Friday, June 7, 2013

Why is Occupational Therapy so important?

This. This picture above. This is one reason why Occupational Therapy is so important. This is the first time I have been able to get James on a swing at the park. He wouldn't even stay in a baby swing for more than a minute. Six months ago I wouldn't have believed it if you had told me that he would not only tolerate the swing, but that he would say "swing fast". This is a huge feat for him to have accomplished. His brother Andrew finally got on a swing a couple months ago at the park and he is almost 9. Andrew did not get proper OT until we changed school districts last summer. It is obvious how important the right early intervention is to a child's progress when you look at my 2 boys.

People are always asking me what OT is and why it is important for my kids. I mean, they both can walk. Why do they need OT? Hopefully this will help people understand what OT does for my kids, and why it is important for kiddos on the spectrum.

Both of my boys have always had major issues with having their bodies on unstable surfaces. It would cause some extreme meltdowns when we would try to do a seemingly simple task. Like walking down one stair from our house to the porch. James still pauses and whimpers a little when he has to walk down that step with no rail to hold on to. But at least now he will do it. He is overcoming his fears and has more awareness of his body and where it is in regard to his surroundings.

When James started speech therapy right after his 2nd birthday, his speech therapist in the first 10 minutes of meeting him came out of the therapy room and asked me if he was getting OT. I said that I was fighting to get it, but that I was denied by the regional center. She insisted that he has a weak core, is unstable even sitting on the floor, wiggles a lot, and had sensory issues that needed to be addressed by an OT. Furthermore she told me, as I had recently learned with Andrew, that he would make more progress with his speech if he had OT services as well. This was something I wish I had known when Andrew was this age. If I had, I know that his outcomes would look very different than they do today.

Movement facilitates speech. A year ago I was told by Andrew's Speech Therapist that she was able to get more language and concentration out of him if she worked with him while he was sitting on a plank swing. She would do almost the whole session swinging him on the swing and working his goals. He would respond verbally more often. He was calm. Focused. Engaged. It was quite amazing how much they were able to get out of him when he had his speech in the OT room.

We have had the same results with James. Immediately after that first session of Speech Therapy, his therapist moved us to a different location that was further away from our home, but that had OT therapists and Speech Therapists working together with the kids. She had their OT assess him while she worked with him and figured out that he was much more receptive to working with her if he had the movement during the sessions. I was more determined than ever to get OT services for James. I fought for 4 months and was pushed back and forth between Regional Center and Kaiser. Finally, after having to go in front of a mediation judge, the Regional Center approved OT services for James. His services started in November.

At that time, he was having lots of meltdowns. He would scream and shake in terror if his therapist tried to get him to crawl through a tunnel, or walk up stairs, or sit on a yoga ball with her holding on to him....working on his balance. His anxiety and so high and he was non compliant with many of the tasks. Forget walking on a balance beam, swinging, etc. His OT session focused a lot on movement at this time. The OT would make obstacle courses with highly preferred items at the end of it to get him to learn to navigate his body through the tasks. Walking up ramps....jumping over small items....etc. It may not seem that movement like this is important, but it really focuses on safety issues and social issues too. Imagine him trying to navigate a park with other children and learning to play when he has all of these problems with movement and balance.

The other extremely important part of OT is how they deal with Sensory Integration issues. Andrew's sensory issues are extreme. He is sound sensitive. He is a sensory seeker. He needs deep pressure compression squeezes on his body constantly through the day. He is orally fixated and needs input in his mouth often throughout the day. The list goes on. James also has sensory needs. He asks for squeezes often throughout the day. It is so nice that he can tell me when he needs it now. It prevents the meltdowns he used to have when he was dis-regulated and couldn't tell me. OT's will help parents and school implement a sensory diet that is appropriate for each individual child. This will help them to regulate their body throughout the day, and minimize behaviors due to being unable to get those needs met. This is as important as all other aspects of OT.

Now, 6 months after starting OT, James is a completely different kid. He will willingly crawl through tunnels, walk up and down stairs holding the rail, go down slides, jump off high surfaces, and of course swing. He will even hold on to a zip line 5 feet off the ground and zip down and fall into a crash pit full of soft, fluffy foam. It sounds so fun for kids to do, but for him it was hard work and it filled him with fear. I am so proud of how far he has come. You can't imagine how much this has helped him on play dates the park.

Not only has his gross motor skills improved, but his fine motor has come a long way as well. He has a lot of problems with bilateral hand movements. Getting his hands to work together. So they work a lot on tasks that require passing items from one hand to another. Like stringing beads, pulling a rope one hand over another to pull himself along the floor on a platform with wheels, etc. These tasks work on core strength and balance as well which are so important for him. He has always needed to put at least one hand on the ground to hold himself steady when he is sitting on the floor, and you can't do that if you are using both of your hands to perform a task. Think about when you need to put on your shoes and socks. That is impossible with only one hand. All of these tasks that seem unrelated to everyday needs are so important in giving him the skills to be able to do self-help on a daily basis.

One of the biggest things I have learned in this process, is how imperative OT services are for kids on the spectrum. I have also learned how terribly hard it is to get it. Schools rarely will provide these services unless you can prove an educational need for them...and even if you can, they usually only have one OT for an entire district. I am grateful that laws have passed in California to make it easier to get OT through insurance companies, but you still have to fight for it. Don't give up. If your kids sound like mine, advocate for OT services for them. It is for so much more than just basic motor skills. My kids wouldn't be talking as well as they are without OT. They are stronger, safer, their meltdowns have minimized, and they have learned coping skills to help them get their needs met. Fight for it. It is that important. 

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