The Texture Of Things

Evaluations

September 1st, 2008

It seems kind of unfair to the tot that I haven’t written any updates on her progress with textures here on the blog, a blog whose purpose was designed around such updates. I should rectify that.

Way back in the day (like, April or May of this year?), I took the tot for an evaluation by an Occupational Therapist. This was not the first time we had been to this center. About a year before, I took the tot for an evaluation for Sensory Integration – an eval the tot pretty much passed. The OT indicated she had some delay in Gross-Motor development and, yes, some tactile hypersensitivity and auditory hyposensitivity. Basically, yeah, eating is a problem, she’s a klutz, and she’s the kind of kid/person who loves music and needs it in the background all the time to help her focus. We all know a person like this or close to it, right?

At the time of the SI eval, they recommended weekly therapy, including body brushing (still not sure what this is or how it works) and Therapeutic Listening (still not sure how this works; more on this as soon as I know more). I opted to continue working with our Food Friend (S.), for more reasons than the simple fact that something about the therapist just didn’t feel right to me. And it was not free. And I’m bad at “breaking up” with people. And I didn’t want to break up with S. anyway because the tot loved/s her and I rather did/do, too.

But the respite from transition was short-lived. The tot would “graduate” out of the Food Friend program at her fourth birthday (in the summer) and, we learned, shortly before that date our Food Friend was leaving that clinic to take on similar work with another foundation. So. A transition was necessary, and while S. would not say outright what she thought we should do, she did suggest two possible paths, if we wanted to continue working with a professional. One was Occupational Therapy at the center that did the SI eval and one was an eval at an Anxiety Disorder clinic at a nearby university – although S. was clear that she only saw that as a resource if things took a turn for the more anxious/phobic.

I struggled with whether or not I should take the tot for an eval, but I ultimately did, and this was our visit earlier this year. What the OT (not the SI eval OT) found was, I think, worth the tot’s and my time.

K., the OT, revised the previous diagnosis of Gross-Motor Delay to Motor Planning Delay. She didn’t outwardly agree or disagree with the auditory hyposensitivity, but she did suggest that we might try Therapeutic Listening at some point to see if it would help the tot regulate herself. The biggest revelation, however, was that the tot has an Oral-Motor Deficiency. As in, she can’t lift her tongue up, either inside or outside of her mouth.

Imagine taking a bite of a chocolate covered doughnut and getting chocolate frosting around your whole mouth. You begin licking your lips to get the frosting. The sides and the bottom are easy, but you can’t lick your upper lip. (For the purpose of this example, it does not occur to you to use another method of removing the substance.) Emotionally, you go from alert (“Ah! There is yummy frosting on my face and I will lick it off and get to enjoy it”) to anxious (“There is a something on my face and I can’t seem to get it off – WTF is up with that?!”) to panic (“Get it off! Get it off! Get it off!”).

What would this do to your relationship with eating? Particularly if we change the example food to a bite peanut butter sandwich that is stuck to the roof of your mouth.

Suddenly, the crunchy-only-or-liquid-only diet is making a lot of sense, wouldn’t you say?

more on the therapy and advances later – must wrap this up for now.

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