Occupational Therapy in the Pool

At Casa Colina, John is taking swim with an occupational therapist.  It has been so rewarding on so many levels.  John is 5.  In January, he was not water safe. 

I've had private swim instructors for 3 years try to teach him in my parents pool.  He is good at distraction and a master of manipulation.  He was in charge more than the teachers, having them resort to baby games you'd play with toddlers or use in a mommy and me classes.  He'd sit on the edge or on the step, they'd splash water on his legs and the two of them would sing silly water songs that would end with John being pulled into the pool.  John would love this so much that they would do this over and over.  He wouldn't attempt picking anything off the bottom of the pool, would get disorientated when his head would go under water, and could not hold his breath. He hated doing anything with the kickboard and refused to do "big arms".   He'd swallow lots of water and most attempts to teach him to close his mouth just didn't work.  We'd resort to him wearing a life vest every time he went in the water.  He had no fear at other times and would want to jump off the edge, but then do nothing to try to swim to the side.  The life vest made it more fun for him and put us at ease.  But, that doesn't solve the problem.

This year,  I talked to John's OT about moving an OT session into the pool.  Casa Colina (where John is in OT) advertises an 8 week swim program that is taught by an Occupational Therapist.  After speaking to her, I realized that this was the perfect fit for John.  The water provides a sensory experience for him and they can work on motor planning, as well as water safety and swim.

Watching him progress so rapidly in this class has been so awesome.  They work on strengthening his core, breath control, floating, swimming, motor planning, water games, swimming to bottom of pool, jumping in and swimming to the edge, etc.   Having an OT teach John these skills was exactly what we needed to see improvement.  He's on his second, 8-week session.  He is holding his breath, swimming to the bottom and getting rings, swimming the length of the pool, and floating on his back.  He used to avoid tipping his head back, but she got him to relax and float.  She taught him that when he is swimming or feeling like he is sinking, he can roll to his back and float.  She has worked with him, going from front to back and then back to swimming.  He has some motor planning work to do on this skill, but it's a long way from sitting on the edge singing songs and being splashed in the legs!  They work a lot on strength, endurance, muscle control, motor planning, etc., while playing games and swimming.  It's a great fit and I'm so thankful for the programs we have found for John. 

Maui: Plane Ride, Water Slide, & Work

The plane ride to Hawaii last Friday was awesome! John and Katie were calm, excited, and very well behaved!

John sat by the window next to Bill and Katie sat by the opposite window by me. Using a video iPod, portable DVD player, books, headphones, crayons, and activity pages, the children were kept busy and happy.

John kept saying "riding in airplane". He told us he was "happ-n" (happy) and didn't have a single meltdown. Katie was talkative and enjoyed every moment, taking it all in. Traveling was pleasant and everyone stayed in good spirits.

Once we arrived in Maui, there was Starbucks in the airport and all enjoyed some cake. Katie, my dad, Steve, SeAnna and myself went to check in, while Bill, John, and Grammy went to Costco and then back to the airport to pick up Erin. John had fun shopping at the store and told Grammy she had to "pay". As we use the stuff from Costco, he tells us he bought it at the store.

We've been here for almost 3 days now and everyone's had a blast! The first morning, John and Katie went into the ocean with their clothes on. After changing into bathing suits, they went on the huge twisting water slide over and over. John asks to go in the spa a lot, so we have termed the kiddie pool as a "big spa", which satisfies John. He loves the independence we give him in the "big spa". Bill and I can sit on the edge and allow both kids to roam around the kiddie pool, which is so shallow both kids can touch. There is a waterfall on one side of it, which makes it fun, and a stair around the other part. John wears a lifevest and swims around, playing with all the other kids' toys. Its a "Free for all" as far as the pool toys that everybody brings. We have two floatation animals and our kids usually play with some other kids sand toys and they ride our water animals!

We've met another family who have an 18 month old son who is in early intervention as well, due to not crawling by 12 months old. They love the occupational therapy they receive through Regional Center and will not be needing it anymore, now that he is walking.

Every morning, John and I do our "work" and Katie and Grammy do her work. John is building 'bridges' with blocks, working on opposites, practicing his pronounciation with flash cards, playing with puzzles, finding hidden objects in play dough, matching photos, and reading books. Katie is practicing her writing -lowercase letters--, addition, reading comprehension, opposite puzzles, and trying to master a more advanced jigsaw puzzle.

All in all, vacation is nice and relaxing. Everybody is having a blast!

A little this...a little that

Catching up from the weekend....
Katie has developed into a wonderful swimmer over the last 4 days! Once she felt in control under the water, she has excelled rapidly. She glides both on her stomach and her back across the pool. She swims underwater and comes up for breaths. She is learning how to use her arms to stroke. She jumps in without someone catching her and actually loves it now.

John's last day of Early Start is tomorrow! He will move into the START program next week.

On Friday, John has an evaluation with Foothill Presbyterian Hospital for Occupational Therapy/Sensory Integration (finally!!!)

Now for today...

John had speech today, but instead, they began his START evaluation. Step One is to evaluate his play to see at what level he is "playing' at. The idea here is that autistic children tend to take everyday objects and use them in different ways, instead of the intended use.

So, Tonyia gave John a baby doll, hair brush, bar of soap, bottle, and toothbrush. He started by brushing her teeth. Although, at first, he picked up the bottle and the toothbrush, which looked odd, but then he used the bottle as the toothpaste and then proceeded to brush her teeth. He then grabbed the brush and brushed her hair. Tonyia asked John to give her a bath and he used the soap on her legs. She then took off the babies clothes and put foam soap on the baby's tummy and John grabbed a tissue and cleaned the baby. Tonyia then assisted John in dressing the baby and John brushed her hair again, pretty hard. Tonyia told John the baby was crying and gave him the tissue to wipe her eyes. John wiped away the tears and picked up a cup out of Tonyia's bin. He grabbed the bottle and "poured" something in the cup and took a drink himself and then gave some to the baby.

Tonyia set up a house with a bed, sofa, TV with DVD player, table, chairs, and a slide with a ladder. She then gave John a boy, girl, and later, a mom. He laid the mom on the ground. He had the girl sit on the couch. He then took the TV into his hands and played with it for a long time... there was a "pretend" DVD that went in and out of a hole in the TV and he kept putting it in. Tonyia eventually took it away from him. He then took the boy and had him climb the stairs and slide down the slide. Then he asked for bubbles.

He played with cars, play dough, and bubbles and it was time to go home.

John had another session of Neurofeedback today. We are on session number 20. The first 20 minutes is spent on the part of the brain that controls sleep and impulse control. John was so quiet and calm. The next 20 minutes made John a little agitated, as it has the last few sessions. They added an element that helps with motivation. Today, we decided that it may be too much for John. We are going to eliminate that protocol from the training and add 10 minutes to each of the other protocols. The last protocol is training the part of the brain that deals with social/emotional responses.

Things I've noticed since beginning Neurofeedback:

• biting of skin stopped
  
• chewing of shirt stopped
• doesn't drag his toes anymore while walking
• Achieving goals rapidly at Casa Colina
• Speech improving
  
• Falls asleep easier
  

Now, I'm not saying Neurofeedback alone has contributed to these things. John is working hard and there are a lot of PEOPLE helping John, but I am beginning to believe that Neurofeedback is enabling him to be present for learning and helping with behavior. The goal of Neurofeedback is to calm the brain down enough to teach it how to self-regulate itself. Through brain self regulation, the nervous system no longer feels under threat. The body is able to think beyond itself and begin to "take the blinders off", seeing the world around them. When we feel under threat, we naturally get "tunnel vision". When our brains cannot self regulate, we will operate as if we are "under attack", manifesting itself in ADD, ADHD, migraine headaches, some Autistic behavior, sensory issues, pain in the body, etc. Through self-regulation, the brain is able to calm itself and the outward symptoms disappear.

Opening our eyes

Katie discovered opening her eyes in the water yesterday right before swim lessons. While John had his lesson, Katie and I went into the spa to "practice". She wouldn't push off the side, so I got an idea to have her walk underwater from one side to the other. She thought this was a good idea. She held my hand and walked, holding her breath and going under. I had read in the sensory integration book that some kids need to feel "grounded" -- often sitting with one foot on the ground or needing a stool when on the toilet. I thought this philosophy may help Kate in the pool since she seems so scared if she is not holding on to someone. By walking across the spa underwater, she was able to feel her body and where it was going, making her feel in control. She kept doing it, and opened her eyes one of the times. She came up so excited! "I saw your bathing suit underwater Mommy!" She wanted to keep doing it. She even walked without holding my hands once she could see and could keep an eye on where my hands were if she needed them. The "accidental" opening of her eyes has progressed her swimming lessons a ton. What a difference a day makes!

And what a lesson to be learned -- open your eyes and try to touch the ground, and if nothing else, remember that tomorrow is another day.

Getting even busier

I always thought I was busy. I didn't know how busy life could get. Well, this week, it's even busier. To our already full schedule, we have added swim lessons for both Katie and John. We have a family vacation planned for Hawaii in the fall, so late summer lessons were always on my 'to do' list.

Katie has never had any formal swim lessons, so we have a lot to make up for. She loves the water if someone is holding her or catching her jump in, but she is petrified to swim by herself. She clutches with all her might to anyone near her that tries to have her swim or stroke alone. If you let go of her and tell her to kick to the side, she just goes limp and sinks. She holds her breath, but then panics after 2 seconds.

John loves the water. He kicks pretty good and can go under holding his breath. He swallows a lot of water, but it's while he is on the surface that he allows the water to go in his mouth. He loves blowing bubbles and playing on the steps.

Hopefully, by our trip, both kids can swim to the edge of the pool on their own.

Until then, our schedule will just be jam packed -- 2 days of early start preschool for John, 3 days of preschool for Kate, 3 days of in-home therapy for John, 5 days of Neurofeedback, 2 days of speech, and 5 days of swim lessons for both. Vacation will feel good when it comes!