Tuesday, August 2, 2011

Ethan's Sensory Diet - Brushing & Tactile

During our first couple of months of occupational therapy, the therapist had us participate in a variety of "experiments" in order to create a specific sensory diet for Ethan. Tapping into Ethan's 6 different senses can either help calm him or help stimulate him.....and we were on a mission to discover his tailored program.Why is this so important? Well....after trying over 100 OT activities in the first 2 weeks, I was asking myself that same thing. Our occupational therapist showed me a graph.


What happens to Ethan is that he tends to sit at the top of the graph.....his senses put him in a state of hyperarousal. This doesn't mean that he is running all over the place with energy. It means that his senses are very heightened, so something (like a hair dryer) that seems like no big deal to me, is a VERY big deal to Ethan....because his senses are heightened. So, let's look at this through Ethan's body.....

He wakes up to the sound of my hair dryer....not all that bad since I am a room away, but it is enough to wake him. He wakes easily to sound. So, right away, he is moving up the graph....he is still in the Optimum Zone, but he is moving up towards the top black line. Then, we go to the bathroom. The light is turned on, the temperature changes because he takes he bottoms off to go to the bathroom on a cold toilet, and we flush the loud toilet in the small echo-ish room....sensory overload. So, now, he is either at the top of the Optimum Zone or he has crossed over into the Hyperarousal state or Sensory Overload. When this happens, Ethan has a very difficult time doing anything. It is like he is paralyzed with fear/anxiety. So, in order to calm him, we must do something from his sensory diet. This is why we are doing the experiments....to see what makes him climb to the top of this graph (triggers) or what helps him fall down the graph (calms). An interesting note....if Ethan is above the optimum range, and he doesn't calm far enough down the graph....he will continue to be paralyzed over & over again. This is why events, such as Vacation Bible School or birthday parties or family functions, are difficult for Ethan. There usually aren't very many opportunities to calm down completely. So, Ethan tends to exclude himself from the main events or from the large group....it helps him stay in the optimum range. (He's so smart!)

Back to our morning routine, we now know that the sound & feel of running water is calming to Ethan. So, washing his hands after going potty isn't only important for sanitation....it's important to his sensory systems. And he usually spends a lot of time playing in the water.....which is fine with me! And, as I'm writing, Ethan brought me his yoga ball & laid down on the floor. He is watching morning cartoons....which tends to make him climb the chart. We know that pressure is calming to Ethan. So we use a yoga ball a lot! He can roll around on it....allowing him to crash, hang upside down, kick/throw, or just lay on it.....all things that involve his muscles & calm his senses. He also likes to lay down while we roll the ball up & down his body with VERY slight pressure. I believe that, even at his young age, Ethan is aware of his needs even though he can't communicate it to us with his words. Just like bringing me the yoga ball & laying down. He knows he needs it, but he can't tell people....but we are working on that too.

So, after working with Ethan's Proprioceptive & Vestibular Systems (cardio & weight...see previous post), our therapist introduced us to a Brushing/Compressions Technique. For the first 2 weeks every 4 hours, we would complete this routine.You literally brush Ethan's skin (using a special brush) in order to wake up his senses. Then you give quick compressions to his joints in order to "reset" his system. It was the weirdest thing I had ever witnessed in my life! Here is a YouTube video of a mom doing this with her child.....and this is what we did with Ethan every 4 hours. It was so strange, but the results were amazing! Ethan was a different kid! He was sitting for longer periods of time, he was making more eye contact, he was following directions better....his senses just seemed more calm overall! It was totally worth doing this weird thing!

We did that for about 6 weeks. Our therapist told us that once Ethan was aware of what calm "felt" like, he wouldn't need to be brushed as much or at all. And she was right. Towards the end of the 6 weeks, we actually saw this technique hype him up! So, we knew that he was done with the brushing. But I'm so glad we did it! Now, we only do the joint compression, and it's only as needed....another tool in our toolbox.

During this time we also explored Ethan's tactile system. This is our sense of touch. After participating in 43 tactile activities (yes...I did them all), here is what we found most helpful to help calm & reset Ethan's system. This pushed the reset button on his senses so he can start anew on the graph.

1. Rice Play - Similar to a sand box, but using rice or beans & can be used inside the house
2. Kid Sandwich - Picture an Oreo cookie. Ethan is the filling & pillows/cushions/Mom&Dad are the cookies
3. Heavy blanket
4. Massage/Bear Hugs
5. Matching & Finding games
6. Deep pressure - Firm tickling, firm hand-holding, firm shoulder touch for guiding, etc. Firm - NOT HARD

2 comments:

  1. So interesting! Did Ethan seem to enjoy the brushing? It looks like that would feel good for any child. I'm so happy to hear about things that you have found.

    ReplyDelete
  2. He did like the brushing! He would even bring me the brush before the 4 hour mark, so sometimes we did it more often. I just assumed that he was realizing when he needed it, and taking my cues from him. OT is so amazing...it has been a miracle worker!

    ReplyDelete