Once upon a time a sweet little girl was born. Everything was going smoothly until developmental delays were discovered. Although she was speaking 3 syllable words at 12 months, she was not crawling, pulling up to stand, or even getting up or down in a laying down position.
Physical Therapy and Speech Therapy Begin
After a year of physical therapy, she eventually gained gross motor skills, after which she also began speech therapy.
Developmental Specialist Exam
A new pediatrician, Dr. Habel, did her 2 year check up. He recommended that she see a visiting developmental pediatrician, Dr. Morton (?) who was traveling up to Sheppard AFB from Lackland AFB.
Dr. Morton was intrigued by my daughter, whom he said definitely had something going on, but short of a very scary to her MRI, there is nothing to be done but push forward because she was so high functioning.
All those who worked with her agreed she was high functioning, quite intelligent, though something was amiss. No one knew exactly what.
Later that year her brother was born six weeks early. He spent 3 weeks in the NICU, but everything was tracking well. Six months later the pediatrician also sent him to physical therapy because he wasn’t sitting up by himself. Nor was he ingesting enough calories.
Dr. Habel recommended him to see Dr. Morton, the developmental pediatrician. Dr. Morton remembered us from a year before. Again, he saw my son as high functioning so there were no special services Dr. Morton could recommend.
Occupational Therapy Begins
Meanwhile Dr. Habel also sent him to an occupational therapist at the base hospital.
Soon after meeting my 6 month old son, she assessed he had a texture issue with baby food in his mouth.
She diagnosed him with Sensory Integration Disorder, which I had never heard of before. She said we’d focus on texture-based activities to encourage him to eat.
My 3yo dd was with us at the evaluation. The OT said dd also had SI and encouraged us to include her in the therapy activities at home. That way one wouldn’t feel left out and the other wouldn’t feel like the odd ball. This would build team spirit while helping both. Besides, it’s all fun and good for anyone to do. Especially when Luke the therapy dog was there to help.
Meanwhile Maj Perry asked how his physical therapy was going at the off base physical therapy center for my son. I told her he was still having trouble sitting up independently.
Maj Perry said that he didn’t have strong enough core muscles to hold himself up in a sitting position. To develop them, Maj Perry showed me a quick and easy exercise to do for fun with him at home, which we did a lot of while watching the USA Olympics gymnastics team in Atlanta. In two days he was sitting up by himself.
Three months later there were no improvements with his eating, so the pediatrician referred us to WHMC in San Antonio for medical testing which proved ds was perfectly healthy! That’s when the WHMC OT came to me with an idea.
What is Sensory Integration Disorder?
He explained that SI therapy is comprised of 3 parts. When they focus on one specific area of concern, they see few results. But when they focus on all 3 parts of SI therapy, their patients make greater gains.
As the OT explained the 3 parts of SI and how it affects childhood development, I sketched it out in my notebook:
At the base of the pyramid are the three parts:
*proprioceptive – messages from joints during movement
*kinesthetic/ vestibular – knowing your body’s position in space while moving
*tactile – feeling things
Developmental Steps
Most babies normally progress with the proprioceptive, vestibular, and tactile senses well, developing at a normal rate.
As they reach toddlerhood, they move on to developing auditory and visual skills, the next level on the pyramid.
In their continuing development, they reach the next level, audio visual perception, which is typically developed in preschool and kindergarten years.
After the audio visual perception is developed, the child is ready to learn reading, writing, and arithmetic, the next level of the pyramid.
By teenage years, they enter the highest point of the pyramid, abstract thinking skills.
When children have a glitch in one of these areas developmentally, abstract thinking (the top of the pyramid) cannot be attained unless intervention is done.
Our Occupational Therapist Reworks our Program
After our meeting I called our OT back home to update her with the news which she was glad to hear. She was going to use that very recommendation of using all three parts of the program with all her clients.
On our first day back in the OT office, instead of only focusing on texture, she also incorporated activities for vestibular and proprioceptor as promised.
She also gave me lots of reading material, including a book written by Jean Ayres the pioneer in the topic: Sensory Integration and the Child.
She specifically taught me how to think SI all the time, showing me lots of examples in the clinic. I devoured all my reading material at home and worked played with the kids.
Then each week in her office she’d play with the kids, teaching us new techniques and answering any questions I had. Weekly we repeated this process.
No obvious results were noticed until 6 months when we returned to San Antonio for follow-up medical appointments at WHMC and a visit with my parents.
Encouraged by Immediate Results
On our eight hour drive to San Antonio a bathroom pit stop time arrived, which was always a dreaded moment for my daughter. Being enormously sensitive to loud noises, my dd hated the toilet flushing in the women’s bathroom. Every time she would cry.
This time however she didn’t react at all to the noise. Although in a sea of other inhibitions, she was perfectly calm. Wow! With elation I reported that to the WHMC OT team at our checkup, and then again to Maj Perry back home. All the OT’s burst into huge smiles!
One of dd’s other fears while a toddler was that she didn’t want to sleep alone in her bedroom anymore. I kept finding her sleeping on the floor near her brother’s crib. Finally, I moved her bed into his bedroom, making that the dedicated sleeping room and her old bedroom the dedicated playroom.
Another huge fear for my dd was thunderstorms, especially where we lived in Tornado Alley where major storms were both wicked and frequent. Tornado sirens sometimes blasted nightly. She had a picture of an angel guiding a little boy and girl over a bridge that one of my friends had given her when she was born. I hung it over her bed and showed it to her during storms. During storms I’d hold her and take her to the picture to talk about it. But it was after I told the story of Noah with flannelgraph that her fears subsided.
A few years later we moved to San Antonio and bought our first house. I wanted her to have her own room, but wondered how well that would go over. She happily chose her own bedroom and there she peacefully slept, never again to feel all alone in there.
Lots of Activities at Home and While Out and About
SI (Sensory Integration) exercises weren’t a cure all, but the activities were a huge help.
We will never know exactly when this or that SI activity benefited various inhibitions or the overall path to development. SI cannot be evaluated by a blood test.
At the end of the day I’ve learned that variety, opportunity, and movement are major keys to development, all of which encompassed SI.
Click on any of the pictures to see more photos of our Integration Activities (which are each detailed) at my Flickr set.
Dyspraxia Diagnosis
Maj Perry had also very quickly diagnosed my daughter with dyspraxia, which is basically problems with motor planning. That was an ah-ha moment. Every thing new my daughter had ever needed to learn, from crawling, to sitting up, to taking her first steps, etc, needed literal step by step guidance.
Prognosis
Would she always need help with motor planning? There is so little known in this field of Sensory Integration and Dyspraxia, that Maj Perry had no idea of a prognosis.
In another year Maj Perry was reassigned to a different base. The new OT, after looking at their records, called me on the phone to discuss future treatment, which I highly advocated. However the new OT felt my kids were quite high functioning, so he ended their sessions.
Frustrated that that was the end of that, I was at least glad for the tool box Maj Perry had given me.
We forged ahead with the tools we had.
Epilogue 2024
Now for a 2023 update: My son has always been very active and interested in doing anything but eating. He now affirms that yes; certain textures excessively bothered him when he was little. While some textures continue to annoy him, others are no longer an issue. He happily eats when he wants. He’s even become quite a gourmet cook.
