Submitted by W.S., OTR/L
| Before | After |
|---|---|
| Hyper-vigilant | Calmer, less distractible, and better able to follow social rules at school |
| Could not stay seated | Stays in his seat during instruction |
| Would often pinch and push others | Rarely touching others inappropriately |
| Frequently picked up items off other students desks | No longer fiddling with things on others’ desks |
| Teacher needed to take extra steps to create an environment that would inspire good behavior | Returned to school after the long 2020 Spring closure, without having had any at-home movement practice in the interim, and is still able to maintain good classroom behavior without special set-up or activities |
Daniel was an 8 year old boy who was in the 3rd grade at the time I assessed his primitive reflexes and implemented rhythmic movements and reflex integration activities [from the Brain and Sensory Foundations course].
When he was referred to occupational therapy at school at the near the end of 2nd grade, his various multidisciplinary evaluations indicated he had mild intellectual disability, sensory processing disorder, and learning disabilities. Prior to referring him to OT, his second grade teacher had tried providing alternative seating to get him to stay seated longer, fidgets to give him sensory input and keep him from touching others, moving his desk away from others to reduce distractions, and giving him breaks out of the classroom to go to a quieter room where he got to play with Lego, kinetic sand, or look at books several times a day. He had also been provided with counseling services for social skills, but his challenges persisted and intensified the next year.
During the first few months of 3rd grade he was literally following the teacher around the room ½ the time. Many times during the day he had his hands on other kids and was taking things off of other’s desks. At various times he was approaching the teacher from the back and touching her. He had pinched her arm numerous times leaving bruises. In Oct. he had been suspended for several days for one of the pinching incidents.
I started working with Daniel at the end of Grade 2, providing therapy for sensory processing disorder and including mindfulness and yoga. At the beginning of Grade 3 he resumed his weekly OT sessions at school. I became aware that his behavior was becoming more aggressive with other students and the teacher after the pinching incident that led to his suspension. By that time I had read the Brain and Sensory Foundations Level 1 manual and I believed that Daniel would benefit from the rhythmic movements and reflex integration isometrics and activities. When I assessed his reflexes, I found that the Spinal Galant and ATNR [Asymmetrical Tonic Neck Reflex] were not fully integrated.
We would start each session with PACE followed by rhythmic movements [from the Brain and Sensory Foundations course]. Daniel could initially tolerate doing the rhythmic movements for 2-3 minutes. After a couple sessions he could do two of the movements by himself and that made him feel good. For 11 sessions between Nov. and mid-March we continued the rhythmic movements building up to 10-15 minutes per session. We followed that with core-activation, Spinal-Galant isometric activities and developmental movements and games for integration of ATNR. I also did some direct social skills instruction with Daniel to help him become more aware of his behavior and what was expected for a third grade student in regards to his physical contact with teachers and students.
Daniel’s disruptive behaviors decreased dramatically and quickly. After 3 sessions he had stopped touching and pinching his teacher. Within 4-5 weeks he had completely stopped following her around the room. Although he still got out of his chair frequently he stayed in a designated area most of the time. On a checklist the teacher completed between Feb. and mid-March, Daniel had only one reported incident of pushing another student which was not enough to cause harm. Daniel himself reported to me every session, “I am not touching my teacher anymore.” His relationships with his classmates were improving as they felt more comfortable around him. Daniel felt good about these changes in his behavior and he was proud of himself.
Our sessions concluded due to our Spring break which was immediately followed by the COVID-19 school closure. Daniel’s family did not respond to any attempts to contact them via phone, email, or Google classroom, so he did not participate in a home program during that time.
Daniel returned to school for 4th grade. His teacher has indicated that he stays in his seat during instruction, he is not touching others inappropriately, and he is not fiddling with things on others’ desks.
I have learned that using rhythmic movements [from the Brain and Sensory Foundations course] helps calm a hyper-aroused nervous system, sometimes very quickly, and that the effects are long-lasting. I have seen Daniel be able to reduce his hyper-vigilance so that he is calmer, less distractible, and better able to follow social rules at school. He has developed increased confidence and feels good about the new skills he has gained.
[Edited for length and clarity, emphasis added]