Sensory Integration and therapy question

[kRenee]

My son, nearly 10, had an evaluation recently and has been going to an

SPD OT for 2 hours a week for 2 months. We do brushing and some exercises at home daily. He is sensitive to sound as well as the deficits noted in the OT evaluation (listed below). He is easily fustrated, reacts too quickly in anger and avoids all social contact with anyone outside the family.

 

(He is also in vision therapy and has APD)

 

I know that some kids go to OT for years, but how quickly might I see any sign of improvement?

 

 

 

Thanks,

Karen

 

muscle tone/postural control

proximal weakness

bilateral coordination & sequencing

balance and motor planning

tactile discrimination

fine motor skills/handwriting skills

visual motor skills

ocular motor skills

low registration of vestibular sense

low registration of tactile sense

low registration of auditory information

decreased body awareness

[Sandra in FL]

swimming, setting up a swing in your back yard, therapy putty for strengthening the fingers, the book "The Out of Sync Child" and NeuroNet (http://www.neuronetonline.com).

 

NeuroNet has helped ds tremendously - uses jumping jacks, "candlesticks" (child holds up hips in the air and does various kicks and taps), ball tosses, toe taps, balance board, etc. It can be done using webcam if you live outside Florida.

 

HTH,

Sandra

[nitascool]

We saw improvement after the second session, but the bulk of the improvement has come only recently, we are on month 5 of 1 hour bi-weekly OT with my 6yo. Our OT told us that we will see a great deal more improvement of his vestibular problems and sleep problems when he gets his Benik Vest on the 4th of June.

 

You should discuss with your OT the possible need for a weighted blanket/vest or a pressure vest. Different children have different needs, but I would think after 2 months you should be seeing some improvements. Of course, with your son being a bit older it may take a little longer to retrain his neuropathways. Also the other issues may be compounding the SPD issues.

 

Our OT told us to give the behavioral issues at least 6 months and the social issues a year before deciding if it's working or not. And our ds's issues are pretty minor compared to some of her clients. Kids call him weird among other things, at 6 he's just now realizing these things and while he's very emotionally sensitive he's still pretty quick to forgive.

 

My son has some of the same issues as your ds, but not all... just from memory I believe he has issues with...

 

muscle tone/postural control

bilateral coordination & sequencing

balance and motor planning

tactile discrimination

fine motor skills/handwriting skills

low registration of vestibular sense

decreased body awareness

 

he also has some over-registration issues with sound and textures.

[Kathy in MD]

[My ds, with severe SPD, had most of your ds's problems (some were hyper instead of hypo), but treatment took about a year for the SPD. He was 7 when we started. However, the secondary effects of SPD needed work outside of OT. This would include self-esteem, temper and social skills. These behaviors often are a result or a self-defense to the initial problems but become ingrained and stay even after the SPD is partially or even fully remediated. Social classes or a special type of drama class where the children act out their problems are sometimes recomended.

 

Here are a few things your OT could help you with:

 

1) Teach you how to see the signs of an incipient meltdown and how to derail it.

 

2) If you missed the signs, teach you how to calm your ds promptly

 

3) Your ds should have a sensory diet to help him. A few things that might be included is heavy shoes, tight clothes, sleeping under heavy blankets, chewy foods or crunchy foods (not both), drinking through straws, chewing gum, etc.

 

4) There are a few sports that are good for SPD patients. Swimming, martial arts and horse back riding were recommended for my ds. Wrestling was recommended for him to get his needed deep pressure therapy once he hit puberty and started rejecting hugs.

 

Some of your ds's problems are compounded by his APD. I would guess his avoideness of outside social situations is probably a major one. Remember he probably doesn't understand conversation and feels at a loss. If you think of how a deaf person relates to conversation and social interaction, you might better understand his social avoideness problems.

 

A ST can help him with many of his auditory problems. I don't know your ds's exact APD problems but a few things my ds's OT worked with him on were sound discrimination, expressive and receptive language, and auditory memory. Towards the end of therapy, the ST worked on more social type language skills -- tone of voice, volume, word selection and general conversation.

 

A couple of other things you might consider is The Listening Program (or other sound therapy) and food allergies/sensitivities. I used TLP with my ds and it did help *somewhat* with his sensitivity to loud noises. He's still sensitive, but he doesn't go flying off the handle like he used to. Sensitivities to wheat or the milk protein Cassien can create problems with impulse control, which allows tempers to flare. Have you check for either of these problems? You can do a search on my name and dairy or milk to find out how to test for cassien asensitivities. I'm sorry, but I don't know how to test for wheat problems.

 

Finally, I've known of some SPD clinics that kept their patients for years. However my ds's first OT said that even my ds, with severe SPD, should only take a year to remediate. And we did it only one day a week until about a month or two before she moved out ot state (which is why ds had 2 OT's) Now my ds was only 7, so that would possibly affect how long he needed therapy. And he wasn't "cured", he still needed to maintain his sensory diet and participate in one of his sports. And his handwriting was still bad. But he didn't need the intensive hour-long therapy with an OT.

 

But I'd start looking at the experience of your ds's therapist (is she certified in SPD? has lots of experience? or is she moonlighting and actually specializes in a different area?) Also check if your ds and OT are a good match. Also talk to her and find out why you aren't seeing better results. There may be good reasons that we aren't party to.

[kRenee]

Very good ideas and suggestions.

 

I will be talking to the OT (and checking on her training) - I think ds would like a weighted blanket so those vestibular issues might need to be addressed before any others. But I will plan on patiently waiting for changes. I just let him quit swimming since he hated it so much (too loud, I think). We have a swing set which he occasionally sits on and swings ever-so-slightly. Neuronet sounds great, but we have so many other things is motion already, I hesitate to drop them all and start over. I am going to do Tomatis sound therapy with him. After that, I'm looking at Interactive Metronome, FastForWord and LearningRX. I can see where remediation of undesirable behaviors might be necessary. And I'll have to think about the cassein and temper connection...interesting.

 

Thanks a bunch, everyone.

[Frelle]

[My ds, with severe SPD, had most of your ds's problems (some were hyper instead of hypo), but treatment took about a year for the SPD. He was 7 when we started. However, the secondary effects of SPD needed work outside of OT. This would include self-esteem, temper and social skills. These behaviors often are a result or a self-defense to the initial problems but become ingrained and stay even after the SPD is partially or even fully remediated. Social classes or a special type of drama class where the children act out their problems are sometimes recomended.

 

Here are a few things your OT could help you with:

 

1) Teach you how to see the signs of an incipient meltdown and how to derail it.

 

2) If you missed the signs, teach you how to calm your ds promptly

 

3) Your ds should have a sensory diet to help him. A few things that might be included is heavy shoes, tight clothes, sleeping under heavy blankets, chewy foods or crunchy foods (not both), drinking through straws, chewing gum, etc.

 

4) There are a few sports that are good for SPD patients. Swimming, martial arts and horse back riding were recommended for my ds. Wrestling was recommended for him to get his needed deep pressure therapy once he hit puberty and started rejecting hugs.

 

Some of your ds's problems are compounded by his APD. I would guess his avoideness of outside social situations is probably a major one. Remember he probably doesn't understand conversation and feels at a loss. If you think of how a deaf person relates to conversation and social interaction, you might better understand his social avoideness problems.

 

A ST can help him with many of his auditory problems. I don't know your ds's exact APD problems but a few things my ds's OT worked with him on were sound discrimination, expressive and receptive language, and auditory memory. Towards the end of therapy, the ST worked on more social type language skills -- tone of voice, volume, word selection and general conversation.

 

A couple of other things you might consider is The Listening Program (or other sound therapy) and food allergies/sensitivities. I used TLP with my ds and it did help *somewhat* with his sensitivity to loud noises. He's still sensitive, but he doesn't go flying off the handle like he used to. Sensitivities to wheat or the milk protein Cassien can create problems with impulse control, which allows tempers to flare. Have you check for either of these problems? You can do a search on my name and dairy or milk to find out how to test for cassien asensitivities. I'm sorry, but I don't know how to test for wheat problems.

 

Finally, I've known of some SPD clinics that kept their patients for years. However my ds's first OT said that even my ds, with severe SPD, should only take a year to remediate. And we did it only one day a week until about a month or two before she moved out ot state (which is why ds had 2 OT's) Now my ds was only 7, so that would possibly affect how long he needed therapy. And he wasn't "cured", he still needed to maintain his sensory diet and participate in one of his sports. And his handwriting was still bad. But he didn't need the intensive hour-long therapy with an OT.

 

But I'd start looking at the experience of your ds's therapist (is she certified in SPD? has lots of experience? or is she moonlighting and actually specializes in a different area?) Also check if your ds and OT are a good match. Also talk to her and find out why you aren't seeing better results. There may be good reasons that we aren't party to.

 

We were in OT for a year, and the first two items you listed about how to spot a potential meltdown and how to calm your child pronto, along with providing ideas for a sensory diet were totally NOT my experience.

 

*sigh*

 

You are really fortunate.

 

I so need to get my 8 yr old back into therapy. We could find no OT in our area certified in SPD or anything I had no idea that certification in SPD existed until I read your post. And we live in the Raleigh NC area, a large city!

 

We couldn't really even get an OT who had much experience with sensory issues. Grace got a lot of help with her fine motor and motor planning issues. But sensory, not so much. And Sensory Therapists were not covered by insurance. We have recently had another very serious spiking in sensory overload stuff in our house, and I feel like Im losing my mind. I have the OOSC and the OOSC has fun and I even have Raising a Sensory Smart Child. But I just dont understand how to put a sensory diet together for her... and I totally dont know how to calm her down right away. My younger daughter has opposite sensory issues, and weve found that we can give her deep pressure to calm her. But still no idea with our oldest.

 

Thanks for psoting this. I need to make some calls on Monday.

[Kathy in MD]

We were super fortunate. Our original OT trained under the "second in command" to Jane Ayres (the OT who described SID/SPD and developed much of the early treatment protocals) Our original OT also had SPD herself and had extra insight into the problem. To top it all, she was as much a teacher as she was a therapist. She hated working in the public schools, a part time job for her, because the parents wouldn't attend therapy with their children.

 

It can be hard to find someone specialising in SPD, but you should be able to find someone in the research triangle area, possibly closer to Chapel Hill. I believe our OT was located in the triangle area for a while.

 

Putting together a sensory diet is hard because it's so easy to misinterpret your dc's exact type of SPD. I tried to do one for my ds while hunting for an OT, and did the exact opposite of what he needed.

 

One last thing. When you're looking for certification, some practioners may be certified under the older name for SPD, Sensory Integration Dysfunction (or Disorder?)

[NCW]

This may be a technicality, but it could lead to some confusion. There isn't a specific "certification in sensory integration" that an OT has to have to be skilled in using sensory integration treatment techniques in their practice.

 

I think what you're looking for is certification in administering the SIPT (Sensory Integration & Praxis Test). Certification requires completion of four courses (usually 4-5 days each), which address theory, testing and assessment, interpretation of assessment data and intervention planning, and intervention delivery. The SIPT has a very limited age range, and is costly to administer, so even therapists certified in administering it don't actually use it that often. However, the training is valuable.

 

You can also look for a therapist that is Board Certified in Pediatrics. This is a credential from the American Occupational Therapy Association, and requires more training/work experience, than the SIPT certification does. They will typically add the letters "BCP" after their name.

 

You can also check Lucy Miller's site for therapists using a SI frame of reference in their treatment - however, they pay $100/year to be listed on her site, so don't expect all good therapists to be there.

 

http://www.spdfoundation.net/directory/index.html

 

All that said, please do be aware that there are indeed very many excellent therapists out there studying and using SI treatment techniques who may just not yet have had the opportunity, time, or funds to obtain these letters after their names. You can ask what courses they have attended, and all of them should feel comfortable discussing their training with you - treating SPD does require advanced training after graduation. As someone else already mentioned, it is also important to make sure you have a good personality fit, so that your treatment time will be as productive as possible.

 

You definitely should be able to expect workable suggestions for home, a sensory diet if warranted, and at least an idea of the timeline they expect treatment to require. Treatment ideally should not go on forever.

 

I hope this helps.

 

NCW