Wednesday, September 16, 2009

The power of Subtlety

As an occupational therapist I am very blessed to have the opportunity to work with a very wide range of children. Their diagnosis vary and include Autism Spectrum Disorder, Pervasive Developmental disorder, Cerebral Palsy, Down syndrome, Attention Deficit and Hyperactivity disorder.

Today I would like to share my extraordinary experience working with a 4.5 year old adorable little girl who is diagnosed with Cerebral Palsy (Cerebral palsy or CP is a neurological disorder that causes very poor development of movement and posture, causing activity limitation, often presenting with muscle rigidity and tremors). Caitlin is also diagnosed with a seizure disorder.

I began working with Caitlin 6 months ago. And even though I do have experience working with children who are diagnosed with CP, at first I was somewhat afraid to approach her. Caitlin has a g-tube attached to her stomach because she is unable to eat using the muscles of her mouth. She is also unable to move independently unless someone else is moving/repositioning her body. She is able to vocalize a lot of sounds that I have learned to identify as words she is using to communicate. Caitlin is highly sensitive to sound, touch and movement.

I work with her in her bedroom with the door closed however her ears are so sensitive that every sound coming from behind the door affects her. As she hears a sound she demonstrates a startle response as if she is in danger. Her muscles are immediately triggered, becoming very tense and impossible to move. One of the ways that I have been able to help Caitlin to be able to relax her body is by using her sensitivity to sound to her advantage. I have been playing "Sacred Drums" music CD during my sessions and she seems to respond beautiful. It is such a pleasure to watch her body process the music she is hearing. The CD starts very slowly with birds chirping and the sound of river floating. Her eyes begin to move back and forth helping her ears to focus and tune in to the music and the direction it is coming from. As the music gets a little more intense since the drums are beginning to play she lights up the room with a huge smile. I cherish these moments so deeply. Her smile is like a precious stone that you find only when you are really paying attention. The simple joy of life, such as a smile of this beautiful little girl, is a life worth living.

Caitlin receives lots of therapy among which are physical therapy and speech therapy. I have observed these well-intentioned individuals stretch her muscles and put her in positions that were causing lots of stress based on her facial expression and frequent crying. I have thought long and hard about the question "how useful is this type of rigorous therapy for her?". I have come to my own conclusion by experimenting with my own ways. I have learned that she responds beautifully to a very non-invasive, subtle type of touch, vibration, and stretch.

I have seen Caitlin this Saturday and had an amazing session. During this session I decided to experiment with vibration on her muscles, and joins. Her favorite part to be touched is her feet. Knowing that I first held her foot in my hand for about a minute without any movement. I was just thinking and feeling how much love I have for this precious girl. I then began to shake her foot in a very subtle manner, almost vibrating. I saw the vibration spread to all the joins and muscles of her body.

She let out a huge grin, a wonderful vocalization, followed by yet another huge smile. I continued to experiment by playing with the position of my hands and the subtlety of the vibrations. Caitlin and I were in this zone of total connection for the next half an hour. Through out the entire experience she was smiling and sighed with a depth that I rarely observe. She decided to let go and surrendered. I was in awe of how powerful this exercise was. In that moment I truly learned the power of subtle movement.

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