‘Sensory Processing’ Category Archive

Time Flies When You’re Having Fun

Posted October 24, 2012 by pehl

I received a wonderful surprise just the other day – evening, actually.  I had completed my preparations for the new week on Sunday evening and was lazing about when my phone chimed indicating a new email in my ECPT account.  I do my best not to attend to work related issues on the weekends, but I don’t often succeed.  This time my lack of discipline was rewarded with the previously mentioned surprise – an email from a former client who left our practice about 8 years ago when they moved out of town.  I truly do love it when “our kids” come back to us.  Robin and I often wonder, “…what has become of so-and-so.  Let’s see, he/she would be…what? 12 – no 15 years old by now!  Wow, time flies when you’re having fun!”

I asked the sender, J. permission to post her email as I felt it would provide hope and encouragement to those of you who are just beginning “the journey.”  It’s a long road ahead for many of you, with much hard work and often some heartache and tears.  But it also includes the joy of growth and independence gained.  In response to my request J. wrote back, “I’d be honored to help others.”  So here it is:

Do you remember helping a little three-year-old boy, S. and his family 9 years ago?

We moved from Vancouver to Southern California after we’d worked with you both for about 18 months.  Robin started with casting S. for toe walking after he’d had Botox injections in his legs.  She provided PT to address S’s toe walking.  Then Elizabeth added OT and introduced us to Sensory Integration Therapy.  Dr. Willis helped with the AD/HD and sleep issues….

You started us on a very long journey.  We knew so little at the time and all the information was overwhelming.  Not only did you provide therapy for S., you cared about the mental health of Mom and Dad too.  You both were saviors for us at this time.

Fast forward many years…..S. is in sixth grade now.  At age 5 he went thru several intense neurological evaluations and we learned that the ‘something more’ was Autistic Spectrum Disorder, specifically Asperger’s.  We went thru school district evaluations and S. has had an IEP since Kindergarten.  He has always been mainstreamed but with a one-on-one aide.  After all the hard work and thanks to a wonderful support team, S. is now in the Gifted and Advanced class, completely independent.  There are still challenges, but he has made amazing progress.

There was more, but in an attempt to not be self-aggrandizing I edited out the parts that were the most touching to Robin and myself.  My point for posting it in the first place is to provide a sense of the possibilities that lie ahead.  I am honored to have been trusted with this young man’s care, and to have had the opportunity to work as a team member with his parents and I know this is true for Robin also.  We learn from each child we touch and each family we teach, which is what keeps our work exciting and new.  It’s true that time does fly when you’re having fun.

Blessings to all of you as you walk your path, Elizabeth


Posted July 8, 2012 by pehl

All of the children with whom I work have sensory processing difficulties of one sort or another, to one degree or another.  Because all of the sensory channels work together synergistically it is highly unlikely for any one system to be unaffected.  But the one sensory channel that is the most over-looked and taken for granted is the visual system.  It is also, in many ways, the most important, as well as the most controversial.

A child with perfect eyesight may suffer from significant visual difficulties, which can negatively impact academic learning, sports and daily function.  Visual development and behavior begins at birth and progresses along a continuum with clear milestones.  By the age of 12 months visual tracking skills are typically mature and this is one area I screen in all of the children I see.  A typical 5-year-old should be able to visually track a moving target horizontally, 180 degrees in both directions without moving his/her head, (upon request) and without any jerks or loss of pursuit at midline.  This same child should be able to do this in the vertical plane as well, follow a moving target in a large circle both directions and in random patterns that cross his midline and should also be able to maintain convergence on an object moving towards his nose to approximately 2- 4 inches from his nose.  If I see any difficulties including fatigue with this exercise, I have concerns.

Another visual screening tool I use is a game of catch with a playground ball of approximately 9-inches in diameter.  A five-year-old should be able to catch this without allowing it to touch his/her body, consistently.  If the child traps the ball against his body, closes his eyes, looks away and guesses or grabs at it, or consistently misses the ball, his visual skills are not supporting a functional outcome, and again I have concerns.

Likewise the manner in which a 5, 6, 7-year-old sits while writing or coloring at a table is full of clues to his visual function.  Can he hold his paper or project still with his non-dominant hand, while his dominant hand is busy?  Does he hold his chin in his non-dominant hand?  Does he cover the eye on the non-dominant side after working for a few minutes?  Kids can be cagey about this – it can appear that he is holding his head up, when in fact he may be doing both, covering his eye and holding his head.  Does he always tilt his head to one side, or turn his head so one eye is closer to the page than the other?  I’ve seen children who do all of these things, (not one child who does all of them, but often a couple) and they all had difficulty with writing and/or reading.

Yet another big red flag with respect to visual function is the child who “just doesn’t like to _______” color, draw, write – you fill in the blank.  Kids start wanting to use a writing tool as soon as they’re able to take yours away from you, so not wanting to, or not liking to color just isn’t a typical response.  I worry about these kids and I feel that it is my job to try to figure out the, “why not?”

One strategy in figuring out the “why not”, and/or the “why” is an assessment by a Developmental/Behavioral Optometrist.  This is usually where the issue becomes controversial.  Unfortunately not all insurance companies will pay for these evaluations, or reimburse for vision therapy.  Their reason is often because they consider it to be “experimental” and this is unfortunate because it’s been around almost as long as Occupational Therapy, which officially began in the early 1900’s.

The field of Behavioral Optometry was founded in the 1920’s, based on the work of Dr. A. M. Skeffington.  I found the following quote from Dr. Skeffington in Seeing Clearly, by Lois Hickman MS, OTR, FAOTA & Rebecca Hutchins MS, OTR, FAOTA:

“Vision cannot be separated from the total individual or from any other sensory systems, as it is integrated in all of human performance.  Vision is learned, and therefore, trainable…Behavioral optometrists put a major emphasis on the prevention of vision problems as well as enhancing visual related performance which is at a level less than the individual’s potential.”

Did you know that once a child enters school, approximately 75% of all classroom learning is through the visual pathways; that 90% of the people who have problems with their visual skills are never diagnosed.   I agree, it’s a little overwhelming but as Dr. Richard Kavner, OD, FAAO says, “…seeing, more than any other sense, guides and shapes a person’s behavior and experience of life…it is one gift all people deserve.”