Occupational Therapy Diary

I’ve decided that I’d like to share my thoughts on how Caden’s occupational therapy sessions are going as a way to document his progress. So I am starting this occupational therapy diary, hopefully you will learn something from this or be willing to share your insights if you have experienced occupational therapy in your family.

To get you up to date if this is your first time reading about our occupational therapy sessions, Caden has some sensory integration concerns as our occupational therapist put it, which impacts his ability to cope in certain situations and shows itself in some maybe not-so-normal behavior.

On Monday we had our third occupational therapy session. Caden is still not so keen on jumping right into the activities that the therapist has planned, so we gave him some time to warm up and adjust to the idea. While Caden was warming up, the therapist and I went over his evaluations from a month ago. In the final evaluation report the therapist noted her observations and explained how Caden’s behaviors impact his development. She noted that Caden has reduced attention and a high level of activity. These behaviors make it difficult for Caden to learn certain skills because he is not able to maintain his attention long enough to practice. His fine motor evaluations show significant delays because he was unable or unwilling to participate in the tests. Part of the reason for this is because he refused to do some of the test, even though I know he can do what they asked, but the therapists cannot score what they don’t see. I don’t know why he refused to do parts of the test. I believe he was just bored, but the therapist is concerned that it is due to sensory issues and motor-planning skills. 

Based on the sensory processing evaluation, the therapist is significantly concerned with Caden’s over-responsivity to certain stimuli. Caden is in fight or flight mode for much of his day. I may have mentioned his constant awareness of the noises around him which often scare him or his exaggerated reactions to crowded or noisy rooms which have caused him to run away upset and crying. The therapist is also concerned with Caden’s tactile and auditory sensory discrimination. He is easily distracted by noises and uncomfortable with certain textures such as sand, dirt or sticky hands and feet.

After the therapist went over Caden’s evaluation report, it was time for the therapy session to begin. Caden resisted at first, but after some coaxing decided to join us on the floor to play with a peg board. Caden did pretty well finishing filling in all the holes with pegs, but did need some redirection towards the end. He had started to get tired or bored of this activity and started to lay down instead of sitting up. After the peg board was all cleaned up and put away, the therapist got out some large pop beads. Even though this is an infant toy, it is good for Caden to practice his hand-eye coordination as well as his persistence. Caden was having fun and goofing around a little, being dramatic as he tugged off the beads and handed them to the therapist. But then he got a little too excited and threw a bead. This is where things started to get a little dicey. The therapist had to physically make Caden pick up the bead and hand it to her. Caden of course got very upset. And then Caden had to pop all the beads back together. Once he calmed down, he quickly finished popping the beads together. He was mad and was just doing whatever he needed to do to end the session. He kept asking when the therapist was going “back home”? But the session wasn’t over yet, and neither were the tears. The therapist had one more activity she wanted Caden to complete. The last activity was to build a Mr. Potato Head, that should be simple enough right? Wrong! Caden has no problems being able to physically put the face pieces on the potato head, but halfway through he had enough, but the therapist wasn’t going to let him get away without finishing and putting the Mr. Potato Head back together. She had to physically bring him back to the activity and sit him in her lap. Meanwhile Caden is screaming and crying and squirming and pushing, trying to get off her lap. The therapist had to physically take his hands and make him put the pieces together. Then when he calmed down he helped put the Mr. Potato Head away and the session was over. Caden quickly escaped the room to decompress while the therapist and I talked about what happened and what our weekly goals will be.

Caden actually did very well during the session, previous sessions involved me chasing him all over the house to bring him back to the room. But this week Caden actually stayed in the room. He is learning what is expected of him during these sessions. I’m sure next week he will do even better.

The plan for this week is to continue to do joint compressions throughout the day. And to keep up with the twice daily structured play times. I am getting better at remembering to do the joint compressions, but structured play times is something I am still working at and trying to figure out. So far I have just been letting him choose what he wants to play with, and then making him complete the activity and clean up when he is done. This seems to be working well, Caden now knows that we expect him to pick up his toys and put them away when he is done. He complies with this request relatively easily. We have also been working on using “first and then” when talking about our routine and what we will do next.

I have also recently started to remember to play music while he is playing to see if it makes a difference with his auditory sensitivities. Caden is not a big fan of music and often says he doesn’t like it, but yesterday I played music through the new iTunes Radio on my iPhone and although he said he didn’t like the new song, he contently played after I changed the song.

The other therapy we might try is brushing. The therapist brought this up at the end of the session as something she might try with him. I don’t have much knowledge about this, so I am doing my research. If you have tried the brushing therapy with your child(ren) please let me know your thoughts. I’m very interested to know if this worked for your family.

Have you experienced occupational therapy in your family? I’d love to hear any thoughts or advice!

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