Friday, November 21, 2008

Occupational Therapy

Little Bug had his first session with his OT L yesterday. She wants to teach us brushing, but did caution that it would be done every hour and a half except when he is sleeping for two weeks. Other than that she didn’t give us too much information. Nick is going to follow up with her in order to get more information before we decide to go ahead with it.

She didn’t have much information about the self injury- she said that until he gets more speech, we won’t know why he is doing it. To me, that is a non answer. Little Bug isn’t in speech therapy and even if he was, it isn’t a miracle! It takes time and work. We are going to have a meeting with his therapist and our FRC as we don’t feel like enough is being done about these behaviors. When it comes to hurting others, the strategy is to prevent it- which means that while the intended victim doesn’t get harmed, someone still does.

Going back to the visit, L plans to have a snack time next time in order to help get Little Bug to try more food. She is also going to do bathing and dressing in future visits.

Right now, Nick and I are frustrated as we watch our sweet boy hurt himself for who knows what reason. Everyone seems to be pinning their hopes on speech. Well, let’s analyze this for a second. Children by the time they are 2.5 should have a vocabulary that is close to if not exceeding 300 words and be able to use two to three word sentences. Little Bug has 53 words, of which only 30 are spontaneous. The rest we prompt him into saying. While I am not saying that he will never reach that summit, I believe that we need an interim solution.

You can always have hope- you *should* always have hope. Hope that there will be change, hope that your child will achieve their fullest potential, hope that you will be able to help them overcome whatever challenges they face in life. But while you are hoping, don’t forget to work and plan and strive. Nothing is achieved without a great amount of work. I am the kind of person that always prepares for the worst. To me, pinning our child’s safety on speech therapy and the hope of speech is not an option. Now, we just have to have a plan.

1 comment:

Anonymous said...

Brushing is very helpful for a lot of kids. I highly recommend trying it. We follow it with joint compressions, and given Little Bug's love of deep pressure, my guess is that he'd dig that too. It's just my opinion, but if it were me, I'd really invest the effort to do this.

I'm not going to tell the OT how to do her job (well, maybe I am...) but I'd give some thought to focusing on one or two issues at a time based on how big a problem something is. He is getting enough nourishment to get by. Again, not wanting to side-seat drive, but if I was the OT, I'd be dealing with self-injury and broader sensory problems first. Unless he starts being malnourished or something, it seems like that could wait a bit.

It feels like she's trying to do a little of everything. Maybe that'll work for you all, but it didn't for us. We have to concentrate on a small number of things and make strides before we tackle something else.

I totally agree with your feelings about speech. Pinning everything on that is like hanging out and waiting on the rainy season while your house is about to catch fire. There are things you can try and then you can note changes in behavior (good or bad) and go from there. Our kids rely on us to be their rational, thinking, analytical brains in the midst of all the stuff they are going through - even though I often feel neither rational nor thinking nor analytical.

It's like playing warmer-colder. You try something and you either get closer or farther away from improvement. I guess I see it like this. If a little baby is crying, you don't wait for him/her to develop a working vocabulary before you do something. You think, "it's been two hours, she's probably hungry" and you go feed her and see if that helps. Little Bug is obviously a lot older and my son is even older, but the basic principle still applies in my mind.

Again, I say this with some hesitancy, but I'd call BS on the notion of waiting for speech to figure out the self-injury. There are things you can try until you find something that helps, and then you build on that. It's trial and error, but that's better than error and error. Besides, if he's banging his head, even if he could talk, does she expect him to pull back and perform some rational analysis of why he did it?

Anyway, didn't mean to go off like that. Sorry if I overstepped my bounds. Bottom line - You all are smart; trust your gut.