His Father's Son

I am the first to admit that Nathaniel gets a lot of his traits/personality/etc from me, but Thursday was another sign he may be more of his father's son. Nathaniel just turned 2 years, 3 months old and Thursday for the first time he didn't nap at all. Anthony has told me that he stopped napping at an early age. I really hope that this is not a sign that naps will stop soon. He appears to still need them, so I would hate to have him give them up so early.

A few other things that Nathaniel has been up to lately that remind me of his dad include:

- Constantly being on the go. The other day my grandfather said that he must have run back and forth from the kitchen to the living room "checking out the road" 50 times in the morning alone.
- Love of all "things that go". He loves cars, trucks, trains, tractors, daddy's transformers, etc. I hear Anthony had the same loves as a child.
- Memory for facts that others don't often know. Anthony's misc fact knowledge is much more misc than Nathaniel's at this point, however Nathaniel knows and remembers things that Anthony and I aren't often aware of in the environment.
- They are both total sensory seekers. Anthony seeks movement and oral input. Nathaniel also seeks movement and some oral input, but he also seeks tactile (touch) input.  On the flip side of that Nathaniel has sensory aversions to a few things, which he gets more from me.

I am frequently annoyed by some of their sensory seeking behaviors. However, I work on making our daily routines a "sensory diet" for both of them in various ways. Some days they are probably grateful and happy to have me as their wife and mom, while on others they probably wish they could do their own thing without me getting in their way. Last weekend we went to the apple orchard and pumpkin patch. It was daddy's idea. They both enjoyed it and while allergies got in the way for all of us, we didn't really notice because it was the perfect mix for all 3 of our unique sets of sensory needs.



Nathaniel and the pumkin he picked

Peeking out from the train

Busy driving the train

Enjoying the "bumpy ride" through the orchard on the tractor trailor

Brushing Protocol Round 2

Being a pediatric OT has obviously affected the way that I parent, but more and more I am realizing how many things I have done for/with Nathaniel due to my education and work. I have obviously analyzed him subconsciously since the moment he was born with OT eyes underneath my mothering ones. I analyzed his movement and sensory development as well as every other part of his development on a daily basis. I watched his primitive reflexes come and go and made sure he was on track in every part of development as the days went along. I mean, that is my job, to assist other parents in helping their children move through all the stages of development. It was almost done without noticing or thinking some of the time.

So from day 1, I positioned him in certain ways to work on various things and have done many things to help him develop better tone/posture (already). I have watched his tone and his gross motor development as well as postural compensations at every step along the way. I brought him in to see an orthotist and got him orthotics to wear for a while. He still has low tone. I am still watching his gait and movement and will probably use kinesiotape with him down the road; I'll do anything to help him prevent having the gait issues his father has down the road.

I also have known since he was very very young that he is a "sensory seeker" just like his dad. He loves to be on the move, loves to explore things with his hands (and whole body), loves to chew on things (and uses this method to calm - much like his father), and thoroughly enjoys music, lights, fans, mirrors, and any funny sounds. I have never seen him as a sensory sensitive or sensory averse child (with the exception of playground swings). Of course he went through phases where the vacuum cleaner scared him and he doesn't like water in his face/eyes much in the bath, but those to me are within the typical when it comes to infants/toddlers. I did however notice that he had a hard time calming himself to sleep (probably because he revved so easily) and started the Wilbarger Deep Pressure Protocol (therapeutic brushing and joint compressions) when he was a little over 1 year old to help aid his sleep patterns and also made him a weighted blanket to go to bed with at night. I taught my husband how to use the brush and we stuck with it for the 6 weeks at 5-6 times a day and then weaned him off.  I have used the protocol with many other families and children and even used it on myself, so it just seemed like the right thing to do and it worked. The combination of that and the weighted blanket made sleep so much better in our house and made him more regulated and relaxed throughout the day. His development just spurted overnight it seemed.

So here we are, over a year later, and I'm back to brushing him. This time it's for sensory aversions though. Apparently something with the NG tube (the feeding tube that went down his nose and into his esophagus and stomach for almost 4 weeks) and all the cares associated with it caused things to switch and my little boy to be very averse to food entering his mouth. Now I am not saying he wasn't a "bird eater" before all of this happened. He was a snacker - small meals every 2-3 hours and lots of milk to help those snacks fill him a bit. He woke hungry to nurse at night until he was 10 months old (and I know this was hunger as he only drank 4-6 ounces at most at a feeding during daytime hours at his peak liquid period - I think he drank an 8 ounce bottle once). He has always been a slow eater as well. Part of this is low tone and part is probably laziness. He knows it is work to eat and he, as most toddlers, would rather be playing.  However, I never ever worried that he was averse to mealtimes or utensils or textures (other than stage 3 foods - which are wrong and a whole different story IMO). He used to eat pretty much everything. His favorite foods continue to be ANY GREEN VEGETABLE (and I mean any - broccoli, peas, green beans, edamame, asparagus, green peppers, lima beans, and the list goes on) as well as any fruits. These of course don't pack much caloric punch to a small child. He would feed himself at meals for a while, but then got lazy and preferred to be fed for the remainder of the meal. I didn't push it as I figured as long as he wanted to keep eating, he'd get the self-feeding thing eventually. He, unlike many kids, needed reminders to eat though as I don't think he got clear hunger signals, though we as adults could read them loud and clear. So while he was a slow eater with high metabolism and a small stomach, he was eating and we just wanted him to gain more weight if he could. (He gained on average 1 ounce/week from age 7 months until age 2 when they placed the feeding tube). 2 days after his second birthday the NG was placed and something changed. He gained nearly 3 pounds in 3 1/2 weeks and stopped taking basically anything by mouth except for some liquids. We were told this is normal as he was getting the calories he needed overnight and gaining nicely on it and that kids will start eating by mouth again. Now here we are 3 weeks later and still struggling with mealtimes. He is acting like the kids I have worked with who have sensory aversions to their face and mouth and who are fearful of mealtimes. What happened to my boy?

So I decided it was time to brush him again. It has now been 4 days and again I think it is working. This time around it is just like what I have said to many parents that I work with: "try to get it in every 2 hours, but usually the ones who really need it will let you know when it's time for another "dose"; older ones will ask for it, while younger ones will show behavior changes and you will just know". Every 1 1/2 to 2 hours he starts to get cranky and irritable, I check the clock and notice, "oh it's about time for brushing", I brush him and we are happy and ready to go again. The nice thing is that it is often timed out well to be before meal or snacktime and has seemed to help that routine as well. There aren't enough studies out there to prove/disprove this therapeutic technique, but with my own son, yet again, it seems to be doing the trick. It has only been 4 days, but over the next week I'm sure I'll have more confidence one way or another on this one. Yet again being an OT has maybe, just maybe, helped me stay a little saner as a parent.