BY JAYMIE MERRY
As an OT working in a sensory integrative clinic, I am working with clients who are having difficulties with regulation (including arousal level, sleep, bowel/bladder, and breath challenges), sensory defensiveness, emotional regulation (anxiety, inflexibility, anger, aggression), motor coordination, feeding, and social skills, among others. Each client comes with so many questions. Where are these challenges coming from? How deep do they go? When did they start? Can I really treat all the way back to the root of the issue? And if I can, can that support these children to make real, lasting, and deep changes with greater efficiency?
As OTs, we are all on a journey. My journey took a turn for me at the Camp Avanti Pre-Camp Conference in 2017, when Patti Oetter and Irene Ingram challenged us to be thinking about how far back we really can treat. They introduced their Advanced Intervention Model (AIM) for early developmental etiologies. They taught us about a model of development that begins at conception, teaching about the innate mechanisms that are in place in typical development that assist a child to move all the way up to skill. They also taught us about when something happens that interferes with the developmental process during this early time, such as trauma, stress during pregnancy, cord wrap issues, drugs, induced labor, emergency C-section, prematurity, and embryonic development issues, the trajectory of that child’s development could potentially shift and may be playing a role in the issues we are seeing as pediatric occupational therapists.
I now had a framework to begin thinking about the true roots of the issues I was seeing with the clients on my caseload. So I started looking at my client’s histories. I began asking questions. I began observing with more precision. And I began experiments and playing with some of the concepts and strategies I learned with my kids and families. Using rhythm, vestibular, relationship, movement patterns, and this developmental framework, we could go back to the point in development where something went awry and provide a more organized experience of what those early life experiences could have been and create new, more efficient patterns at the most foundational level, from the bottom up.
For a child who did not get enough movement in the womb due to bed rest, we could use drumming, rhythm, and lycra to create the vestibular, deep pressure, rhythmic, floating atmosphere of the womb. A child who was born wrapped up in the umbilical cord could be wrapped in a lycra tunnel and empowered to unwrap himself with the motor patterns he was not able to use the first time around. And a child who was not in full control of their birth (due to a C-section or induction), could wiggle out of a lycra tunnel or from in between two crash pads with control and competence. With the right combination of factors, it is amazing to see how kids will start to heal themselves, teaching us so much along the way.
And then to see the real results of these interventions! Anxiety turning into confidence. A need for control turning into more flexibility. Anger turning into joy. Frustration turning into kid power. Sometimes results would happen right away. Sometimes it took a while. But hey, I’m still learning. I am so excited to continue playing with these concepts and strategies and learning along the way. My perspective on treatment is shifting, my practice is becoming more refined, and my kids are becoming more and more who they are meant to be.
Patricia Oetter and Irene Ingram will be presenting Advanced Intervention Model (AIM) for Early Developmental Etiologies at the 5th RAIR Symposium.
As an OT working in a sensory integrative clinic, I am working with clients who are having difficulties with regulation (including arousal level, sleep, bowel/bladder, and breath challenges), sensory defensiveness, emotional regulation (anxiety, inflexibility, anger, aggression), motor coordination, feeding, and social skills, among others. Each client comes with so many questions. Where are these challenges coming from? How deep do they go? When did they start? Can I really treat all the way back to the root of the issue? And if I can, can that support these children to make real, lasting, and deep changes with greater efficiency?
As OTs, we are all on a journey. My journey took a turn for me at the Camp Avanti Pre-Camp Conference in 2017, when Patti Oetter and Irene Ingram challenged us to be thinking about how far back we really can treat. They introduced their Advanced Intervention Model (AIM) for early developmental etiologies. They taught us about a model of development that begins at conception, teaching about the innate mechanisms that are in place in typical development that assist a child to move all the way up to skill. They also taught us about when something happens that interferes with the developmental process during this early time, such as trauma, stress during pregnancy, cord wrap issues, drugs, induced labor, emergency C-section, prematurity, and embryonic development issues, the trajectory of that child’s development could potentially shift and may be playing a role in the issues we are seeing as pediatric occupational therapists.
I now had a framework to begin thinking about the true roots of the issues I was seeing with the clients on my caseload. So I started looking at my client’s histories. I began asking questions. I began observing with more precision. And I began experiments and playing with some of the concepts and strategies I learned with my kids and families. Using rhythm, vestibular, relationship, movement patterns, and this developmental framework, we could go back to the point in development where something went awry and provide a more organized experience of what those early life experiences could have been and create new, more efficient patterns at the most foundational level, from the bottom up.
For a child who did not get enough movement in the womb due to bed rest, we could use drumming, rhythm, and lycra to create the vestibular, deep pressure, rhythmic, floating atmosphere of the womb. A child who was born wrapped up in the umbilical cord could be wrapped in a lycra tunnel and empowered to unwrap himself with the motor patterns he was not able to use the first time around. And a child who was not in full control of their birth (due to a C-section or induction), could wiggle out of a lycra tunnel or from in between two crash pads with control and competence. With the right combination of factors, it is amazing to see how kids will start to heal themselves, teaching us so much along the way.
And then to see the real results of these interventions! Anxiety turning into confidence. A need for control turning into more flexibility. Anger turning into joy. Frustration turning into kid power. Sometimes results would happen right away. Sometimes it took a while. But hey, I’m still learning. I am so excited to continue playing with these concepts and strategies and learning along the way. My perspective on treatment is shifting, my practice is becoming more refined, and my kids are becoming more and more who they are meant to be.
Patricia Oetter and Irene Ingram will be presenting Advanced Intervention Model (AIM) for Early Developmental Etiologies at the 5th RAIR Symposium.
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