Wednesday, August 10, 2011

sensory therapy

My son, Danny, was diagnosed with Sensory Processing Disorder over 5 years ago by a very competent therapist. I love Danny's OT, Linda; she is practically psychic, a kind of SPD whisperer, if you will. The only drawback to taking Danny to Linda for therapy is that she is located about 45 minutes south of Chicago, which is 2.5 hours north of where we live.
Because of the distance, after Danny was diagnosed, I searched high and low for a therapist who was closer. After trying just about every pediatric OT within a 70 mile radius (which really isn't that many; apparently southern Illinois has a serious shortage of OTs) we have decided to stick with Linda. She is the only therapist we have worked with who really understands SPD.

I have been amazed at how many OTs and other professionals out there who really don't understand the nature of SPD and how to treat it. Many of the supposed experts seem to think that sensory activties (or a sensory diet) is the same thing as Sensory Integration therapy.
If you have a kid with SPD, I am sure you know that a sensory diet refers to activities you can do at home to engage a kid's senses. Some popular activities include playing with clay, dried beans, playing in a ball pit, working with fine motor activities like Legos, lots of jumping and other deep pressure activities, among many, many other things. These activities are most efficacious when done consistently every day. They are vital in keeping a kid regulated and able to focus and deal with life and sensory stimulation, in general.

But they do not constitute SI therapy.

I'm not an expert or an OT, but from what I understand,
Sensory Integration therapy has some important distinctions from sensory diet. SI therapy has a lot more to do with training the brain and the nervous system to work together, while engaging various parts of the body. (Check out Sensory Integration and the Child by Jane Ayers for a good idea of what SI therapy looks like.)

And I have Lucy Jane Miller to back me up on this. A few years ago I attended a conference at which she was the keynote speaker. At the time, we were seeing an OT who just had Danny cut with scissors, play with some Theraputty and sometimes swing in a net swing. When he was in the swing, all he did was swing. These were all very basic, sensory diet activities, and despite the fact th
at we had been seeing her for months, it had never advanced beyond them.

I happened to run into Dr. Miller during a break, and though I hated to bother her, I asked her about my concerns. I described the activities the therapist was doing with Danny and asked if this were really proper SI therapy.

I will never forget her answer. As she looked me straight in the eyes, Dr. Miller said, "You already know the answer to that."
She said that my instincts were right on, and she encouraged me to find a therapist who knew the difference between sensory diet activities and SI therapy.

And then, once the conference reconvened, Dr. Miller took a minute to explain to all the Occupational Therapists in the audience the difference between SI therapy and sensory diet. She said, "If you are just swinging kids in swings, you arenot doing SI therapy."

This is why I now regularly drive 6+ hours round trip to take the kids to Linda. Though the drive is a major burden on us, it is worth it, because I am confident my kids are receiving good, solid SI therapy. As they gets older, the exercises become more advanced, and they are always in response to a very specific need, like building core muscles, learning better motor planning, self
-regulation, among many other things.

Linda NEVER has Danny just sit in a swing. When he is swinging, he is doing all kinds of activities, like throwing a ball through a hoop or aiming at a target, etc. Also, she has him change positions. Sometimes he swings sitting up, other times, he is on his stomach and still others, he is on his back. This change of position is really important because exercising in each different position affects the vestibular system in a different way.

Don't believe me? Just try swinging on your back compared t
o on your stomach. It's pretty trippy!

Both sensory diet and SI therapy are vital for kids with SPD. Neither can replace the other.

So, if you have an OT who is merely doing sensory diet activities with your child, I suggest you question her.

Do some research and ask your OT why she is doing a particular activity and how it will help your child. Make sure that the therapy goes beyond just simple sensory diet activities.

After all, you can and should do sensory diet activities at home.
The OT should be concentrating on actual therapy. That's why she charges over $100 an hour!

Check out S-O-S Research blog for more posts about therapy and special needs.


Sprite's Keeper said...

Amen for a parent who doesn't just drop off and pick up at the end of the hour!
Too many parents trust their therapists because of the degrees behind their names, but just don't question enough. Good for you!

Heather said...

Good for you for questioning!!! I LOVE, LOVE, LOVE Eli's OT. She too is an SPD whisperer. She is always trying to figure him out. She is good to admit when an issue is out of her realm of expertise and helps us find other experts (cue the worry doctor and neuro-optomitrist). I hate that you have to drive that far but am glad that you have someone wonderful.

Trish said...

So glad you found somebody who can make a difference for you. I heard Dr. Miller speak at the National Autism Conference a few years ago and was very impressed with her. She was recently on The Coffee Klatch's Blog Talk Radio show too.

K- floortime lite mama said...

Absolutely excellent post

Martianne said...

we have a new OT for our son and I am only able to go in every 3rd or 4th visit b/c of childcare issues for my other two, but when I do, I am pleased to see that she is doing what you speak about. I just wish we could see her more often. I often feel that 45 minutes once a week does not go that far in retraining the brain! what do you think?

Lisa Quinones Fontanez said...

Great post! We always sit on our OT sessions, I ask questions and seek advice. I can totally appreciate the power of a good therapist/session.

At Martianne - I don't think 45 minutes is enough. School disctricts tend to be cheap about giving them out. We were lucky to get 2 hours a week. My son does really well after them.

This year, we'll have to start paying for them out of pocket...but because our OT is $175/hr I can only do 1 hour a week not 2.

Susan Case said...

What an interesting post! My grandson was diagnosed "autistic" when 2 and we were trying to learn sign language. But one dr. said many autistic children have sensory issues and are misdiagnosed. He is now classified PDD-NOS, doing great in school and we can't get him to stop talking. I think having tubes in his ears helped and chiropractor realigned his neck (birthing process misalignment?) Thanks for educating me on this.