Friday, February 17, 2012

The plot thickens...

We are learning so much from the SMILE program, I just have to share and explain, cause we are getting into some good nitty gritty. I love nitty gritty.

What they do here is a little different than just OT work. The way I think of it is that it takes all the different therapies of usual OT sensory work and digs deeper, breaking it into smaller pieces. The program director here said it's like OTs only have 50% of the picture. To me at least, this all makes a lot of sense.

Dr. Masgutova developed the method the SMILE program uses. It's called, get this, the Masgutova Method, also of Neuro-sensory-motor Reflex Integration. (see if you're interested in a much better explanation than I can give at this point) She found that children with developmental delay, for a large variety of reasons ranging from autism to a traumatic accident, have a dysfunction in their reflexes. The reflexes we have as a baby are there for survival. But as we grow, they are not 'active' anymore, though they are still present in a protective sense. The maturation of reflexes have all kinds of learning implications that I won't really go into but if anyone is interested, I am happy to share the info from the Power Point printouts I have. It's fascinating.

I'm going to explain only what I know in my own head for my own child, but just know that there are so many combinations of difficulties and this is just a little bit of what we are dealing with. I will know more when his report card comes back. They test 32 different reflexes and then write up a report and it takes some time.

Basically, they test all these reflexes (an example is sticking your finger in a baby's hand and they automatically grip your finger), and the reflex is either normal, dysfunctional, or pathological. Here's another example that pertains to James: if someone falls forward, a normal reflex would be to stick their hands out if front of them. Dysfunctional would be putting their hands out a little but not protecting their face from hitting. Pathological would be their hands fly out behind them. James is pathological on this. So while some might think he does this consciously so as not to touch things due to his tactile sensitivity, it's actually his automatic reflex. The problem with the OT work we have done in the past is that he's a super smart kid, as most of these kids are, so he will learn any skill you ask him to do and adapt. But the reflex is not there when he needs it in a 'survival' situation. So that work was not harmful, or wrong in any way, it's just not enough. But I had never even heard of MNRI, honestly, until James had been going to school for a few weeks. I mean, I saw their website, but I didn't get it.

Now when these reflexes are wonky (technical term, sorry to get so scientific), they create a rough world for a kid to live in. So much uncertainty, lack of confidence, lack of muscle tone in some instances. Imagine going through life instinctually aware that you can't catch yourself if you fall, you can't tell how far off the ground you are, you can't save yourself. (On the flip side, kids that have amazing reflexes get put on the gymnastics team.) But also imagine the difficulties in day to day life, like school, riding a bike, climbing into bed, getting OUT of bed. Everything is a struggle, and while I think James will be an amazingly strong person for all this, it's hard on the little dude right now!

So at school, they go back and reset each wonky (it'll catch on) reflex. I'm not super sure how this works for each and every one, but it takes time and we are seeing progress. For instance, it's always been so difficult to rinse James's hair in the tub. I always thought he didn't want to get water in his eyes and was just resisting. But it's because it is u bearably hard for him to look up! If you get him to tilt his head back, his eyes still point down. He can't hold his balance to look up, even while sitting down. We are practicing this a lot and it's very evident how uncomfortable it makes him. Once again, he's such a great kid, he'll do it while gripping your arm for dear life. We will get there!

Here are a couple of pictures of some of the exercises in class!

Okay, and I can't post anything without posting some cuteness photos. So here goes:

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