Occupational Therapy: how it applies to our family and a few bunny trails:)

I am writing this post not to bore you with details of our lives, but to encourage those out there who may be dealing with similar issues and looking for some options.  I did not know of the benefits of OT and wish we could have started this several years ago... 

I have come to understand and accept that most people do not understand most other people.  There are so many issues in this fallen world and we just don't have the time to get to intimately know all of the ins and outs of everything.  Unfortunately that usually breeds distrust and misunderstandings of those things which we do not understand.  It has been a painful journey for me to know that people do not agree with much of what we believe in and do, but we continue to forge ahead.  When we first started the adoption process we were trying to adopt from Liberia, West Africa.  Most of the people adopting from our agency at that time were on the same closed group.  We encouraged and supported and prayed for one another.  It was a precious connection.  When we were not able to bring any of our 4 kids home from Liberia, and other things happened we no longer were on that group.  I desperately missed the connection.  Foster care (3 of our adoptions) does not promote strong connections between foster parents and the foster parents themselves vary so much that connection is difficult.  I have joined several yahoo groups specific to our kids' needs such as one on home schooling adopted kids, trouble with reading, dyslexia, etc.  I was very excited (although also saddened) to be asked to be on a new group of the same women I had connected with 6-7 years ago who are now, unfortunately, dealing with all of the struggles of parenting adopted children.  The struggles are many.  Adoption is still VERY worth it.  However, adoptive parents NEED support (and NOT to be told, "well, you chose this") and this is a way for us to get support.  I appreciate fb and technology that even though there may not be people geographically near us to support us, we are able to receive support from around the world:)  People who are looking into adopting need to know what they are about to experience.

Via one of these groups one the mom's started talking about some of the issues that I see with Grace in particular.  (I don't wish to not include dad's, it is just usually mom's who are doing the leg work and seeking connection/relationships for support lol!)  That confirmed what I had learned last fall from Karyn Purvis, PhD and TBRI (yes, I know I promised a year ago to start blogging about what I have learned.  I promise that I will blog about it, I have the posts running around my brain, I just have not done it) that all kids who come from trauma need to have full educational, OT, and PT evaluations to assess their needs and strengths.  I am tired of the people who tell me that if we just disciplined more we would have better results.  I am tired of the people who say we don't discipline enough.  I am tired of people not understanding.  I am thankful for the One who always understands:)  It is so, so much bigger than just discipline! So armed with new hope I took Superman and Grace in to pediatric OT and PT therapists for evaluations. (Bunny Trail: medications have helped, the allergy testing/treatment/weird stuff has helped, the nutritional stuff has helped, different disciplines have helped, TBRI has helped...I think that each of those issues are just dealing with a different part of the elephant and this is another part of the elephant).

I had always thought that Occupational Therapy was what people did when they had a stroke or a accident and needed help with some type of fine muscle skill, and that PT was about gross motor skills.  I was wrong!
Both of the kids sailed through their general OT evals.  Grace did very well on her PT eval. Superman came back with some PT areas to work on - primarily core muscle issues that contribute to his "floppiness" and lack of endurance.  Grace, however, was found to have many sensory issues that can be helped through Occupational Therapy.

Permit me another bunny trail/soap box.  One thing that the vast majority of people do not understand is the utter vital role of prenatal health.  People will constantly tell us "Grace came to you at 4 months though, right?" as if getting her so early, or getting JJ at birth for that matter, somehow means that since we have had them all of their lives and have been responsible for their "nurture"  we are at fault somehow for their issues or that we are making their issues out to be bigger than they are.  Prenatal exposure to drugs and alcohol are not the only prenatal elements that can negatively impact a child.  What the mother eats (or fails to eat), antibiotics that she takes, a normal and stress free pregnancy but a traumatic delivery/NICU, and cortisol levels from her stress levels can all have the SAME IMPACT AS DRUGS AND ALCOHOL on the developing baby.  Just take a moment to let that sink in!  It is a wonder to me that any baby turns out ok!  Only by the grace of God!  The impact is neurological one.  Many times it is permanent or at least requires intervention.  Three of our kids have prenatal exposure to drugs/alcohol.  The effects are very different in each child.  Then we have JJ who has no known drug/alcohol exposure but born to a mom who was very sick vomiting most of the time, did not gain much weight, had very poor nutrition, and had stress levels THROUGH THE ROOF getting pregnant with a 6 week old baby at home, no help from the birth father, a family who was condemning her, and, well, her lifestyle isn't great. Neurological insults abound.  And sensory issues are neurological.

OK, back on track.  Grace's issues are sensory.  Essentially she it utterly over stimulated by visual and auditory sensory feedback.  Isn't that the core of ADHD symptoms lol!  Conversely, she is totally under-stimulated in the areas of tactile, proprioceptive (deep muscle pressure), and vestibular (balance/inner ear) stimuli.  The under and over stimulation war against each other in her brain where it doesn't know what to be processing.  Also, when she is overstimulated in one area, she will gravitate toward trying to stimulate the other areas.

In practical terms, the ways that I have seen this are:

Auditory: Grace will cover her ears and not like sounds.  When she is in an area with many sounds she cannot discern what she is supposed to pay attention to.

Visual: again, when she is in an area with lots of visual stimulation she misses the forest for the trees so to speak. She is forever noticing what everyone else is doing rather than what she is supposed to be focused on.

Tactile:  Grace is the messiest eater EVER!  She is the messiest everything always!  She is always washing her hands and playing in water until her hands crack and bleed all of the time.  She is always chewing her hands, hair, etc.  She digs out the sheet rock mud from on top of the screws on her bedroom wall with her bare fingers.  She has ripped all of the wall paper border off of her walls, again with her bare fingers.  She is forever dirty playing in sand, digging in dirt, pulling apart anything she can find. She wants to fully feel and physically experience everything.  No personal boundaries?  Craves physical touch/tactile stimulation to connect.  She has a bed so full of toys that I cannot imagine how she sleeps!  She needs the "feel" of them and their textures.

Proprioceptive:  When grace is getting overstimulated she will stomp her feet or walk as if flat footed so it seems like she is stomping her feet.  The OT explained that kids like her have a strong need for keep joint/muscle compression so while she "knows" how to walk heel/toe stomping flat footed will give her sensory input that is soothing to her.  She is not just doing it to be rebellious.  I was worried she was going to blow out her knees!

Vestibular: another huge one for Grace.  When overstimulated Grace will spin in circles a lot (remember her first black eye??!), hang upside down off the couch/ottoman (2nd story railing of my parents deck), and swing/rock.  She much prefers circles to back and forth.  Again, when visual and auditory are too stimulated she will go to the 3 areas that are understimulated to self-soothe.

Whew!  We had the week of vacation between the eval and the first appt so I had a chance to just sit back and watch her behavior.  Putting a different framework on the "why" of what she was doing was so helpful! I was able to have hope that one day it will be better:)  The problem was that I still didn't have any tools to make it better as vacation is VERY stimulating lol!

Interventions we are starting:
First, I am to really think about all of her environment and her responses in terms of the 5 categories of stimulation that we are dealing with.  Second, I have been asked to do, as interventions, things with Grace that we have totally, totally, totally removed from our lifestyle due to the issues she has.  For example, can you IMAGINE her with PAINT!  eeee gads!!!  Ok, but I can do this...

Visual: we are to get a lava lamp, bubble maker, or fiber optic tree/something to give her something to look at that is visually stimulating but in a calming, methodical, and structured manner.  Meaning, it will keep her attention but keep her calm.  We are to have a place for her to go in the house that is visually calm.

Auditory: unfortunately there is not much that can be done for this sense other than graded exposure until she is able to handle it - and the use of headphone/earplugs.

Tactile:  this is the one that scares me the most.  We are to give her lots of controlled sensory input.  Playing in rice (beading string but she had to pull the beads out of rice to give her the tactile stimulation), painting (again, imagine me physically cringing!), playing in sand (same cringe!), fidget toys, play doh (arrrgggg!  the mess!), squeezing clothespins, sorting items that she finds in a bucket of beans, etc.  This one will take the most creativity and patience from me.  I was also horrified that I have been removing the very things that she has so desperately needed because of the huge messes that she makes (do you remember just for a moment what our bars of soap look like lol!)  Sugar free candy for oral stimulation.

Proprioceptive: We are to get a bean bag and have her lay in it, enveloped by it, with a heavy blanket over it.  Rolling over the top of a big bouncy ball (the kind you sit on), pushing against walls, sweeping, carrying  various heavier items, stretching, etc.  Anything that will give deep muscle stimulation/joint compression.  Wheelbarrow, bear crawling, jumping jacks, etc.

Vestibular: swinging, rocking, listening to/feeling drum heavy music (African or native American) where she can feel the beat.

Finally, we learned the Wilbarger brushing technique.  Karyn Purvis, PhD talked about this one a lot.  It is a mixture of brushing her skin with a soft brush alternating with keep joint compression.  Grace LOVES it, it relaxes her, and she gets to do this every TWO hours.

We have a schedule of what to do every 2 hours with her.  Even though this is a time commitment it will hopefully take up less time than the hours of screaming we get when she is overstimulated.  These techniques are supposed to help to sooth over stimulation and stimulate what is under stimulated so that she can regulate better.  We are ALL ABOUT having a better regulated Grace!!

I know this post is very long, for those of you who have read it to the end I hope it has been helpful:)  Feel free to ask me any questions that you may have about this, or you just read The Connected Child by Karyn Purvis, PhD or The Out of Sync Child by an author I can't remember right now:)

Ready to Home School!

We have always done our schooling at the kitchen table (or on the couch or a table by the fireplace on rare occasions).  With the addition of children it became more necessary to stay at the table...and after having 5 at the table last school year I decided that was not working anymore.  I wish I had a school room but I do not, given that all of the rooms are inhabited by children:)  So, during my "thinking time" this summer while I was recovering from surgery I had time to step back and think about how we are doing life rather than just plunging ahead day to day.  I came to the conclusion that if my priority was going to be parenting and home schooling that I would have to sacrifice yet another "fun" part of my life.  Yes...my scrapbooking table.  As you can see here it is not like my scrapbooking table was useful any more - for other than collecting those odds and ends that "someday" would be put into some one's album.

I went through every piece on that table and organized it or threw it away.  I stored my scrap booking items away in a cupboard thinking that maybe, when the grand kids come, I will have time for these kinds of projects.  But for now I need to focus on educating the kids.

Here is the old space...

 Here is the new space...

I am very pleased with this area and hope that it will be as functional as I want it to be!  For the first time in 8 years I have all of my supplies and things in one area!  I was shocked by the number of duplicates that I have.  I won't have to buy supplies for a very long time lol!  I left a space that you cannot see well for us to do a long visual timeline of history to help my more visual learning children.  Beautiful was given her own personal, private, and quiet school area in another room that we hope will help her to be less distracted and thus able to focus on her studies uninterrupted by little ones (and the other things that she finds to distract herself!)

This year we have continued to use My Father's World.  I have tweaked some of the subjects using Shurley English for Language Arts and ALEKS Math for the older two.  I am totally loving ALEKS math.  It is an online program that teaches them at their own pace, gives and corrects all of their assessments, and will not let them progress until they prove mastery in a subject.  The best part is that I don't have to do ANYTHING!  Perfect!  They can complain to the computer about having to do math and I don't have to hear it lol! 

I have the schedules made, the lessons plans written, the dry run done, and now we are just waiting for 8/27:)  But for our family the nuts and bolts of the books and space are the least of my preparation needs.

When we got the 3 Middles I was excited that I would be able to teach "1" lesson, 1 time as if to 1 student.  God was really laughing about that one!  He blessed us with 3 very, very unique kids who learn totally differently with very different learning "abilities."  Last year kindergarten was really an experimental year for me to try to figure out how this was going to work.  I have not talked about these things much as I am still so overwhelmed with their various levels that I don't really know what to say about it.

Each of my kids struggle in a different way to learn information.  I have to constantly keep the Main Thing the Main Thing and not be focused on the expectations I have contrived in my own mind or the World has placed on me/them.  I am so thankful for many of my fellow adoptive and/or home schooling mom friends who help keep me focused when I fall into discouragement and frustration.

I have to keep in my the kid's Love Languages - each child has a different angle on how to be motivated to work diligently when it is hard to learn.  Most of the time I feel more like a cheerleader than a teacher.   I used to read about home school students who were "independent" where you could hand them their lesson plan and they would hand it in completed at the end of the day, week, or even month!  Ha!  I am blessed with with "hand holders" who need me to be within eye or arms reach to be sure due diligence is pursued;)

I am choosing to share here about some specific issues that we deal with, not to embarrass any of my children but to give hope to anyone else who is struggling with these issues out there that they are not alone!  I have been so blessed by the vulnerability of others who share their struggles on their blogs and want to be a blessing to others if possible. Let me say though that while you are not alone...I do not profess to know all (or any!) of the answers:)

Superman has difficulty with processing auditory information.  He is fully capable of hearing - he just has a very, very, very difficult time processing what all of that verbal stuff means.  I used to be convinced he had dyslexia.  However, he is making strides that suggest to me that he does not.  This summer we worked on math all summer.  I discovered this summer if I work with him in a room totally quiet (yes...any time you can stop laughing here) with no other people in the room but us, and we first do his Brain Integration exercises along with deep breathing, that I could get successful work out of him that he actually retained!  This was a HUGE breakthrough for us after 4 years of him struggling with not learning the information, then if he actually did learn it he would not retain it.  This boosted his confidence and made me more confident going into this school year.  He is a very visual learner.  When we read him stories he "thinks" in "pictures."  Thus he will get the general understanding of something (retained as a picture) but he will not remember specifics.  That, obviously, can be problematic.

The primary enigma with Superman is how much is Auditory Processing and how much is Post Traumatic Stress Disorder?  Children who have suffered trauma tend to be extremely hypervigilant and watchful of their surroundings.  This means that they are also attending to insignificant details (worried that they are dangerous) and thus are not focusing on actual relevant stimuli (e.g. teaching) at hand. So, for example when we go to the zoo we are convinced that Superman never even sees an animal because he is so fearful of all of the people around him and watching to be sure that Faith is safe and near him.  These kids will also answer questions based on what they "perceive" (based on facial expressions, voice inflections, etc) what they think is the "right" answer for the situation rather than actually learning that there is a "right" answer that is always "right" if that makes any sense.  Thus, they don't retain information over the long haul as they believe that all things change depending on other people's mood.  This is quite adaptive for a kid who is growing up in abuse to keep physically safe...but obviously maladaptive when they are placed in situations where things stay the same and are not dependent on people's mood.  It is all quite mind boggling.  If you are interested in more of this you can check out Jim Wilder and his brain research.  I have one of his videos that has been so helpful in my understanding brain trauma.  It is called Joy Bonds.

As for teaching an ADHD child...realistic expectations, short lessons given at the "peak" time of medication, lots of activity, etc.  We have decided to schedule our day around Grace.  We will keep her schedule flowing and moving one on one as long as we have her attention and will flex the other two around her work with more independent work (loving the IPad, Math Shark, and computer!) until we have her subjects completed.  Then we will set her up with a lot of teachable game options to keep her in one spot while we work with the others:) 

Faith is doing great in school.  Our biggest problem with her is keeping up with her!  Again I am thankful for the IPad apps with math and spelling that can self-correct her and keep moving at her pace.

Dysgraphia is a problem that I never knew existed until I heard Dianne Craft speak about it at a conference.  Wow!  I just thought it was laziness.  We have been pleased with the results of her Brain Integration materials and are so thankful for computers with spell check! 

Two of our kids are having PT and OT evaluations done this week with one of those children also having a full academic assessment done this month.

We just keep moving along, doing what we can within our power and leaving the rest to God:)