Wednesday, April 8, 2015

OCCUPATIONAL THERAPY: It's the Little Things that Make Life BIG!

Thanks to Rachel at for providing this amazing post in celebration of "OT Month."
Dawson was a 5-month old recently discharged from the hospital following a Traumatic Brain Injury that resulted in one-sided weakness and severe visual impairments. His young mother seemed at her wits end when I arrived to evaluate her baby boy for home-based OT. As a result of his injury, Dawson was totally different - he didnt reach for toys, hold his head up or look and smile like he used to. He had cried around the clock since coming home and his mom said she was starting to just tune it out. She was told by his hospital team to do Tummy Time, but no support or strategies for HOW to help Dawson feel comfortable belly-down. He cried so hard when she tried that she gave up the first day home.  Together we set goals for Dawson to enjoy playtimes in a variety of positions, including Tummy Time.

First, we brainstormed ways to soothe Dawson - I pushed her to think of things she hadnt needed to do with him since his first weeks and things that had helped her other children soothe when they were babies. After some trial and error, we discovered that a swaddle blanket, a pacifier, gentle rocking and mommys calm voice settled Dawson down. He sucked furiously on the paci as his eyes shakily scanned his mothers face and they enjoyed a moment of reconnection. I talked through some basic sensory concepts related to deep pressure and movement and encouraged mom to experiment in the coming week with other ways to give Dawson the types of inputs he was showing helped him feel comfortable.

With Dawson calm, it was time for Tummy Time to help him regain strength, body awareness and to use his vision to the best of his abilities. We began with Dawson positioned on his side, and I encouraged Mom to show him simple toys and objects from around the house - a bowl, a hairbrush, a set of toy keys - and watch his reactions. When she exclaimed that he really liked the shiny mixing bowl, I coached her to roll him onto his tummy and help position his weaker arm as he looked at the mixing bowl in this new position. She could hardly believe that he happily stayed belly-down for 4 minutes!

As our initial session ended, I encouraged mom to take the time she needed to calm Dawson completely before playtimes and to find toys or objects that captured Dawsons interest before rolling him over for Tummy Time.

When I returned a week later, moms face beamed as she gushed, You HAVE to see this! She rolled out a soft blanket in the shade of a tree in the front yard and brought a plastic tub of metal household objects - spoons, measuring cups, a mirror. She showed me how he calmed almost immediately when he was brought outside with a paci and slowly rocked as she walked a lap around the front yard. She gently placed him on his side and captured his attention with a set of measuring cups before lovingly rolling him onto his belly, all the while explaining that she noticed he sees shiny objects best, especially when placed on the dark navy blue blanket.

Not only was Dawson showing greatly improved self-regulation, visual attention and much more even weight-bearing through his arms in just a week, the way his mom interacted with him was dramatically different. She was proud of him, confident in herself, connected and warm towards her baby even when he grew fussy. She saw Tummy Time as a position for play, not an misery to endure. Both mom and baby were enjoying belly-down playtimes. From then on, the hour a week I spent in their home was merely a jumping off point and Dawsons mom continued to show me new activities and skills she discovered each week.

To read the previous post in the "little things series, click HERE!

Rachel Coley, MS, OTR/L, has been a pediatric Occupational Therapist for 8 years. As a new mom, Rachel lets her personal passion for parenting and her professional expertise in infant development collide in CanDo Kiddo, a family business with a mission to help fellow parents understand baby development so that they can confidently and playfully give their kiddos the healthiest start possible.

1 comment:

  1. Rachel, Your story is both inspiring and wonderful. Your patience and ability to quicly assess the situation helped both mother and son! Great article. Thank you for sharing it.