The Texture Of Things

Day One

January 7th, 2011

Day one of therapy:

The timing of the session appointment is such that S arrives right when the tot gets home from school, so today the first few minutes was small talk and such while the tot ate some pretzels and had some chocolate milk. It will take a bit to hit a routine and find a way to expedite that after school snack, or we might have to move the session by a half an hour. We’ll see.

The structure of the session was split between play and gathering history. S and the tot played in her room (it’s going to be just the two of them) for a bit before S came out and we all sat together and talked family history and anxiety patterns. A lot of the conversation was just refreshing her memory about the tot’s history — her birth, her size, her early anxieties. Ultimately the session will be an hour of play, just the two of them. I’ll hang out with Tater elsewhere in the house.

S and I emailed a bit before today’s meeting, and in those emails, we decided a team approach is necessary. S will work with her on the anxiety, and we’ll find a clinic for therapy surrounding the actual eating process. As we talked about the tot’s tongue tie and early eating difficulties, S suggested that perhaps instead of an Occupational Therapist, we look into a Speech Therapist for the clinical therapy because a Speech Therapist is trained in oral-motor strengthening and such. We’ll see. I thought it was an intriguing idea, and frankly, I don’t care which kind of therapist it is, as long as it’s the right kind.

I need to:
*request of the tot’s growth chart from the pediatrician
*email S regarding some details I didn’t want to share in front of the tot
*get some baby dolls together (S requested next week they play with babies)

6 Comments »

  1. esperanza says

    Now that you say that, that is how Sweet got into speech therapy in the first place. She had trouble learning to eat from a bottle (not to mention the boob) in the NICU and beyond. A speech therapist came and worked with her every day in the hospital. I’m suspicious that some of her speech difficulties now are due to her failure to develop certain mouth muscles then. I can see that the tot might have weaknesses in various mouth/tongue muscles due to the tongue-tie.

    They have recommended various things…electric toothbrush to stimulate the nerves, etc; making funny faces, licking food off the corners of her mouth, some straight up exercises. That’s just in addition to the actual speech activities. Some have worked, some not so much.

    Some have been a little stressful for us, so I’m not sure how it would fit in with S’s anxiety work with her.

    I’d definitely say it’s worth looking into and asking some questions about.

    January 8th, 2011 | #

  2. admin says

    I feel cheated. How is it that I got put with an OT? Why didn’t they put us with a ST in the first place?

    The tot’s hypersensitivity to tactile sensations will present a sizable obstacle. She has rejected an electric toothbrush (in spite of many bribes) on many occasions. The tot is also obstinate and stubborn, so doing exercises will also be a battle.

    Thanks for the reminder of the stress of therapy. I had kind of blocked it out, but thinking about it helped me put together my post about the problems we had with OT. I just put it up, but I didn’t proofread carefully. (Oh no!)

    January 9th, 2011 | #

  3. esperanza says

    Ha! I just read your OT post and was thinking to myself, “I wonder why Sweet Baboo has never been offered OT?” The grass is always greener…Seriously, I’d like for there to be a person overseeing everything, with the big picture of how she is doing. I mean someone besides me.

    January 9th, 2011 | #

  4. kathy a. says

    yes, about the someone besides you overseeing — provided you get veto power!

    i was remembering these conversations when i went to visit my cousin and her daughter who is in ICU, with multiple problems, but one of them is eating. [way different situation! but i’m grasping at straws…] i’m just wondering if a speech therapist might help, since it is a complicated set of problems.

    January 9th, 2011 | #

  5. esperanza says

    kathy, I know that speech therapists, in their work with stroke patients for example, do swallow studies and the like. That determines if a patient is aspirating food and might need pureed or thickened liquids, etc. I’m not sure that a speech therapist would work on encouraging someone to eat. And I’m not sure of your cousin’s daughter’s situation either.

    January 10th, 2011 | #

  6. admin says

    My prediction is that no single therapist will be a good fit. Since S wants to do a team approach, I can imagine that seeing two different therapists (an OT and a ST), perhaps alternately, could be one way to bridge the gap. Not sure, won’t be sure until we have a chance to figure out where to go and which evaluations to do. I know the tot needs to work on manipulation of food (for instance, her utensil handling is fairly dismal — a fine motor skill/motor planning problem) and managing food in her mouth (chewing, swallowing, spitting out without choking — an oral-motor skill/ motor planning problem). This is in addition to her anxiety about food. Then, we have her anxiety in general that needs work. Hm. There is a lot of work to do…

    Good news is that I trust S, and I will always have veto power, though if S thinks I’m making a mistake, I believe she’ll tell me. We’ll see how it goes, I guess.

    January 10th, 2011 | #

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