More Insight: IEP language and Heavy Work

More from the chapter in Miller's book, Sensational Kids:

Discussing school adaptations, LaTonya has "an Individualized Educational Plan (IEP) stating that she has sensory problems causing her to have behavioral issues that hurt her academic performance".  I took note of the specific wording here for possible use in Katie's plan.  "The plan contains specific objectives, and one of these is to calm her overreactivity so she can pay attention in class".  Again, wording that could apply specifically to Katie.

Miller goes on to discuss a particular intervention of heavy work used in LaTanya's case "for calming her overalert sensory system and recharging her batteries for the big challenge of the classroom".  In this case, LaTanya goes to the library every morning and carries a load of heavy books to her classroom- one example of heavy work.  I wonder if such a scheme would be helpful for Kate too?

Miller defines Heavy Work here as "a term applied to any activity that engages the muscles and joints of the proprioceptive system".  She had previously explained the stimulating the proprioceptive sense can generate calming messages to the brain. "Tasks that engage more or bigger muscles generally create greater proprioceptive stimulation and have the biggest effect on behavior".  

"In (Occupational) therapy, children are taught to recognize when they need heavy work and to generate it for themselves with activities such as pushing against a wall or another resistant surface, pulling a heavy load like a wagon with another child as passenger, or walking up a flight of stairs".  Miller says that "heavy work tends to lower arousal levels and reduce cumulative effect so that the child is prepared for the next sensory surprise."  and "Heavy work for LaTanya (and Katie) is the equivalent of finding the volume button on the background noise that is always buzzing in her sensory system and turning it down."

Interesting note here, on one of Kate's visits to her therapist, the blinking tic was particularly bad and the therapist decided to try some heavy work.  She had Katie plant her feet and push hard against the wall, as if trying to push it over, and then gave her a squeeze ball and had her squeeze it as hard as she could for as long as she could hold it.  She reported to me later that after this the tic was gone and did not return for the rest of their session!  Hmmm, something to think about....

Diggin' the Dirt

The girls are getting a chance to try their hands at some gardening this year in my father's garden.  They planted peppers and tomatoes, as well as marigolds.  Katie prefers to take her sandals off and go barefoot in the dirt, but is then extremely cautious about where/how she steps, which exacerbates her issues with balance.  She came across a worm while digging and practically FLEW out of the garden, so fearful is she of the creepy, crawlies (especially since a certain sister told her some of them bite!)

Hadn't even thought about how her poor awareness of her position in space could influence her overall sense of direction, but the poor sweetheart had a very upsetting experience at Granddad's when she went inside to use the bathroom.  She made it inside successfully, but on coming back out she lost her way and couldn't find us again.  She finally called out for me and I could shout out so she could see us, but by then she was terrified and sobbing, thinking she'd been abandoned.  She said every way she went the fence was there and she just didn't know where we were.  I had to hold her tight for quite a while before she could settle back down, and it brought the evening to definite end for her as she had no further interest in activities after that.

Earring Issues

My poor baby!  Katie woke up this morning telling me her right earring was 'bothering' her when she tried to turn it.  I had a look and was horrified to see that she had pushed the back on so tightly that it had dug into the skin and was bloodily encrusted to it.  Checked the other ear and it was the same so I insisted we take them both out immediately, which was quite traumatic and, I'm sure, painful, as they both look like they could be a bit infected.  Cleaned them out well with peroxide and applied Neosporin liberally to keep the backs soft.  

Feeling like an awful mother for letting this happen, though, how could I have known?  Why on earth didn't she say something sooner!! I can't go even a few minutes with an earring back too tight without adjusting it, how did she keep quiet?  Usually she is more than vocal about every little hint of discomfort!  Only explanation I can think of is inadequate tactile input, like she literally didn't feel it the way others would.  Poor thing.

Symptoms: Fearful of the sound of a flushing toilet (especially in a public restroom), vacuum, hairdryer or dog barking. Excessively startled by loud or unexpected sounds.

All of the above!  For a long time Kate refused to flush the toilet when she went, and still skips it quite frequently.  But public restrooms are by far the worst.  The hollow sound in multi-stall restrooms seems to echo and amplify the sound, causing her to scream.   

These newer automatic flushing toilets add a whole new element of fear, as she's so small the sensor seems to lose her and they wind up flushing while she's still sitting!  Oh the horror!  The force with which they flush has her convinced she's about to be sucked right down. At the library one day she had to go, but it kept flushing prematurely, so she's hop off and claim to be done, but then still have to go about 5 minutes later, so we'd try again, but she'd get freaked before she was finished, again...after about 4-5 attempts we just had to go home so she could finish going in peace.

Hand dryers in restrooms are another source of panic, primarily because of the noise, but also because of the hot blast of air.  She also hides when I use my hairdryer and the vacuum.

We got a beagle a year ago, and thankfully she's not too much of a barker, because Katie screams and practically jumps out of her skin at every little yelp, and nearly hyperventilates if Tess actually barks.  This extreme reaction to loud sounds was one of the first things that got me thinking of SPD.  Sometimes it's not even that a sound is too loud as much as if it's unexpected.  Where another kids might jump, Katie's whole body convulses and she's in tears.