I am pleasantly surprised that the occupational therapy interventions with Grace are producing pleasing results. In the previous post (the one with all of the bunny trails that is really, really long and no one probably read to the end) I wrote about some of the specific interventions we are to be using with Grace. This post will be about what we are seeing.
ADHD and sensory issues are such multi faceted issues. Even though I had read about and had training regarding ADHD I still did not know enough about it until I got to deal with it day in and day out. In 7 days I get to attend a day long training for Psychologists by the world renowned expert on ADHD. I am curious how it will go:)
For so long the primary issue with Grace was hyperactivity. For years we just tried to calm her down enough that she would not be hurting herself or others. We tried all kinds of interventions and finally used Ritalin. We did get effects from other interventions but the Ritalin finally slowed her down to manageable levels:) We did an increase one time, but with dietary and nutritional changes we were able to reduce it again.
At that time, once she was a bit slowed down, we noticed how bad the concentration problems were. She was in Kindergarten and her lack of ability to attend to the lessons was causing her to really lag behind. We were happy to keep her from hurting herself, others, or wrecking something - forget about math facts and reading! In the spring we switched her to a different medication, Vyvanse. That medication, administered below the recommended start dose, helped to control both her hyperactivity and poor concentration. She made significant strides in school over the summer.
The 3rd issue we have with her is impulsivity. She never stops talking, loudly, without listening for answers. She is seeing something interesting and running for it without regard to it potentially being dangerous or belonging to someone else. She is ever seeking to pin blame on others and not be found at fault herself. We found that this also improved with the medication change. Today we tried a no-med day to see how much of the improvement is from the meds and how much from the occupational therapy (OT). The main problem from the day was impulsivity again. Constant talking and inability to respect others' boundaries led to many sibling conflicts that we have enjoyed not dealing with as frequently (as in, a good day is perhaps 1 - 2 conflicts an hour).
Those issues are primarily dealt with by the medication. So, you ask, what else is there that the OT could even help? The mornings and bedtime have been the worst times for Grace. She wakes up at the crack of dawn, wakes up her sister who needs more sleep, wakes up the house, and essentially bounces around like Tigger creating chaos before people can even open their eyes. Bedtime usually involves at least 30 minutes of out of control screaming, if not longer, that means that no one else can be going to bed. She doesn't stay in her room (much less her bed) and is verbally and physically out of control. 90% of the time we have to remove her sister and have her sleep in her brother's room (in JJ's bed, which means that JJ is still in out bedroom). Her waking and going to sleep have come to be the most dreaded part of my day.
Grace potty trained very quickly at 21 months (I am glad that was easy lol!) She loves to go to the bathroom...and wash her hands. We only use bar soap (which is healthier anyway:) as she will go through a pump bottle in a day. She is forever playing in dirt, sand, water, anything messy. She spins and spins and spins - preferably upside down. She sits upside down during meals - hitting her head on the table for added drama when told to sit up. Superman has to be placed between Grace and Faith at the table and in the van as he is able to defend Faith better. She picks the drywall mud off of the wall. She is the messiest eater alive as she plays in her food rather than eat it. When told no, well, we say it to her countless times a day but it is almost always a battle. She is smart and uses it to be sneaky. If she sees it, she wants it and she goes for it.
Occupational therapy has reduced most of these issues! She is sleeping at night without screaming! Faith actually gets to sleep in her own bed, and Grace is VERY CAREFUL about not waking her in the morning when she gets up. Just so you really get the effect, I said that Grace was CAREFUL! We have only had to removed Faith from the room 2x in 3 weeks and this was not due to screaming! Grace has always been very fearful of the dark (or, more realistically, she wants the closet light on so she can play with her toys since it takes her awhile to wind down and fall asleep). This has hindered Faith from falling asleep as well. Last week Grace announced to us that she wanted the closet light off and has done this successfully! She has a long history of nightmares, and has only had one in the past 3 weeks! Then, when she came to us she came QUIETLY so as not to wake JJ (it used to be that she would charge into our room numerous times during the night as loud as she could be - she now seems to understand quiet) and was quickly calmed and able to go back to her bed. It is quite amazing!
In my mind I am trying to categorize and conceptualize what is really going on with her. We have nutritional issues with digestion that we are still in the process of correcting. We have a ton of food allergies - that we are dealing with nutritionally and via diet. We have ADHD (hyperactivity, concentration, and impulsivity) that has been adequately controlled with medication at a minimal dose and very watchful eyes of my husband and I who try to ward off any "dangerous" triggers. And now the issues that I thought were part of ADHD that seem to be sensory processing issues are being addressed with the OT.
I am so thankful for being able to wake with the sun and not a child screaming or jostling me or slamming doors or running all over the house waking everyone else. I am SOOOOO thankful for bedtimes that do not include out of control screaming. I am so thankful that the girls are sleeping well in their room...and maybe we can have JJ in he and Superman's room...perhaps by the time he is 3? I am so thankful that there are fewer injuries to siblings from her impulsiveness. I am so thankful for calmer days where she is not nearly as impulsive spiraling out of control where the only intervention is to have her scream in her room until she exhausts herself before we can reengage her. Now she is better communicating to us and having a more quiet spirit. She really likes the interventions (like brushing, being wrapped tightly in a blanket and rolled on a big ball, etc) and will ask for them when she is feeling out of sorts. I dare say that life, at least as far as she is concerned is a bit calmer and..quieter! I know we are only 3 1/2 weeks into the interventions (messy eating issues are next!!!) and we have months and months ahead of us. But, we sure are enjoying what we are seeing so far:)
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