins he said this.  Took me a few seconds to figure out what he was saying, but then I got it. A new phrase I hope to keep hearing over and over!
• "Mo wawa peeze."  Unnecessary Translation: More water please.  Usually he brings me his empty cup and I ask him what he wants, and then he'll say "mo" or "wawa peeze" but this if the first time he said this as a three word phrase without any prompting.  A few hours later, he said it again.  
• "Go up."  Absolutely no translation necessary.  And although this is not a new phrase, the fact that there was a "p" at the end of "up" was new.  I've heard "uh" as "up" since he was 16 months old. "Ow" and "Uh" were his first and only words for a looooong time.  He said this multiple times today as we were playing with his car, pushing it up the hill and then letting it "go dow".
• And finally, today I asked him "Do you want to play in the play room or your room?"  He responded clearly "My oom."  I was stunned, because first of all, I've never heard him say room before (well, 'oom like they do in the Chronicles of Narnia), but also because he knew to say "my" rather than repeat "your."  And then (just to make sure my ears weren't deceiving me), once we entered his room he proudly declared "my 'oom."

So darn proud! 

Progress Report

Speech: Kiddo surprises me more and more with the little things that come out of his mouth.  Here's some examples, all from today:

• We were heading out the door to go to preschool when he told me "Grrr packpack!''  Oh yes, how could I forget the beloved Angry Birds backpack?  Thanks for reminding me Kiddo!
• Hubster, Little Brother and I picked Kiddo up from preschool and were driving into town to get some lunch and go shopping.  As we drove down a big hill we heard him exclaim "Wheee!"
• Kiddo was playing with bubbles outside and he spilled quite a bit of the bubble solution on our porch.  "Oh no!' he told me.  Never heard him use that expression before on his own, ever.  
• Seconds after the "Oh no!" incident he stepped in the puddle of bubble solution and then started walking around, admiring the footprints they left.   "Look at your little feet," I told him.  "Bubba ee!" And he stepped in the puddle and left "bubble feet" over and over and over again, proclaiming that phrase every single time he took a step.  I should have gone to get my camera to take a video for you, but honestly, I was just savoring the moment and didn't want to miss any of it.
• Kiddo came running to me in the kitchen, crying.  Normally, when this happens I have to run through a list of bazillion questions to find out what's wrong.  "Did you get hurt?  Was it your head?  Your arm?" etc.  This time, however, I asked him, "What's wrong?"  And he told me.  "Toe hur".   He pointed at his little baby toe and I gave it a kiss all better, and I told him how very proud of him I was that he was talking to me and telling me what was wrong.
• I had laid all our couch cushions on the floor in a big square for the kiddos to walk across and play on.  Kiddo's foot slipped in-between the two cushions and he fell over.  "Uck!" he cried.  And I helped him get his stuck foot out from between the cushions.

This kid is blowing me away with how quickly he is learning new words and phrases.  I hope this speech surge goes on forever and ever, because I hate those speech plateaus and finally having a glimpse of what he thinks about and is experiencing is such a treasure.

Little Brother's Speech: Little Brother (18 months) has had speech therapy with our beloved speech therapist once a month since January and we're seeing great progress.  He now makes lots of animal noises (my favorite is his quacking noise for the duck) and is repeating some of our words and phrases.  "Bye bye" and "Do aga" (do it again) are a few of the phrases we've heard, as well as the "go go go" and "da da" (all done) he's been saying since around 15 months.  As for individual words, don't have a lot of those yet, except for "titi" for TV and "ti" for eat.  (Apparently I'm raising a kid that wants to eat and watch TV all day.  He hears no a lot).  Occasionally he'll say "Mama" and "Dada" but it is always whispered and he signs it while he's saying it.  I have heard him say "gaff" (giraffe) a few times and "go" (goat), and "tiga" (tiger) once or twice.  This kid ADORES animals!  He still seems to prefer signing to speaking for now, but he LOVES to babble.  "Goolioolioolio" is my favorite babbling phrase we hear from him, and if you say something back to him in response he'll continue the babbling like he's having a conversation with you.  Kiddo never babbled and I've been enjoying hearing baby babble.  I'll try to get a video of the babbling and also his animal sounds for you soon.

Kiddo is Potty Trained!  Yep, that's right, Kiddo is potty trained!  Check out my previous post if you want all the fun deets about the potty training process.  We've been accident free for a week now and though he needs help pulling his pants and underwear back up, he can now pull them down by himself.  He is willing to sit on a toilet when we go out in public, but at home he prefers to use his potty chair, though I've sat him on the toilet a few times and he didn't complain about it.  He's been going to the bathroom at school with no problems, which his teacher and I are both thrilled about.  He also is staying completely dry through the night!  We've been putting a pull up on him every night but the last four nights it has been dry in the morning.  I've been amazed how quickly he has taken to potty training once he was ready, and the fact that he is night trained already blows me away.  So proud! 

New Therapies: I've been trying to figure out what we're going to do therapy-wise over the summer since Kiddo didn't qualify to get physical therapy/occupational therapy (PT/OT) through the summer and can only get limited speech over the summer through his school.  I wasn't really looking forward to going back to the clinic we have gone to previously, because although he did make progress there, it was slow.  So, a fellow apraxia mom/friend of mine recommended I check out this children's clinic because her son has had great progress there.  So I called, expecting a long wait list, but was able to set up a PT/OT appointment, and had our evaluation this past Tuesday.  This therapist was ah-maz-ing.  She was pointing out things about Kiddo that I never noticed, or at least didn't realize what they indicated.  She explained to me that the majority of his gross motor struggles stem from the fact he has "poor postural control", and once we strengthen his core "he'll become a really active little booger".  So we'll be working with her twice a month and I'm optimistic about what both Kiddo and I will learn from her.  The clinic also has a speech therapist, and I immediately asked to be put on the wait list to work with her.  Should be to the top of the list by May they said, and I was so impressed with the clinic (it has an awesome sensory gym and an indoor playground that the speech therapist uses too!) I was sold.  Kiddo's making great progress with his speech therapy where he sits on the floor or at a table, but I've noticed he gets a little more vocal when he's moving (common of most kids) and so this therapist uses that approach for building speech and I want to see what that's like for Kiddo and how he responds to it.

Anyway, I'm sure there's more I can report, but that's all I can think of now.  Loving all the progress I'm seeing in both of the boys.  I love my little blessings so much and am so proud of both of them! :)

"Cheese!"