Do you think OT is appropriate?

Rose.9.6.03

So my nearly 8 year old DD has been complaining of headaches 3-5 times per week for the last several months.  We've been making sure she's very hydrated.  The pediatrician order a CT scan, which came back normal.  She gave us a referral to the headache clinic at Cincinnati Children's, but we can't get in until the end of March.  The pediatrician said that she could also recommend a neurologist who could probably see her sooner.  I told her that I don't really think the headaches are a true neurological problem, but rather stem from DD's poor sleep habits and anxiety.  The headache clinic has both a neurologist and a behavioralist that see the child, so I told her I'd like to wait for that.

We started talking about DD's issues.  DD is a horrible sleeper and has been since birth.  She has a hard time falling asleep because, in her words, she's "thinking thoughts."  Some times they are bad (like when she was embarrassed because she thought her teacher laughed at her picture (which she did not)) or good (excitement about random small activities that will be happening the next day).   She also wakes up at least once per night about 4xs per week.  

She also has a fair amount of anxiety.  She is quite smart and gets high marks,  but struggles with high pressure situations - timed tests, in particular.   She is highly distractible.  She tends to either rush through work, resulting in skipped problems, clerical errors, and/or really sloppy handwriting.  Or she takes a really long time on her work because she's paying attention to other things or complaining that she doesn't want to do the work.  Her teacher last year also told me that DD was afraid to ask her about the assignment if she didn't understand something, despite encouragement to do so.  

DD largely stays out of trouble because she is terrified of being in trouble.  In the rare occasions that she gets a time out, she has a complete emotional breakdown.  Not a tantrum, but just crying and sadness.

For what it's worth, DD has some rare skin and hair issues (we know of one other case in the US).  I don't think that it's related to her anxiety issues, but really, who knows?  Her condition is so rare that there's not much known about it.

Anyway, the pediatrician suggested OT for DD to help her cope with her anxiety (which, will also hopefully help with her sleep, as well).  I've often thought of OT as more as a fine motor therapy or for kids with real sensory issues (I do think DD does have some sensory issues, but not enough to label her with SPD).  I'm fine with trying it because I'd love to treat these headaches (and anxiety)  without the use of medicine or invasive procedures.  But I'm just wondering if anyone else has had any luck with OT in a similar situation or has an insight before we head down this path.  

I appreciate any thoughts on this matter.  Thanks.

hopecounts

My first question is is she seeing someone for her anxiety?
I think OT is worth a try if she is already in appropriate therapy.
I'd meet with the OT and see what you think.
Sensory issues can contribute to poor sleep as well. It could be a chicken or the egg situation. Sensory keeping her up allowing her anxiety to ramp up which keeps her up allowing the sensory to keep her awake and so on.

If she does have some sensory issues she may be using a lot of processing power to deal with that making dealing with normal bumps in the road more difficult to handle.

I wouldn't use OT for anxiety but if the anxiety has a sensory component it may be worth exploring in combo with more traditional therapy.

kcisthebombdotcom

I've had luck with ot...but it wouldn't be my first choice for an anxious child with broken sleep. I have an anxiety disorder and poor sleep is a big trigger for me. Have you seen a sleep specialist and done a sleep study? Perhaps they would have some drug free interventions you could try.

kcisthebombdotcom

Also you may want to try Epsom salt baths before bed. Magnesium both prevents headaches and makes you sleepy. It will take a few months if it will help with headaches but you would know pretty quick if it helped sleep.

Rose.9.6.03

We have not seen a sleep specialist or a counselor/psychologist.  I had actually started looking into counseling before talking to the pediatrician.  I really don't think she needs long term therapy, but I do think she could really use some coping and relaxation skills.  

I have thought about the sleep specialist as well (particularly because she used to have sleep terrors, which have now been resolved), but have never executed on it.  I may look into it, particularly, if I think that there might be something non-medicated they can do.

I am intrigued by the Epsom salt bath!  I'd want to run it past her dermatologist, though, because she has highly sensitive skin.  

Thank you all for your quick feedback!  

ppants

DS is almost 9 with ADHD (on generic concerta) and he also gets migraines.  He got reading glasses before K.  He no longer needs reading glasses, but got glasses for distance this summer (before 3rd grade).  Before both of these changes, he complained of headaches.  Has she had her eyes checked? 

 His biggest trigger for a migraine is dehydration and/or a lack of food.  He's not on any migraine meds currently.  We try to prevent and give him pain meds if he does develop a headache so it doesn't progress to a migraine.  I'm no help with the OT question.