Trying to help our little guy with sensory issues for an atypically high pain threshold has been quite a learning curve for me. He appears to be hyposensitive, meaning that sensations that should bother him do not. This much we already knew because we saw his under reaction to pain. However, we are also seeing that he seeks out stimuli in his environment by using more force than needed when playing with toys. These are probably his efforts to calm his sensory system.
His OT has explained that we should use therapy techniques that target his proprioceptor and vestibular senses. I did not know much about these senses, but she explained these senses provide feedback to our body through our muscles and tendons. They help us keep our balance, to react when something is painful, and know how much force to use when interacting with our environment. Our little guy’s therapy will try to help him in these areas by providing feedback to his body through deep pressure and play that is heavy work.
To generate the sensation of deep pressure we first put a wrap on him. The wrap is just a back band from a fitness store, and we wrap it snugly around his torso. Now that he is used to wearing it, we have added a weight belt. The belt consists of two 1lb ankle weights linked together. Lastly, he wears baby ankle weights that are half a pound each. In total, he wears an extra 3lbs!
I was definitely apprehensive the first time his OT suggested our little guy wear a weight belt and extra weights. I was concerned it would be too much weight for a toddler to wear, and thought he might get distressed wearing it. However, I was also curious to see how he would respond. When his OT put on the wrap and weights, it did not seem to faze him one bit. She explained that most babies would really dislike it and try to pull it off, but he seemed perfectly fine. We started by having him wear these for short periods of time, and we are slowly building up to longer time periods. Ideally, he would wear this for two hours on, two hours off.
While he does not seem to mind wearing it, putting it on him can be very difficult! My little guy thinks diaper changes are a time to roll and squirm. Trying to get on this extra wrap and weights can quickly turn into a game of chase, which can be really frustrating for me. It’s also difficult trying to have him wear the wrap and weights for very long because he needs to take it off to eat in the high chair, nap, or go with me to take his sister to school. The other problem we encounter is that he gets hot wearing it. This was not a big problem during the winter, but we will have to be mindful of this as the weather gets warmer, and if he needs to wear it outside of the house. For now, he only wears it inside.
I am really hoping this deep pressure technique will reset his sensory system. Because of his medical history, his body has a negative association to soft touches. Unlike most babies, a soft touch for him was painful, like the needle sticks he received for blood draws. Therefore, deep pressure instead of soft pressure is positive and comforting for him.
Heavy work is another technique we are using to give him the input he is craving. Basically, heavy work can be any activity that involves his muscles and tendons encountering resistance. The resistance forces his muscles to work harder and gives his body the input he craves.
Most toys and activities can be modified for heavy work. Our little guy has a sit to stand activity walker that he likes to push. We added 5lbs of ankle weights to this toy to increase his resistance. When we play outside, he carries a bucket or pushes his kids’ wagon. I also try to keep an empty diaper box out and he likes to put board books in it. Then he pushes the weighted box around or sometimes tries to carry it.
Our little guy is responding well to this therapy. He will sit and play at one activity for longer stretches of time and his posture has improved. We obviously do not want him to get injured to test his pain tolerance, so we will watch this area carefully. We are also using a different set of tools for sensory issues with feeding that have helped tremendously. I will share our experience with feeding therapy in a future post. For now, we are hopeful that with deep pressure and heavy work we can reset his system and phase out of therapy. If not, we appreciate having tools to help him.