Aaron's OT at daycare

Jane's email from Tuesday: "We had a good session yesterday. staff reports he is doing well. he is getting to sleep at nap with pats on the back. He was yawning when I came in at 11:15. We did some scooterboard play in the gym and threw basketballs at the goal along side other children. Prior to lunch I let him suck and chew on the z-vibe. He ate the chicken patty and I encouraged play with the peas and canned pear pieces. He smashed the peas with a spoon and dipped the z-vibe (not vibrating) into pear juice and sucked it off the probe. He would not eat any tiny tiny piece of pear on the vibe. Megan prompted him to take a bite but he refused. He did go back to sucking up the juice. I encourged the staff to continue to allow food play. He picked up some peas and pears and placed them on the clean-up napkin. Sometimes it takes ten to twenty one days of seeing a food on the plate before a picky eater will try a new food. the nice thing about daycare is he will see the same foods over and over.Dana put the z-vibe in his backpack. I suggest you keep it at home and offer it as soon as he gets home and prior to eating dinner. You can also ask if he wants it before going to bed. He can keep it until he turns three or is no longer interested in using it.How are things at home? eating, sleeping, crashing toys?"

OT with Jane

Our last session at home for a few weeks - Jane is going to go to Aaron at daycare. Today's theme is "sticky" ..... trying to get him to experiment with that texture & sensation.

• This may be one of the more entertaining things I've seen.....hammering golf tees into a styrofoam cooler. Luke was very happy to help. Big goal is the joint compression from hammering or pushing, but also eye-hand coordination & the low frequency sound.
• Jane talked about setting up a ritual for dropping Aaron off at daycare in the morning. (Maybe also get a vibrating toothbrush for daycare)
• Cutting practice - spring loaded scissors from Dollar Tree, and cutting strips of construction paper - strips are good for the satisfaction of watching the pieces fall off - then use a glue stick to attach them to paper. Also adding foam stickers.
• Syrup on a plate - dragging the z-vibe through it, and to our surprise he rubbed the z-vibe on his arm and chin as well as tasting it. He had a wet washcloth available for clean-up as he needed it. He dipped poptart pieces into the syrup, and eventually drew cirles with his fingers and sucked on his fingers.
• Jane will do his next appointment at daycare on Tuesday during their gym time and lunch.

OT with Jane

Will add photos when I'm on the other computer!

• Moon Sand (SpinMaster is the manufacturer) - weird stuff - looks like sand, but feels damp and can clump together. Dig and drive trucks in it for a more resistant surface, or squish it
• Swinging in the stretchy with 2 people, then spinning in circles with one person - helicopter
• Oval stability ball - have him lay on his back and roll it up and down his body - vary pressure, and also do the same thing laying on his tummy. This looks like an amazing massage
• Stretchy fabric with an Aaron train- head against the knot, facing his engine person. He's covering and uncovering his face and saying "Cocoon, Butterfly." He really likes this today, and it wasn't something he wanted before
• Heavy ball - bowling, including backwards through his legs
• Rolling and pushing - push Aaron's knees to his chest, then he pushes his feet back against her chest
• Texture plates for coloring, plus a new way to pick up a pencil to help him move away from the fist grip

Greenhill Therapy Center for after 3 , when he is too old for First Steps services - he'll continue with Jane, including using therapy horses! Jane says that this is wonderful for core strength & proprioceptive awareness.

Occupational therapy today with Jane

Today's ideas & activities:

• On an oblong shaped stability ball - lay across it on his tummy and do a puzzle that's on the floor, or straddle sit and do a puzzle on a low chair (reach down to floor to pick up pieces) - both give more deep muscle stimulation, balance, and squeezing with his legs. Jane also held piece to either side so that Aaron had to reach & balance to get them. When he finds a piece correctly or isn't sure about a position he says, "A dis goes!" or "A dis goes?"



• 2 person swinging in the big stretchy fabric, with occasional crashes into the stability ball plus singing songs. Tight wrapping "like a hot dog." Hold the fabic tight on all four corners on the floor and Aaron crawls around underneath - tickle, identify body parts, do with both boys - leads to very crazy hair! More whole-body pressure plus pretend play.
  
  
• Blowing with straws - put feathers in the end of a straw and blow out - maybe aim feathers at a target like a bowl. Very challenging with crazy straws.


• Stringing beads and cardboard lacing shapes (also suggested putting pennies in a piggy bank) - coordinative bilateral hand movements, plus soothing & repetitive movements for calming during transitions or to redirect from chaotic play
  
• Chew tube for calming or as an alternative to chewing on non-food items. It's a hollow T shape with texture.



• 6 inch diameter weighted ball (3 or 4 pounds) for general play that required more effort

OT appointment #2

Jane is amazing! Yesterday we focused on stimulating lungs & oral-motor, with the specific goal of reducing the amount of screaming Aaron does. The cool things is that we do this with bubbles & straws....what's not to love? Jane is also ordering us a new weighted blanket and a chair for the dining table, all courtesy of First Steps. Ideas and activities:

• Bubbles - big bag of bubble pipes from Walgreens that require different mouth positions, collect all bubble stuff into a dishpan & put towel down for hand wiping, blow bubbles into a bowl of water & bubble liquid with different sizes & shapes of straws (which require different mouth positions and amount of pressure) then "pop! pop!" all of the bubbles with fingers, sustained breaths and little puffs, straws help with motor planning (blow only vs. inhaling), straw bowl for blowing bubbles and for drinking foods of varying thicknesses, have a bathtub bubble day, races blowing little toys across water with straws
• Voice levels using "Daddy voice, Mommy voice, and Baby voice" and also use these terms with bubbles and breath control
• Harmonica & trumpet mouthpiece
• To encourage him to blow bubbles during swimming, take straws then cut them shorter and shorter so mouth is closer to the water
• Giant stretchy fabric - swimsuit material - drag him in it as our train, have him pull toys, and using it as a swing for full body pressure. Also sing while swinging and gently crash onto cushions at the end of the song
• Use the straws to blow pom-poms - targets, races, or catch between 2+ people, and practice vocabulary "all, none, some, most," and suck on the straw to pick up the pom-poms
• Try CD "Sleepy Ocean with Delta Brainwave Patterns" for calming during quiet time and going to sleep http://www.therelaxationcompany.com/ or on Amazon (we're borrowing to see if he likes it)
  

Aaron's first OT appointment with Jane

Ideas & tasks from Jane:

• Climb lots of stairs
• Heavier shoes like hiking boots in fall
• Mini trampoline with handles for safety - loves it!!!
• Stairs + puzzles - pieces at the bottom of the stairs so he climbs and jumps
• Puzzles + wagon walking - walking on hands across to get pieces
• Puzzles + jumping like a kangaroo
• Puzzles + tippy toe reaching for pieces held just out of reach
• Foam cut out puzzles for pushing with hands
• Take normal games and make them harder (physically)
• New chair - has place for feet. This enables him to lean forward. He eats easier, and does manual things like color more easily
• Pick up fuzzy balls with giant wooden tweezer and put them in a jar(tactile, hands)
• Side bar: Discussed crashing trucks and cars. Pull on arm and squeeze hand (gives sensory satisfaction) and say, "we don't throw trucks, we only throw balls".
• Blowing bubbles
  
  Jane said that compression & pressure helps the brain develop more body awareness and joint compression also releases serotonin. Walking on hands or doing activities that require lots of hand pressure also develops more awareness of sensation in his hands.