First OT Session

We had our first occupational therapy session yesterday. It went so well. Michael was able to fully participate in all of the activities which helped a lot. After watching her brother do something first Ava didn't want to be left out so she'd try too. Our OT's plan was to alternate sensory activities with fun motor activities. The idea was that the motor activities would be a fun break between the sensory activities which might be stressful for her.

First they bounced on an exercise ball mostly as a warm up and to develop rapport. Then they dug around in a container of rice and then a container of pasta for hidden objects. The pasta was no problem. Ava liked the rice until she realized it left a white powdery residue on her hands, but she stuck with it. Both of those were relatively easy because they were dry.

Then they got a ride on a kind of padded dolly as a motor activity break. The next activity was playing with moon sand. This is some kind of synthetic sand that feels moist and sticks together. Ava started playing with it using spoons and containers and resisted touching it with her hands, but gradually as she watched me play, and her brother play, and the OT play, she got bolder. Towards the end she was using her hands pretty well, but was bothered by any residue left on her hands and by the sand that ended up scattered on the floor. She kept moving her tray to a new spot to try to find a clean spot to play in.

The last activity we tried was shaving cream. To be honest, both children were a little hesitant to get in there with their hands, but Michael tried it first. As the texture became more familiar he moved from a fingertip, to multiple fingertips, to his whole hand. Ava took a lot longer and was a lot more agitated, but we eventually managed the same progression with her as well. She needed a cloth nearby and frequently cleaned her hands off.

We would spread a thin layer of shaving cream all over the tray and then draw shapes in it. I would make a flower on Ava's tray and then say, "No, no, please don't erase my flower!" Of course, that made her just want to wipe it away, but in order to do so she had to stick her entire hand in there to rub it out.

All in all the session went beautifully. The children had a blast and will definitely be looking forward to the next visit from the OT. Ava's tolerance for new sensory experiences was definitely stretched, but not pushed too far. I'll have to put shaving cream on our shopping list this week.

The Weekly Review: Week 23

Due to illness and fatigue (mine) I am going to do an abbreviated version of the Weekly Review.

It has been an eventful, but good week. Michael started preschool. We got Ava's OT evaluation results. We had two additional guests in the house for four days (dog-sitting). We finished up the kittens' week long run of antibiotics. All of those things went better than expected and I would be pretty happy about it if I weren't fighting a nasty cold.

Next week should be wonderful. We have relatives coming in from New Orleans for the week. My cousin (Ava's godfather) will be staying with us while my mom's sisters will be staying five minutes away with my parents. One of my mom's sisters is my godmother while the other is Ava's godmother. I am very much looking forward to their annual visit. I am also going to enjoy watching the children getting to know some more of the people who are so important to me.

Have a good weekend everyone.

OT Evaluation Report

Our OT evaluation addressed two main areas: sensory and feeding. Therefore her OT report covered those two topics.

The sensory issues were addressed through a standardized sensory profile administered via parent report. Essentially, I answered a lot of questions about Ava. The profile covers auditory processing, visual processing, tactile processing, vestibular processing, oral-sensory processing, low registration, sensation seeking, sensory sensitivity, and sensation avoiding.

Ava scored in the typical range for vestibular processing, low registration, and sensory sensitivity. She also scored in the typical range for tactile processing, but the OT commented that Ava does seem to have some tactile processing hypersensitivity (doesn't play with food, play-dough, messy art materials, etc.). She responds slightly less than normal to auditory and visual inputs. She responds more than normal to oral inputs (food). She also scored high in sensation avoiding. She withdraws in group situations, avoids noisy places, avoids foods with strange textures, resists being touched by anyone other than very familiar family members, etc.

Nothing in the sensory profile was surprising. That makes sense, because the results were based upon my own observations. I am anxious to begin therapy and see how the OT recommends addressing her sensitivities.

As for feeding issues, again, the report was mostly a summary of my answers regarding Ava's food avoidances and preferences. The only new information was that her gag reflex is not overly sensitive. Again, I am interested to see where therapy takes us. The report itself didn't reveal anything earth-shattering here either.

I am mostly looking forward to beginning her OT therapy to see what that therapy will consist of and how much it helps. I want to help her with her eating issues for obvious reasons. I need to help her with the sensory issues for two reasons. The first is social. I don't want her hypersensitivity to prevent her from being able to socialize normally. The second reason is her speech. With apraxia, the greater the processing demands, the more difficult speech is for our children. So, when Ava is in an environment that is overstimulating for her, her system is so busy trying to deal with that overload, that her speech tanks. I hear her communicate so much less when we are out, when she is at school, and when we have a lot of people around. If we can start to work on that hypersensitivity to her environment, perhaps her speech will improve in these settings.