Initially we focused on stimulating his mouth in a number of different ways: tickling his cheeks; giving him cold drinks before eating; trying intense flavors in food like lemon, vinegar, and spices; using an electric toothbrush; using a Nuk massage brush on his tongue and inside of his mouth. Stacey also gave him different mouth movements to imitate, like puckering and licking. We would practice eating a number of different foods that offered different textures and levels of crunch.
It took over six months to give me an acceptable level of comfort with Gulliver's eating. Today there are still times when we remind him to chew his food. But the majority of the time, I feel like he can handle the things he puts in his mouth. There are still some foods I am hesitant to give him, but there's no rush. Gulliver always has a way of letting us know when he is ready. He has come so far over the past year with his eating. I am so glad we cleared this hurdle.
We also added sensory to the mix when I told Stacey that Gulliver doesn't really enjoy "getting dirty." Every person has sensory integration issues on some level. It's fairly common for preemies to have sensory issues as a result of their little nervous system not having ample time to develop and being forced to deal with sights, sounds, and smells of the big wide world earlier than usual. I want to make sure Gulliver has every opportunity to be exposed to a variety of things. I knew Stacey would have a different way of playing with Gulliver in "messy" activities than Mark and I do, so I asked her to incorporate some sensory play into our sessions.
We started out with shaving cream. At first Gulliver was hesitant to touch it. When he did, he wanted to wash it off right away. After 45 minutes of playing (it just amazes me that he can sit and focus for this long), he really got into it -- squeezing shaving cream through his fingers and swishing it all over the desk top.
We also use finger painting as another sensory activity. His progression is similar to shaving cream, where he starts off very hesitant, but then becomes more comfortable the longer he does the activity.
Play-doh and sand are two other good sensory activities, both of which Gulliver really enjoys.
Some of the things I learned from Stacey during our sensory play include:
1. Incorporating "props" into play
By using sponges or trucks, Gulliver can engage in the activity without getting it all over himself. As he gets more comfortable, we start doing things like painting the truck and rolling the sponges so that it gives him direct interaction with the shaving cream or paint.
2. Modeling
She continuously emphasizes how important it is for the caregiver to get involved in the play. If I want Gulliver to smear his hands in the paint, then I should already be smearing my hands in the paint. Lead by example.
3. Specific, positive reinforcement
Stacey constantly praises Gulliver on specific actions. "I like the way you are painting with your fingers." "I love how you squeeze the shaving cream with your hand." "Nice using your words."
4. Follow his lead
Rather than forcing Gulliver to do something my way, follow his lead. Build on his ideas. Give him the control. Stacey really has a knack for guiding Gulliver to reach a goal and making it all seem like it was his idea. I've picked up new ways of doing things as a result of watching her interact with Gulliver.
5. Cleaning up is part of the activity
When playing with messy stuff, it's often easier to just clean it up later by myself. But Stacey encourages Gulliver's involvement, since cleaning up plays a part in the sensory activity. If the child is ready to wrap up, they are motivated by the cleaning up process because it means the end is near. It also changes the focus so that the child does not realize they are getting messy. And it also simply encourages good habits. Now I try to include Gulliver in the clean-up process whenever possible.
All these things sound so simple and logical. But it's surprising how easy it is to overlook any and all of the above.
We still see Stacey every other week to work on fine motor skills. She uses a variety of activities to assist in this area. Some of these include squeezing balls of all different sizes and textures; pulling beads apart that range in size from large to small; stringing beads together; lacing; doing puzzles; opening and closing little plastic clips; grasping objects with tongs; sorting shapes. It's so rewarding to see the progress Gulliver has made. Tasks he used to be unable to accomplish on his own, he now blows right through.
Stacey is also very good at setting boundaries. Following her lead, we try to set a focused stage for Gulliver by giving him a choice of what he wants to play, playing it, finishing, and then cleaning up before moving to the next activity. At first, he resisted this approach (strongly, at times). But now it is second nature. She has helped us establish good habits early on that we continue to foster.
As with PT, there is nothing "wrong" with Gulliver. OT services help us focus on specific areas to make sure Gulliver doesn't fall behind or miss any important developmental milestones. OT has been such a wonderful learning experience for both Gulliver and me. As a stay-at-home mom, I welcome all the new ideas for enriching activities and play. Gulliver gets so excited when Stacey comes to the door. He gives her big hugs when she leaves.
I love how all our therapists make learning so much fun!
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