OT

After a bit of a hiatus, I’ve started to get back into some of my OT activities to help with the symptoms of sensory processing disorder (SPD). When we moved from Connecticut in late 2016, there was no longer a place to do OT that took insurance or works with adults (one takes insurance but only works with children, and the other works with adults but is self-pay). Therefore, there are no realistic options for me around here.

Occupational therapy is a bit of a strange field because the majority of therapists work with patients with acute issues that affect their activities of daily living, particularly upper body afflictions. Examples include regaining function after a fracture, should surgery, burn, or tendinitis. They also work with patients with paralysis or paresis from a stroke, TBI, or other such causes.

Then, there is the “sensory” domain, where therapists help patients (usually children) with sensory problems. This is such a seemingly dissimilar facet of OT so it requires specialized training or a dedicated focus in most cases, such that an occupational therapist either does primarily only sensory work or none. Even those that do typically work only with children, as there still seems to be an inescapable bias that autism-related services are geared only toward kids or adolescents transitioning to very early adulthood (if lucky). It’s like everyone everywhere forgets that autistic children don’t “outgrow” their diagnosis or issues; indeed autistic children grow up to be autistic adults. However, I estimate that the number of services and focused activities and research for children dwindles to about 1/500th of that figure for the same type of efforts targeted (or even open to serving) adults. It’s frustrating to say the least.

The good news that many of the OT exercises and activities I did when I attended formal sessions in Connecticut are things I can replicate satisfactorily at home. When my sessions first ended, I was fairly diligent in spending time a few days a week at home working on these; however, as time has passed, my verve to do so has all but faded, partly because there’s no structure or accountability, and largely because the benefits or gains seemed minimal if at all detectable. It often seemed hardly more than a way to severely perturb my system and stress my already despicably low sensory threshold, yet after many months without engaging in OT work, I notice some changes. I’m more sensitive to noises and my balance has gotten significantly worse to the point that I’m frequently falling again when doing routine, safe activities. For this reason alone, I need to start dedicating some time a few days a week to my proprioception activities.

OT was never able to “fix” me, but I can see some of its benefits once months of neglect accumulate. I also noticed one lasting benefit: I can read better. When I started OT, I did a lot of vision therapy because we found that my eyes did not work well together; I had both a convergence and divergence disorder. In high school and college, I secretly thought I was dyslexic, because the letters and words always jumped and jumbled on the page. I struggled so much with reading and would get immensely frustrated because I loved learning and wanted to immerse myself in books, but it was such an uncomfortable and slow struggle to get through even simple texts. I always got headaches when I read and I always markedly underperformed in comprehension metrics despite my intelligence (though that sounds disgustingly pompous). Instead of true dyslexia, the real problem lay in my convergence and divergence problems. Rather than working together to help the brain form one unified image from binocular vision, my brain keeps a separate image from the input of each eye, giving me two similar pictures overlapped in an unclean manner. This makes some letters overlap and get spliced over others. Accordingly, it makes reading, and other visual activities (like driving), quite difficult. Vision therapy helped train my eyes to essentially be better teammates. It has made reading less laborious and painful, which is a gift that I now get to enjoy daily.

As I work to reestablish an OT routine a couple days a week, I will remind myself that the work is uncomfortable and the benefits are often too subtle to notice. Despite this, I think it still might be worth it and I will at least try to document my progress and hope I find that some of the exercises make me more comfortable in the long-term. If it’s really not working, or exacerbating my sensory overwhelm, I can always stop again.

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