Friday, February 1, 2013

I Love Therapy (when it works)

Sometimes, we try something in therapy and I feel like "wow, that was a fantastic failure! Never again." Other times I think, "That seems like it might work, let's keep at it." Today, I was somewhere along the lines of "This is a miracle and I want to run out and buy all of the equipment NOW."

Today, we tried Geri on something called Listening Therapy. It's not nearly as simple as it sounds. It's an adjunct to sensory integration (SI) therapies that takes advantage of the fuzzy line between the vestibular and auditory systems. A lot of the modulation that is corrected in SI therapy happens through manipulation of the vestibular system. But the vestibular and auditory fun and games all take place in the same small area - the labarynth of the inner ear. And they operate in basically the same way - fluid in the small canals shifts to stimulate tiny hairs that feed into the nerve bundle from the ear to the brain. Oh, and did I mention they share a single nerve bundle, and nerves in that bundle interact with each other en route to processing in the brain?

See that wall in the middle? Yeah, me neither.
So it makes sense, really, that you could stimulate the inner ear through auditory input and get an SI response.

How it works is using specially modulated music played through super-sensitive, acoustically sealed earphones with an expanded range from the norm. Even those awesome noise-cancelling Bose headphones don't have this range. And it's essential - because the music itself is modulated in frequency, pitch and clarity to include a larger than normal range of frequencies in a specific pattern designed to stimulate the brain in precise ways. The patient listens to the music through the special earphones while completing fine motor or gross motor tasks and the modulated music increases focus, promotes normal interaction, reduces anxiety, and basically helps the child to attend better and connect better.

This morning was the first time we tried this therapy. When we were in the waiting room, she was already throwing a fit. It was not looking good. I was already resigned to a very bad morning of therapy. Of course, she hated the crap out of the headphones. She's not a fan of new things on her body, as the failed experiment with the spandex vest demonstrated. But it was interesting... we put the headphones on her and she immediately cried, then stopped and leaned against me with all her weight and stayed there, still, for a minute. Then she cried again. She cycled between crying and leaning against me, totally relaxed, for about five minutes. Then her OT suggested we sit on the swing, as the vestibular input is normally paired with the auditory input and the swing is an easy starting point for first-time users.

Sweet headphones, dude.
As soon as we sat on the swing she relaxed into a state I've never seen before. She was totally still, completely calm, but awake and alert and listening to the music. She would, occasionally, cry when she remembered she was wearing headphones, but in between she was calm and alert in a way I've never seen before. I was in awe. She asked to see a bin that we nearby, and we took out and examined some of the stuffed animals in it, then tossed them in. She was examining the stuffed animals in a calm and focused way.

She tired of the animals, so her therapist went and got the piggy bank toy and we tried that. At first, she was getting upset because it only had two coins and the one at home has a lot more. We took a break, during which she just relaxed against me and listened to the music. Then she asked for it again and proceeded to put the coins in and take them out again and again, in a very calm and organized way. She was examining the coins with her fingers, not even attempting to put them in her mouth but deeply attentive to their physical characteristics using her fingers. We finally had to stop the fun because we were out of time. She got down from the swing, took off the headphones, jumped on the trampoline with another kid (new therapy boyfriend??) and then we left. She was calm, focused, communicative and verbal. She handled small setbacks easily.

We had a 45 minute break between therapies, so we sat down in the lobby for a snack. I was amazed at how calm, alert, attentive and verbal she was being. She even gave me some very good, very easy eye contact. This is usually tough for her, but she looked right at me and we shared a snack while looking in each others' eyes.

When we returned to her PT and speech appointments, she did very well. She was very verbal in PT, telling Ellen exactly what she wanted to do and didn't want to do. When we settled on an activity (of her choosing) she attended to it for the entire session, not being distracted and cooperating fully. She threw almost no fits.

During speech she was starting to lose the bubble on it, but she was still dong better than normal. She was very verbal, very cooperative, and told us what she needed. She engaged in a small amount of stimming behaviors, very briefly, and was easily redirected. She engaged nicely with me and her therapist.

All through this day, ever since the listening therapy, she's been rocking less than normal. She's made easier eye contact. She's stimmed less. She's been more verbal and thrown fewer fits and recovered more quickly from setbacks.

I'm in awe. Utterly in awe. I'm actually a little scared to share this, because it's only one session and who knows if this will continue to work at all. But this first session had such a pronounced, profound, immediate and prolonged effect that I'm very excited. Next week we will try it again and see how she does, and it she responds well then I'm going to find out how we get her a listening set for home. Ideally, this therapy is done for 20-30 minutes at a time, several times a day. Her therapist may be able to lend us a setup, but I'm thinking of buying one. The headphones alone are $160, but it would be worth every red cent if it continued to work this well.

Anyone else using this therapy? I'd love to hear about it, if you are!