Sensory issues - problems with textures

It seems that quite a few ex-prems develop sensory processing and integration disorders - some need a lot of sensation to keep them happy (sensory-seeking) and some find sensory input overwhelming (sensory-sensitive or sensory-avoiding). I’m sure it’s not just a premmie issue, but it does help make sense of what can otherwise seem like odd behaviour in a toddler. You can read more about sensory issues here.

Recently I responded to a request on a prem forum for suggestions about how to help a child who struggled to deal with certain textures, with the following:

We had an OT visit us for 6 weeks in late 2008 (when Talia was nearly 18 months corrected) as part of the Play and Learning programme, and she did some work with textures. Some things Talia coped with, other things she would not go near, she was sensory-sensitive or sensory-avoiding. Here are a few of the things the OT did which you could try:

1. Put a mix of different dry pasta shapes in a big bowl or plastic tub, and then put in some of your child’s favourite small toys (semi-hidden), so that they have to fish through the pasta to get the toys out. Also works with popcorn, bits of packing foam etc.

2. Invest in or borrow a water table (or sand & water table), and spend some time putting things in and out of water, pouring, splashing etc. This was a huge hit with Talia, and lead to her picking up “wet” things like cut fruit which she had previously refused to touch. The OT also brought shaving cream to put in the water table, we found Talia disliked that almost as much as she liked the water but it may have also been the smell of it. We subsequently bought our own water table and it has been one of her favourite play activities since, even in the middle of winter she wants to play with it!

3. Vibration. We had a cat’s toy which the cat never liked, a little fake mouse with a string you pull to make it vibrate across the floor for the cat to chase. We would pull the string then give it to Talia to hold while it vibrated, to get her used to a different sort of stimulation. The OT had a different toy which had the same effect but it wasn’t as cute as our mouse!

Good luck and I hope you see some improvement over time as your child gets used to different textures and sensory experiences.

Wheezing

We’ve just had our first case of respiratory illness since Talia came home.

When she was discharged from KEMH, we were warned that her chronic lung disease meant that it was very likely she could end up back in hospital with some sort of respiratory infection. So we took every precaution the first winter, staying away from shopping centres and zealously avoiding people with colds. It paid off - not even a sniffle. This year she had a flu vaccination and avoided all but a few minor colds. So I guess we should be very happy that it has been 16 months since she came home before she actually contracted anything even slightly worrying.

Last weekend Talia started coughing, a nasty chesty cough, and by Tuesday she had developed a most impressive wheeze. Maybe not quite as bad as Darth Vader, but loud enough that I could hear her breathing from the next room, over the top of my husband’s electric shaver.

When I called my GP on Wednesday morning they said they were full for the day - but when I said I had a one year old with a bad wheeze they managed to find me a slot very quickly! The doctor thought it might be bronchiolitis, but said that our options were limited. I could try and administer ventolin via a spacer (something I could see Talia struggling against and hating) or if her breathing became more laboured, I could take her to PMH.

Fortunately Talia’s condition remained stable and although the wheezing continued another couple of days and the chesty cough is still with us, I didn’t need to rush her to hospital (thank goodness!) She was tired and not the happiest of little girls, but otherwise handled the week very well.

Now it is a waiting game to see if she develops a wheeze with future illnesses - a possible symptom of asthma - but fingers crossed, hopefully not.

The great spoon strike of April ‘08

Since she figured out solids at the end of last year, Talia has been fantastic, eating all sorts of homecooked meat and veg.  She had started to catch up with her weight and all was going well… until now.

A week or maybe a little longer ago, she started objecting to receiving food on a spoon, pushing it away with her hands and turning her head to the side.  With a bit of ingenuity (”say aaah Talia!”) I could get a spoonful in, and after carefully digesting this first mouthful with all the seriousness of a wine connoisseur judging expensive shiraz (up to but not including the spitting out stage), she would then allow me to feed her the rest of the meal.

I thought I had it all under control until the beginning of this week, when she decided that not even the first spoonful would be considered acceptable, under any circumstances.  It has been very difficult to deal with, as I don’t want mealtimes to be a fight, but I can’t let her go without a healthy diet.  It’s not that she won’t eat - just that she won’t allow herself to be fed.  It wouldn’t matter so much if she was older and able to use a spoon, but at the moment she will only accept a limited range of finger foods - and they are subject to change without warning.  Savoury pikelets were a hit on Tuesday but thrown out of the high chair on Wednesday.  Raisin toast has come back into favour, as have avocado finger sandwiches, but baked ricotta is now out and her acceptance of random veges appears to depend entirely on her mood, the phase of the moon and whether or not the wind is blowing from the west.

This is the sort of point where you realise that being a mother is a full time job and then some.

Café Finisterre

Corrected age: 5 months, 3 weeks
Weight: 5.555kg (yes, today has been brought to you by the number 5!)
Diet: breastmilk, formula, a smidge of vegetable mixed with farex and milk

We’re back with the solids, but not very convincingly. I’m starting to wonder if the tongue is a problem, so I asked the child health nurse this morning if it was abnormal for her to be sticking it out so much. She said it might just be a habit, or it might be the sign of an underlying problem - but she is not qualified to comment. So I’ll just have to wait and see.

I have a freezer full of orange icecubes - sweet potato, pumpkin and carrot. I’ve also discovered that orange coloured mush is really hard to wash out of bibs.

I wasn’t expecting to hear from the hospital until shortly before Talia’s 8 month check up in February, but today I received an “infant temperament questionnaire - 6 months” in the post. It is LONG - 95 questions! I intend to ignore it until later in the month. Don’t ask me what that says about parent temperament.

Physiotherapy

We went to our monthly group physio appointment at the hospital this afternoon.

I don’t know why it is, but Talia hates it. She transforms from a placid, happy baby into a wailing, uncooperative mess every time we go. I’m starting to wonder if she doesn’t like the smell or the lights - because there is nothing else I can see that is particularly different about the place, and she starts fussing even before we ask her to do anything.

I also find these visits stressful, partly because Talia is unhappy, and partly because it becomes ever clearer how far behind she is falling compared to babies of similar corrected age. She is 5.5 months corrected (8.5 months actual) and shows no signs of wanting to roll yet. She doesn’t automatically reach and play with toys, or bring her hands together often, and she doesn’t play with her feet at all.

Finally today they told me they feel she would benefit from one-on-one sessions in addition to the group sessions, so we will be starting in January. We are hoping to avoid the situation where she becomes frustrated because mentally she wants to progress but physically she is not capable.

Talia’s “boyfriend” Reuben also comes to these group sessions. Reuben and Talia were born on the same day, with only 2 days difference in gestation, but Reuben has always been larger. In the beginning Talia was 855g where Reuben was something over 1kg. Now Talia is 5.4kg and Reuben is a whopping 8.7kg.

It’s so cute to see them together!