Friday, January 16, 2015

Week 2- Proprioception, and Goals.

I never should have started a blog.  I didn't realize how many people would be interested in reading it. Now I almost feel like I have to inform people on what SPD is, and how its treated.  I'm just not going to be able to do that, to much pressure. There are some great websites about SPD if you'd like to know more for your individual child, but really I'm just going to make this about Melanie.

From the reading I have done, this is a really wide topic, kind of like Autism or Aspergers; while children are going to have things in common, there are wide ranges of combinations of symptoms. What you read about Melanie could be very different than another child you may know who shows signs of SPD.

A few key things- Kids/toddlers with SPD don't realize they experience sensations differently than someone else. Children naturally want to please others and are not intending to misbehave. Sensory needs and challenges can change on a day to day basis; something that is tolerated one day might not work the next.

Kamber (our OT) came again on Tuesday.  She went over a few things with me from our first session last week. I was able to follow along because I had started researching SPD, and knew the vocabulary she was using, but I didn't write any of the results down, so I requested she email Melanie's official results from last weeks survey.  I know this will help me focus on what type of help Melanie needs other than just what I gather from our OT sessions with Kamber. 

This week was really like the first real session of therapy because it was the first week where it was all about Melanie, there were no questions for me to answer, and we worked on some of Melanie's goals.

GOALS: I forgot to mention these in my first post. The Infant Toddler Program is a government funded program so there needs to be a way to assess and progress monitor how the children in the program are doing, so every child in the program starts with 3 goals... Melanie's are
1- Melanie will be able to transition from play to other activities during the day more smoothly.
2- Melanie will be able to either pick out her clothes in the morning or be able to get dressed by herself, so she is more comfortable with the process.
3-Melanie will be able to tell mom when she wants to eat, and what she wants.

So, knowing that getting dressed is one of the goals I chose for her, I left Melanie in her pajamas until Kamber got to our house so she could see what the process was like and how much Melanie doesn't like to get dressed or change. This also supports goal number 1 which is transitions from play to other activities. 

As I invited Melanie to come get dressed it was a typical situation where she refused to change, she refuses by throwing a fit! Usually getting dressed with Melanie is kicking and screaming, I hold her down and fight to get clothes on. She has become VERY strong now due to the resistance she gives, thankfully I'm still stronger.  Something related to the SPD we noticed during this process is that getting dressed can and possible relates to Melanie's tactile sense. The tactile system involves the nervous system and is all touch, contact with skin. Imagine when you put clothes on, or take them off; the sensation of clothing moving over your skin triggers what the nervous system feels. Melanie seems to preform and respond much better to more pressure on her body, so feeling the clothing pulled off and then putting them back on, which is a very light feeling, could be a trigger for a "clothing change" meltdown.  To work with this Kamber recommended I start using a PECS system. PECS are pictures that I can make into a book, or just have around to show Melanie what we are going to be doing. Since she isn't super verbal yet this allows her to visually understand what we are going to do, and allows her to begin to feel comfortable with it, before I just spring changing her clothes on her.

Proprioception is another SPD vocabulary term that needs to be explained for quick understanding.
"Proprioceptive sense refers to the sensory input and feedback that tells us about movement and body position." (Click link for reference and more information.)

Melly needs a lot of proprioceptive input.  She needs deep pressure, and she needs to do heavy/hard work. She loves to run around at night and play rough with Daniel when he comes home from work. I used to worry a little that she would be getting too riled up before bed, but now I understand that she needs this form of input to help self-regulate her body. Basically, it is calming for her. She loves being rolled up in blankets, she always chooses to climb the 2 flights of stairs to get to the gym rather than take the elevator (pregnant mom would rather take the elevator, but oh well), she loves to climb, and jump off everything (loves the trampoline at the neighbors), and she tries so hard to carry or push things that are just to heavy for her. Her little body thrives on it! Kiddos with SPD are constantly working through the day to self-regulate themselves. I was fascinated to read that you can't get or give too much of this type of input.  So back to the changing clothes issue... Other than use PECS to help Melanie both see and hear that its time to change clothes, I am incorporating proprioception input by rolling her up in blankets a few times to give her some tight pressure to her whole body, to regulate her before we change clothes. (I feel like I'm back to being a new mom where it is going to take me twice as long to get her out of the house, just because of all these new adaptations I need to make to help her. So if I am supposed to meet you someplace and I say I'll be there in 20 minutes, it will probably be 30.)

My homework for this week, is to:
1. Work on giving Melly deep pressure, stretching/compressing/moving her joints.
2. Work on getting shoes and socks off. (This applies to one of her goals. I first need to teach her how to undress before she will learn how to get dressed.)
3. Download the PECS app, or print pictures to put into a book so she can communicate what she wants, and also so I can visually how her, and prepare her for what we need to do.

After this session with Kamber, I could tell that Melanie was feeling a little overwhelmed with everything we had been pushing/encouraging her to do.  But after dropping her off at the babysitter so I could go substitute that afternoon, I realized that I felt really overwhelmed.  Its hard on us mom's to see our kids struggle, and feel overwhelmed; we usually feel their pain.  I'm sure when she is in high school and she is staying up super late because she procrastinated her homework due to the nap she took after school (I did this all the time...), then I'm gonna be able to tell myself, 'she brought this on herself.'  But right now that isn't the case! She is a 2 year old trying to process so much, that she can't explain to anyone, and I feel overwhelmed for her.  I called Daniel while driving to the school and told him it was a good session, but it was hard on Melanie, and on me. He asked if this was something that I could handle doing every week. He said we were in no rush, and we could have the sessions every other week like they were originally intended to be. But I said no. I want to keep doing these session weekly, yes they are hard for Melanie, and yes they are hard for me, but I can't help but have this looming deadline of April 2nd. I have another baby coming, really soon, and I choose to focus on Melanie as much as possible before my attention is broken up.

Keep wishing me luck. And keep supporting me, you guys are my strength!

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