Wednesday, June 1, 2016

James' Occupational Therapy

After James' initial occupational therapy evaluation, we talked to our insurance company and they said that they would cover services for him if we went to a place closer to us in Daytona. So I contacted the new place and ended up playing phone tag with them for 3 months trying to figure out how to get him on the schedule for another eval (they would need to do their own). It turns out that no, our insurance won't cover the services anywhere we go so they didn't know how to handle us no matter how many times I told them we would just pay out of pocket. We finally got an appointment for his initial eval at the new place 3 months after I first contacted them. One month after that I called and figured out where they sent the eval results and I didn't like the report. It was definitely not as thorough as the first one and the treatment plan focused on things like handwriting, which is not high on our priority list (emotional regulation, impulse control and motor planning are definitely at the top right now). So, I called the first place we took him to and got an appointment to start his treatment the next week! I was so happy! After all this waiting and red tape, we can finally start therapy 6 whole months after his diagnosis.

The office is an hour away from us, so his appointment days make for a long afternoon. He has had two appointments so far and I couldn't be happier with it. The occupational therapist is really helpful and patient and is great at explaining things. The more we go, the more I am learning and understanding about James and every time I bring up something I have noticed or am concerned about, his therapist says, "Oh, we can make a plan to work on that!". So wonderful!

One of the interesting things she explained to me is that with sensory processing issues, the brain doesn't do a good job regulating the input. So instead of being able to stay at a calm equilibrium you can process too much and be too sensitive and want to retreat (sensory avoiding), or you don't feel enough sensory input to feel normal so you crave more and more and more (sensory seeking). She said she can tell that James is sensory seeking, which is when he gets overstimulated and just goes hyper and wild seeking more and more input to regulate himself. So to calm him down, you actually have him do activities that give his body a lot of sensory input, like jumping on a trampoline, swinging, or crashing into pillows. Seems kind of counter intuitive at first that all that activity is calming, but I've seen it work first hand!

Getting ready to jump:

We've also started the Wilbarger protocol, which is similar to what we did in the beginning with deep pressure massage. You use a surgical brush to apply pressure to as much of the skin as you can to lightly stimulate the nervous system and then you do joint compressions on the joints in the extremities and the torso. It is helping to retrain his body to not overreact to light touches from his clothes and from people, and it also calms down his overactive nervous system. We are supposed to do it every 2 hours, but it has been hard to be consistent. Hopefully once school is out and we are back to our regular routine we can be more diligent about it.

So at James' second appointment, he was having fun and doing the different activities she had planned for him, when all of a sudden he laid down flat on his stomach on one of the gym mats. After a few seconds, he got up and came over to me and said, "I gotta go poopoo." Now this kid flat out refuses to poop anywhere but at home with his own potty seat. One time on vacation at my mom's house he cried and screamed for two hours on the toilet because we didn't have a potty seat, then he held it in for another 12 hours until we got back to our house.

With this in mind, I'm thinking, "This is going to be interesting" as I took him to the bathroom in their office. He saw that they didn't have a potty seat, just a regular toilet and as I am explaining to him that he will have to use it anyway, he looks up at me and cries, "Ahhhh!!!" because he waited too long and everything was explosively coming out! Thankfully they had a cleaning supply closet in the bathroom, so I could spray down everything (including myself!!) and clean it while he sat on the toilet. After he was situated, I went out to the car and got the bag of spare clothes I keep in the trunk where I got extra pants, shirt, underwear and socks. Yep, it was that bad that we needed new socks. By the time he was redressed and we were ready to leave the bathroom, we were both laughing about how crazy it all was. Seriously epic.

When I told Anthony about it, and then my mom later, James would make the same face. I would say, "Guess who pooped their pants today?" and James would make the face and point at himself. Priceless!

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