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Tuesday, March 11, 2008

Wordy Wednesday – deep proprioceptive input


























Ms. Wordy Wednesday is alarmed on arrival.
“Good grief Maddy! Is he o.k.? What did you do to the little chap? What is that huge thing on him? Or was it an accident? Is that a tooth brush in his mouth? Did he choke?”
“Um…where should I start? That big blue thing is a wedge, shaped like a slice of cake and we use it to do some amateur occupational therapy stuff.”
“Oh.”
“You’re right, that is a tooth brush, he’s cleaning his teeth, he didn’t choke and it’s not accidental that he’s under the big blue wedge, he did it deliberately, himself.”
“Um…..somehow…..that explanation doesn’t seem to help very much.”
“Sorry. Let’s start at the beginning. That’s my youngest one.”
“Ah, the one with all the extra raw exposed nerve endings.”
“Yes and the ‘don’t touch me above the shoulders’ thing.”
“Ah! So cleaning teeth must be a big issue around your house?”
“Yes indeedy. A very loud, screaming issue.”
“Actually, now that I look more closely at his face…….he looks quite happy!”
“He is. He’s found a coping mechanism.”
“A coping mechanism?”
“Something to help him cope with the agony of cleaning his teeth.”
“Yes, I know what a coping mechanism is, duh! I just can’t quite work out what it might be?”
“Do you notice a huge, five foot by 10 foot, blue wedge?”
“Sarcasm doesn’t become you! Yes I see it. How could I miss it, but how does it help?”
“Say you’re experiencing something painful, like at the dentist.”
“O.k.”
“Do you grip the arms of the chair or dig your nails into your flesh to distract you?”
“Yes to the former no to the latter.”
“O.k. how about during child birth?”
“How do you mean?”
“Did you grit your teeth, grind your teeth, grip something with a stranglehold?”
“Epidural!”
“Ooo you’re not helping today.”
“Sorry.”
“So when was the last time that you were in real pain?”
“Er…..when my son fell off his bike and we rushed him to the ER. I kept talking to him and reassuring him but my mind was racing. I think I must have said every prayer I know a thousand times.”
“Ah. Not quite what I meant but that still works. Your brain was in pain so you distracted it with something else, another activity by praying so you didn’t have to think about the other stuff.”
“Yes, I suppose so. Doesn’t everybody do that?”
“Yes I think they probably do, but sometimes they do it in other ways. For my son, deep pressure keeps him grounded, literally in this case. By having his whole body squished it helps calm him, so that he’s better able to deal with the unpleasant sensation in his mouth.”
“Maybe.”
“You sound a bit doubtful?”
“Well it’s not exactly portable is it? I mean how much does that……wedge weigh?”
“I don’t know, but it’s certainly heavy.”
“Not really a long term solution.”
“True, it’s temporary, but it’s his personal fix and now we know, we can make other adjustments.”
“Such as?”
“We have a couple of weighted vests that do the same job and a couple of other vests with Velcro that can be adjusted to give you that same feeling of snugness.”
“Snugness?”
“Yes, like you swaddle babies to calm them, or how your mum pulled the sheets tight when she tucked you in at night, or that heavy winter coat that always feels so reassuring.”
“So "proprioceptive input" is just a big word for squishing!”
"In this particular instance, but there's a lot more too it than that."
"Another time then?"
“Sure. Oh and don’t let an occupational therapist hear you say that! She'd have my guts for garters!”
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