safety concerns related to SPD
thetwinkies&Vivi
member
DD1 currently has a dx of SPD and will be seen by developmental peds and EI in June for suspected ASD, likely Asperger's. She is currently in weekly OT for the SPD issues and in ST for related oral aversions and dysphagia.
Lately, we have had a lot of issues with safety concerns. Her OT eval touched on her lack of safety awareness, body in space issues,etc. She does not fear situations appropriately and is an extremely skilled climber, and can escape anything. We have all of the standard precautions in place (locked gates for the yard, high latches on doors,etc) She still manages to escape when given any opportunity. To add to my fears/concerns, my DH is legally blind (has low vision but no peripheral). Going out with three kids, one who tries to dart away, and a husband who doesn't always see cars backing up etc, is extremely stressful for me.
This week she reached for a skillet on the stove top and showed no response to the heat. We also have concerns with how rough she is with the babies. She knows gentle hands and can replicate it, but does not get that chunking toys at them, twisting arms, pulling legs, and poking eyes hurts them. When they cry, and we explain it she will repeat it minutes later.
She does not seem to understand these safety awareness concepts despite being explained numerous times, being shown ok behaviors etc. She is otherwise bright and learns by observing quite easily. She does not seem to be rough with the babies purposefully, more so that she does not understand how to interact appropriately and does not understand when they are upset, what she did to contribute, or how to read them etc.
I brought this up with her OT who will be working with proprioception issues, following directions, making choices,sticking to the task at hand,etc. In the meantime, what would you be working on at home (we are get tasks to work on each week i.e. staying with an activity for a specified amount of time) How can I assure her safety and the safety of the babies? We have tossed around the idea of a therapy dog considering her dx. Maybe a dog to keep her grounded when she attempts to escape, and especially when going in public would help? Any thoughts would be great here.
ETA: removed accidental c&p repeat.
Re: safety concerns related to SPD
I've been in your boat, OP. While my DS just has an SPD dx and isn't autistic, we initially believed that he might be. He used to be very rough and would seldom respond to pain. The roughness, especially in the hands, we are told are often issues with grading force. She probably has no idea how hard she is pressing, squeezing, rubbing, pushing, because her nerves aren't sending and receiving those signals properly. Similar concept with the pain. If you aren't feeling your, lets say hands, properly, you won't be able to use them properly either.
Also, I see from your siggy that your DD is 1, almost 2. I honestly don't know if a 1-2 year old who doesn't really feel pain, can be expected to understand the concept of hurting someone else. KWIM? We also assumed that our DS was aggressive, which wasn't exactly the case. It just takes him MUCH more input to actually feel things. He has made HUGE strides with OT and ST 2X a week since January. We actually played with baby cousin today, and he did SO well. I am amazed at how far he has come. That playdate would not have been possible 6 months ago.
Your DD may indeed have ASD, or some kind of behavior disorder, but a good OT will be able to help you figure out which things are "behavior issues," and which behaviors are a result of a nervous system that isn't functioning properly. Good luck! I hope that you guys are able to find some solutions soon. :-)
Thanks for the suggestions everyone.
Matthew does this still and he's 7. At her age, I'd put her in the stroller. When he was that age, he had no choice. When he was a bit older, we used a harness with him. My twins and singleton are flipped (twins first, singleton next) and not as close as yours. Mine are a bit less than 2 years apart. With that many kids, I didn't give them a choice.
He also doesn't understand the hot issue, as does Chris. Is there a something you can put on the stove for a safety something?
My niece is 2; she was 17 months when her younger sister was born. 9 months later, she is still rough. It's the age. She might not be old enough to understand. Remember, autistic kids also have issues with immaturity. My boys might be 7 and 5 but they don't act like it. We also have a friend whose 10 year old is on the spectrum (Asperger's and yes I know they changed the DSM but the place we go still categorizes it and said they are "grandfathering" the kids into the new system) and when he is here, he plays Thomas with my 5 year old.
I would suggest ABA to work on the tasks you are doing with the OT rather than the OT. ABA works wonders on some kids and can work with all that you are looking at. Also, at her age, she shouldn't be expected to stay on task long. The therapists expected about 10-15 minutes at a time with Chris.
We threw around the idea of a dog to help the boys but honestly, we decided to not do it because it would mean I would be the one walking them, etc. We went with cats instead since they are more low key.
Don't be so hard on yourself! You have a lot on your plate. I thought Auntie's insight was really helpful.
I think you're doing the right things with trying to control her environment by extreme childproofing, high latches for doors, etc. My older DD has SPD, and she seemed to have no concept of personal safety when she was a young toddler. Around 18-24 months, she did start to become wary of things like heights and swinging. She also fell and/or bumped into things ALL THE TIME because of her poor body awareness. She's actually over-sensitive to painful stimuli which is challenging in its own way. OT has helped a ton with all of that.
As far as the twins go, I think you just can't leave them alone with her even for a second. Is there a safe spot where you can put them for things like going to the bathroom? When you and your H go out places together can each of you wear a baby in a good carrier that would leave hands free to chase your older DD? My younger DD pretty much lived in the ergo until she was about a year old. She loved that thing. Do you have help besides your DH? Family? Close friends?
My kid with SPD is at the other end (mostly an avoider) so I can't help with a lot of specific advice, but I do agree with auntie's advice, especially on expectations for age and restraints while going out. Even with "just" twins, I used a double stroller for almost every outing till they were 2.5. I had one highly anxious, easily-fatigued low-tone kid with SPD and one (neurotypical) risk-taker who would run into traffic without a second thought at that age. I feel you and would have some heightened anxiety in your shoes, too, with your combination of kiddos and your husband's low vision but I think having all 3 restrained for outings is your safest bet, unless you're someplace like the toddler room in the children's museum or a toddler playground where you can safely let them roam a bit. I also agree with pp's not to be too hard on yourself; you're doing your best and learning as you go!
We do have all of the girls in strollers,ergos when out. It's more the "hey let me try to climb out of the stroller,or dart away while getting in/out of the carseat." We've started using bright colors to help DH with visual tracking.
I really do need to work on age appropriate expectations instead of letting her advanced areas influence my overall perception of her. Prior to having her, I taught 2 years old preschool, so I know what behavior is typical. It's just easy to get caught up when she can talk about things some grade school kids wouldn't know.
As far as at home, keeping them separated will be the best idea. I've been looking into a super yard gate system for the babies area,at least that would slow her down. Yesterday, I put in her room which is all taken care of safety wise during a particularly rough tantrum. I felt incredibly guilty as if I had betrayed her. When I thought it over last night, I realized it's fine toto put her where she is safe and the babies are safe. I have to let go of notion that it's going to upset her.
I spent a lot of time reading up on at home play activated that will fulfill her sensory needs based on what is affected for her. Hopefully coming up with a daily plan for at home will keep things running smoothly.
I am really hoping we can do ABA therapy after the developmental ped and EI evals. I agree,OT,isn't best suited for that,I guess it's just what II have available right now.
Thank you all again for the suggestions and encouragement. It's much appreciated.