About this blog.

My son was diagnosed with PDD-NOS at 24 months. I created this blog to bring meaning to the often-confusing label. Sometimes I have answers. Other times, just more questions.

Friday, September 26, 2008

On Occupational Therapy

By popular demand.

Children on the spectrum have a wide variety of sensory challenges. A good OT can identify those challenges and provide the child the sensory input the child needs to feel centered. In Thinking in Pictures, Temple Grandin remarks that until she experienced the "squeeze machine" she invented, she wasn't able to experience a very simple emotion - pleasure. It's a powerful testimonial. In Engaging Autism, Greenspan and Wieder also write of the sensory challenges and advise parents to integrate OT principles with the "Floortime" routine. Last, there are studies that show positive correlation between eye contact and vestibular input among children with autism. It's like finding a sweet spot, and that sweet spot can unlock the door to emotions like pleasure, but also a higher level of engagement. A good OT can do that.

Who's a good OT? One who's worked extensively with children on the spectrum. One who's talented.

My practical advice for the newly diagnosed: if your child is under the age of 3, you're covered by your state's zero to three program, e.g. Early Intervention. What I learned through this process is that you may also qualify for an OT benefit through private insurance, if your child is covered by private insurance. We use a private OT, and my husband's insurance covers the benefit. So if the OT assigned to your child through Early Intervention (or other zero to three program) can't find that sweet spot, it might be time to interview some one new and you may have an untapped resource (private insurance) at your disposal.

We're fortunate in that Brad's OT not only has experience with children on the spectrum, she's certified in Floortime. As for what works for Brad, he benefits from procieptive and vestibular input. He works with the exercise ball and the sit and spin. Weather permitting, he works on our jungle gym - mostly the slide. She does all sorts of exercises with him. But what makes her extra effective is that she integrates the Floortime principles with the OT. She tries to engage him, using high emotional affect, following his lead to an extent and attempting eye contact when possible. She finds that sweet spot.

Compare and contrast to Brad's developmental therapy sessions, which are hit or miss. He goes through long stretches of persevating, zoning out and repetitive speech, in spite of the therapist's best efforts. Recently, we had the developmental therapist do a joint session with the OT, so she could learn how to get him to the top of his range. As a result, we've already seen an improvement in the quality of the developmental therapy sessions.

My two cents.


Anonymous said...

I laugh when I think back to when it was first suggested to me that my daughter could use some OT, I thought that it might be a nice "extra" thing but that she really didn't need it. Boy, was I wrong! Now i only wish i could have OT for my sensory girl every day! Finding the sweet spot is amazing - we get so much out of her (language, eye contact) when she's getting proprioceptive and vestibular input.

A little boy just 2 years old said...

GOOD TO KNOW!! Thanks a lot!

Does Brad enjoy those things on his own (slide/ball/etc..) or does he need to be coaxed into the enjoyment?

Laura said...

In the beginning, he loved it, and in fact it became a source of conflict because Brad and his bro would fight over the exercise ball. Now, like so many things, the novelty has worn off. Also, he's a little oppositional now - that's psych speak for terrible twos. He even gives the OT some 'tude every now and then.