Early Intervention

In Sync Kids OT has been running since 2014, after our Director, Carlyn, identified a large number of children with sensory processing disorders as well as postural control challenges were being referred to OT for poor sleep, being fidgety with an inability to focus or having emotional outbursts.

In Sync Kids predominantly treats children from 2 years with therapy sessions tailored to provide the "just right" challenge for the participant, structure to enhance the under developed skills of the child. The therapeutic sessions are scientifically designed to achieve the set goals through play. The therapy is participant-oriented and provides opportunity for continuous development of skills, self-regulation and confidence.

In recent years we have realised that there were a number of preterm babies who were not followed up on after birth or parents were not given any advice  or information regarding potential sensory processing delays, sleep challenges and milestone delays. These delays were being picked up in Prep when difficulties regulating, sitting still and fine motor delays become apparent in school readiness. We believe that more intervention is required in the infant to two  years stages of development to make a greater impact.

WHY is Early Intervention KEY?

What is the fuss all about?

Early Childhood Intervention has benefits for your child, for you as a parent, and for your family and all families who have a child with a developmental delay or disability.

Evidence suggests that infant brains, between birth and two years of age, goes through the most rapid period of development.  Most new connections and pathways are formed within the brain during this time.  Consider the skills that are developed during this period,  children learn to walk, talk, interact with others, problem solve, eat, drink, play, sleep independently. All of these skills are the building blocks for their continued growth and development into the future.  By receiving early intervention, ideally before the age of two, your child is able to harness this period of natural brain development.  This is the time when your child has the potential to maximise their progress and potential.

In Sync Kids adopts a family-centred approach used in early childhood intervention, which will allow you to receive as much support, guidance and education as your child will receive.  By better understanding your child’s needs, you will be better able to support your child, to make decision that you will be confident are in your child’s best interests, and to advocate for your child.

What does Occupational therapy in early intervention entail?

In early intervention, occupational therapy practitioners promote the function and engagement of infants and their families in everyday routines by addressing areas of occupation, including activities of daily living, rest and sleep, play, education, and social participation. This is done through the following:

Individualized Sensory Integration Interventions

Sensory integration uses tools that challenge the sensory system in order to challenge it appropriately.

Sensory Diet 

A sensory diet is individualized home program that is carefully planned and has a positive effect on functional skills to regulate sensory stimulus. 

Family Education

Used for regulation disorders caused by sensory processing disorder, and constitutes an important part of the treatment process. There are two important benefits of family education. First, family will understand that sensory processing disorders are underlying factor of infant/toddlers’ behavioral problems. By this way, it helps the mother and infant bonding. Second, family education teaches coping strategies to families for infant/toddler’s behavioral problems

Our Customized Process

Our team meets with the family and undergoes an OT assessment that helps identify the specific goals and treatment customized plan. The therapist will then discuss with the family if any other treatment is recommended ie; Speech pathology, vision therapy, physiotherapy. Our therapists will review segments of the session with the parents, write down observations and offer parents a customized easy to implement home program. 

Prevalence of premature birth? 

A staggering 1 in 10 babies in Australia are born premature (before 37 weeks gestation) and approximately 15% of all babies require some form of extra care at birth. Roughly 25 000 babies per year are born prematurely.

When are babies considered premature?

24-28 WEEKS

Extremely Premature

32-34 WEEKS

Moderately Premature

28-32 WEEKS

Very
Premature

34-37 WEEKS

Late

Preterm

Australian Institute of Health and Welfare 2016. Australia’s mothers and babies 2014—in brief. Perinatal statistics series no. 32. Cat no. PER 87. Canberra: AIHW.

 What does a Sensory experience for a baby in Neonatal ICU (NICU) or special care look like compared to a full term baby?

Development of the sensory system?

While the basic physical structure of the sensory receptors (i.e. eyes, ears etc.) develops early in gestation, most of the neurosensory development occurs in the last sixteen to twenty weeks.

The neurological processes are not accelerated by preterm birth. Preterm birth accelerates the maturation of the kidney, gastrointestinal, lung and cardiovascular function but does not alter the sequence or timing of neurodevelopment.

The contrasting environment from the womb to the Newborn Intensive Care Unit (NICU) play a major role in the altered neurodevelopment observed in preterm infants. The brain development in the foetus, neonate, and infant includes not just sensory systems but motor systems, social/emotional systems, and the cognitive systems. These systems are connected and integrated during development. The development of the brain relies on a number of factors including genetics, internal brain activity and sleep but also relies largely on their external environment and appropriate stimulation to support early brain development.

Why are preterm babies at an increased risk for sensory integration problems?

 

In the womb, a baby spends their time curled up, cozy and warm in the dark, listening to natural white noise in the form their mother’s heartbeat and muted sounds from the outside world. Meanwhile, their nervous system is developing forming essential nerve cell connections. When a baby is born prematurely, their nervous system is immature and  disorganized and unable to tolerate all of the sensory messages presented. Most NICUs do their best to minimise over stimulation, however the inevitable beeping and buzzing equipment, room lighting, and busy atmosphere can agitate sensitive preterm babies. 

  • be highly sensitive to noise, light, touch, and movement, even beyond the second birthday

  • retain startle reflexes longer than usual

  • have muscles that tend to be either stiff or floppy, or a mix of both.

  • be very distractible and highly active, or extremely quiet and sleep more than expected

  • have increased risk for vision problems

  • often develop oral defensiveness because of negative oral experiences with feeding tubes, respirators and suctioning. This can interfere with feeding, as can abnormal muscle tone inside the mouth Most of the sensory based difficulties resolve as the baby’s nervous system matures.

 

How does this initial environment impact on your baby’s sensory development?

The womb is the perfect sensory space for a baby, natures perfectly designed swaddle. In contrast, the NICU is a sterile environment that allows for little to no interaction with your little one. In addition their fragile sensory systems are over stimulated.

From a tactile perspective: 
  • it lacks physical boundaries to make you baby feel contained, no swaddling. 

  • Constant changes in temperature 

  • Frequent light touch when changing monitors/cables etc

  • Lack of skin-to-skin sensation

  • Lack of initial hand to mouth soothing

  • Enhanced pain from inserting tubes/lines etc

 
Visual system:
  • Many contrasting colours and patterns

  • Bright overstimulating lighting

  • Ultraviolet lighting

 
Auditory system:
  • Alarms at overstimulating decibels

  • The sound if instruments 

  • Crying of other babies

  • Lack of white noise (calming)

 
Movement & gravity:
  • General lack of movement (being carried or rocked by a parent) which is unsettling and unnatural in contrast to the womb

  • No protection from gravity in a flexed (foetal) position as they would be in the womb or whilst being swaddled.

 

Smell & taste:
  • Strong smelling medical and cleaning agents to support the sterile environment (anti-septics, alcohol swabs)

  • Lack of sweet flavours and taste of breast milk

 

What are common milestone delays with preterm babies?

  • Atypical muscle tone (hypertonia/hypotonia)

  • Delays in motor milestones -  delayed rolling, sitting, crawling, standing, walking

  • Feeding delays – absent gag-reflex and suck-swallow-breath synchrony 

  • Delayed language development

  • Delayed sensory processing skills -  impacting on motor skills, emotional regulation, sleep

 

How does prematurity impact on sleep?

Due to the development of their sensory systems and their initial exposure to the sensory world, their sensory systems develop differently to full-term babies. Consequently they struggle with self-regulation due to the nature of their environment, the skill of self-regulating starts developing at 12 weeks and continues to develop well into toddler years. Self-regulation as decribed by Greenspn & Weider as “the ability to remain calm in the presence of stimulation”. Other than basic needs being met (health, nutrition and warmth) the infant also requires sensory processing and the relationship context. Certain criteria need to be met in order for self-regulation to be accessed. These included deep pressure (swaddling, mimicking the womb), touch to the face (sucking) as well as body position (curled up safe foetal position). Very importantly the role of the parent is crucial in facilitating this process, this is referred to as co-regulation. 

(edited from - infant sensory integration, aug 2016, meg faure)

How do our senses play a role in development?

When we are asked to list our senses we usually are able to recall the most familiar ones: touch (tactile perception), taste (oral perception), smell (olfactory perception), vision (visual perception) and hearing (auditory perception) but did you know there are two others?

Vestibular: sensory information received from our middle ear that is related to movement and balance.

Proprioceptive: sensory information we receive from our muscles, joints and ligaments.

The seven senses work together to help us understand and move within our environment.

Our sensory system provides the foundation for all forms of learning. Our sensory system not only gives us information needed for visual perception, motor planning and body awareness, but provides the essential building blocks required for achieving academic learning, emotional security and social confidence.

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