sensory integration program -- Jacob's therapy sessions

I wanted to talk a little about the types of activities that Jacob's OT does with him during his weekly sessions. But first an apology -- I don't have as good an understanding about Sensory Integration as I do about RDI, so a lot of this is just going to be my observations, there's not going to be a whole lot of "meat" to it. I'm not always sure exactly what part of his sensory system is being addressed by each activity, but our OT assures us that we are making progress in all areas (and I can see the results in his overall integration and regulation). Also, at the same time she's addressing his sensory issues, she's also addressing the skills he needs as a "student" -- pre-writing (strengthening his hands and freeing up his shoulder motions) and pre-reading (visual tracking) -- and his motor planning difficulties.

Each session starts with the astronaut board that I mentioned in yesterday's post. She starts with him sitting on the board, with his eyes closed. She spins him 10 times in each direction (stopping between directions to let him stop being dizzy), then has him follow a flashlight with his eyes. Then she does what she calls "jumping" -- she uses two flashlights held the width of her body apart and he has to shift his gaze to the flashlight that is lit. Then she repeats the entire activity with him lying on his side on the astronaut board, then again with him lying on his other side. (I have to tell you, just watching him spin makes me feel sick!! I've definitely got some vestibular issues!) After that, she does some reading/pre-reading excerices with him to work on visual tracking. She holds a piece of paper with numbers or letters or pictures on it, and he "reads" them across or down or whichever row she tells him to.

Next she does a fine-motor and visual scanning game with him. This usually involves him lying on his stomach on the astronaut board so that he can rotate himself, and she distributes items out around him (sometimes they are cards, sometimes beanbags, sometimes pictures, sometimes toys or pieces of toys). Then she sets the criteria -- he has to find the letters of the alphabet in order, or he has to match numbers or colors to a card she's holding up, or he has to find animal parts to assemble an animal. It's the same activity, but the specifics are different each week -- GREAT stage 4 stuff, even though she is not trained in RDI.

Next comes an obstacle course. Sometimes she has an obstacle course already set up for him (basically a string of activities that she wants him to do, and he visits each numbered activity and does it before moving on to the next -- looking for the next number incorporates that visual scanning). Sometimes he helps her set up the course as they go along (working on motor planning and making choices). The obstacle course is the framework she uses to get one activity to flow smoothly into the next. It's a highlight of Jacob's week, and he and Zoo Boy love to come up with their own obstacle courses at home and at playgrounds. The compenents of the course (the activities) vary each week, but have included:

Zip-line: Jacob "flies" across the room while holding onto a zip cord. His goal changes each week, at first it was just to get him strong enough for him to make it across the room. Then it was motor-planning -- getting him to drop and land on/in a target. The target's gotten taller as the weeks have passed, and now he must really lift his legs while he "flies" in order to get into it. To encourage his leg-lifting (which is working on his core strength), Zoo Boy and I shoot at him with pop guns as he flies by us, trying to hit him in the legs.

Hammock: Jacob lies inside stretchy pieces of fabric while his OT bounces him up and down or sways him back and forth, or both. This is one of the activities that she uses in conjunction with his listening therapy (special Sensory Integration CDs, listened to via a specially designed set of headphones -- honestly, I don't know much more than that). Jacob wears the headphones and listens to a track or two while his vestibular and proprioceptive systems are being stimulated.

Air Pillow: Jacob jumps off of a structure of some sort (that he either climbs up or jumps onto) into a big plastic pillow filled with air. His OT rocks him back and forth, or bounces the pillow up and down, or rolls him around on it. At first, Jacob wanted nothing to do with the air pillow. It's now become one of his favorite items.

Jumping: There's lots of jumping in this room. The favorite thing his OT uses is a big excercise ball held in place by some inner tubes. Jacob jumps up and down on the ball while counting. But there is also jumping on mattresses, crash pads, inner tubes, as well as jumping up onto and off of things.

Climbing: There is a climbing structure, from which Jacob either slides down or jumps off into crash pads or the air pillow. Sitting at the top of the structure, his OT often has him throw heavy beanbags at targets.

Swings: There are lots and lots of swings that are used. Sometimes he swings to and fro on a bolster swing, with a sword in one hand, spearing rings as he goes. Sometimes he swings back and forth on a platform swing, lying on his belly, while he "fishes" for magnets with a magnet-ended fishing pole. Sometimes he swings side to side while sitting on a hammock swing, throwing sticky balls at the wall, or bean bags at targets.

Top: There is a big red plastic top, big enough for kids to fit inside -- Jacob rocks himself around in a circle in it. Sort of hard to explain, actually....

Ball Pit: There is a big ball pit made of stacked-up inner tubes, with enough space and balls inside for a couple of kids to get in and get fully immersed in balls. The OT hides things inside the ball pit for Jacob to dig through the balls and find. Before getting in, he walks around the edge of the inner tubes, then on her signal he jumps in and starts digging for things.

Textured walking surfaces: There are a variety of surfaces to walk across, roll across, bounce across, crawl across, etc.

Tunnels: of all sizes and textures to crawl through, or lie in and get rolled about.

We also have Sensory Integration excercises that we do at home, under the direction of Jacob's OT. More about that tomorrow!