How does OT help a child with subtle sensory issues?

Mara - posted on 01/29/2013 ( 1 mom has responded )

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Hello Everyone,
I am new to this community. I am looking for some advice/thoughts about how to best help my son. He is almost 2 and a half and a fraternal twin. Since he was a baby I have noticed subtle signs of what seems like sensory issues, but it is confusing because it has never fallen into a clear category. We had him evaluated by Early Intervention when he as 17 months and he did not qualify for services- and I don't think he would now. To make a long story short, we decided to opt for private OT to see if it helps. He has gone twice, and he loves it. But my question is- can anyone help me understand how OT can help a kid with subtle sensory issues...it's a bit like a leap of faith since it seems like glorified play (I know it's not, but it seems like it). Also, has anyone else had subtle sensory issues and how did it play out with or without OT?
It also confuses me that he seems to be a mix of sensory seeking and sensory avoiding. Here are some of the things that he struggles with:
Often tries to flee situations like music classes, parties, crowded areas even though he is the most outgoing, fun, social child you could meet- when in a small group.
He is very easily frustrated and used to bang his head when he got really upset/had a tantrum (that stopped around 6 months ago but he still has monster tantrums.
A LOT Of difficulty with transitions (like tantrums every time we come in from the park)
hates having diaper changed and especially lying down for the changing
Very active, runs all the time, loves swinging, jumping, climbing, touches everything, very very curious.

I don't want to rush to diagnose him as having a sensory integration problem, but he does seem to have a much rougher time with things than his sister or a lot of other kids I see...
Any thoughts on this would be much appreciated!

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Jennifer - posted on 03/26/2013

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Hi Mara,
I have a daughter who is now 5.5. She has sensory issues too, but it took us a while to get help as well. Let's see if I can help you out.

OT is a prescribed group of activities aimed at addressing each child's needs. It can push their tolerance to the edge, but knows when to stop. This helps them grow and accept more sensory things they may avoid. It also finds things to help them adapt. It helps them find ways to get the sensory input they crave too. My daughter likes some things and avoids others. The music classes, parties, and crowded area reaction may be due to sensory overload - even with his outgoing personality. OT can help you come up with acceptable plans to implement when you see he is getting agitated.
Transitions are a bear! Advanced warning is crucial! If I can, I let my daughter know how long we are staying. Then, depending on how intensely she is playing, I let her know about 10 minutes before it will be time to leave. I tell her to work to find a stopping place. Another warning comes at 5 minutes, then every minute thereafter. At the end of her time, she gets to pick ONE last activity. I wait for her to finish (example: at the end of the slide) and take her hand as we walk away.
Daily transitions can be addressed with a picture schedule. I made one in a binder with several pictures of what we do throughout the day. (you can check out ideas online too) Then, I had them laminated with very hard plastic, popped velcro dots on the backs, and filled a hard laminated sheet with the other side of the dots. Each morning, I would map out the day with the pictures (as best I could). When an activity is complete, she would remove the picture and put it away. Then proceed to the next picture.
When our schedule was not as predictable, I focused on the problem areas. We have a hanging card of 5 jobs each for morning, afternoon, and bedtime. It's a checklist. The "To Do" column has tokens (fairies, stars, etc.) made from hard laminated stickers. As each job gets done, she moves the token to the "smiley face" side. Again, I used velcro dots.
This system works great because there is no arguing with a chart.
Can you use the new pull-up diapers or Pull-Ups with him? That might cut down on his stress during diaper changes, at least the wet ones.
We use our Love Sac (giant beanbag-type chair) as a crash mat for running/jumping into. I also took a hammock from Target, added a strong rope and a couple of heavy carabiners, and made a therapy swing to hang from the tree. You hang it like a taco. She LOVES it. Pushing and pulling heavy things (loaded blanket, full boxes, etc.) also give good sensory input. We also have a fabric "tube" for her to crawl through. I just took several yards of stretchy fabric, folded it in half length-wise and sewed a seam.

I hope this helps. Hang in there and keep advocating for him. You are being a great Mom!

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