Interview Kelly Beins OTR/L: About Sensory Integration, Private Practice, Book Series

Posted in Interviews, Sensory Issues, Special Needs Children by - November 30, 2017
Interview Kelly Beins OTR/L: About Sensory Integration, Private Practice, Book Series

Kelly Beins is an Occupational Therapist certified in sensory integration, and owner of a private practice, Occupational Therapy Consulting, LLC. Ms. Beins is the author of Ovis Has Trouble with School. She hopes children with sensory challenges will be able to relate with Ovis. Ovis is her  main character and is a lovable sheep that has sensory processing issues; therefore, he misbehaves.  He isn’t BAD he’s just bothered!

Ovis has Trouble With School is the first in a planned series of children’s books that will address other activities that are hard for children with sensory issues. We look forward to learn more about Kelly Beins plans for Ovis and about solutions for sensory challenges that make life difficult for many of all ages and abilities.

Lorna: Congratulations on your adorable book, Ovis Has Trouble with School!  It is written for children with sensory challenges, ages 4-8. I love your sentence, “He isn’t BAD he’s just bothered!” Explain to our readers some ways that show how “bothered” a child with sensory processing disorder can be and how it can make him act as if he is misbehaving.

<<Kelly Beins: Thank you Lorna! Yes, kids with sensory challenges often seem to be misbehaving because they are not in control of their bodies and sensory challenges are internal meaning they aren’t always obvious to outside observers, like a physical disability might be.

Children with SPD are often over-responding or under-responding to the sights, sounds, movements and other various sensations that are an inherent part of simply “being” in the world as a child.  Some things you might see a child with sensory challenges do are things we’ve hi-lighted in our Ovis stories…they might seek lots of movement and not be able to sit still, they might make noises like humming or lack volume control so they seem to be yelling, they may play really rough or use too much force on toys or with people because they don’t have as much control over how they respond or they need more input than a typical child so they squeeze or pull really hard.

Alternately though, some children with sensory challenges, avoid.  They may refuse to do things and seem oppositional or rigid; they may require things to be a certain way like sitting in the same chair, not standing  or following in line because it’s too close to other children or avoiding hugs & kisses from relatives, or refusing to get dressed, wear certain fabrics or not eat certain foods.  Because sensory processing is about how the brain and body are working together, the avoiding and/or seeking is an attempt by the nervous system to re-calibrate or re-set.  These things are not done out of ill will or desire to misbehave.

Lorna: What are some « red flags » that parents can notice that indicate their child has sensory issues? What would be the first steps parents should take to help their child with sensory challenges?

<<Kelly Beins: The decision to seek help for SPD is something unique to each family. What is a problem for one child and family is not a problem for another and vice versa. So aside from offering a checklist for SPD Symptoms (I do have one on my website: www.otc-frederick.com or I always encourage parents to go to spdstar.org ), I also encourage parents to consider intensity, duration, and frequency.

  • How often is the behavior or symptom happening?
  • How long does it last?
  • How intense is the upset?

If the answers are: “It happens frequently or all the time, in many places, and the upsets are lasting upwards of 45 minutes or more…” clearly that is a functional problem. We also always consider disruption to daily roles and tasks that a child is expected to perform.  If the family stress level is becoming unmanageable, the child can’t go to school or struggles every day at home or school to do basic things like sleeping, eating, using the toilet, getting dressed, getting along with peers or siblings, completing homework etc. and the child can’t get through basic tasks or the family can’t get through their day without significant upset, then SPD could be a contributing or a primary factor to consider.  Also, if the child is not progressing, for example a toddler who won’t get dressed is not atypical in and of itself.  But if that same toddler continues to tantrum every day when it’s time to put on underwear, shirts, and socks and that child screams for an hour and is now 5 years old, it’s worth seeking an assessment.

The first step in getting help is to find an occupational therapist with training in sensory integration (SI) to complete an assessment.  Like many health professions there are specializations and SI is a sub-specialty in pediatric occupational therapy.  This advanced training can come in multiple forms and finding an OT with a background in sensory integration will be most helpful to families struggling with this set of challenges.  There is a treatment directory on the STAR Center website (https://www.spdstar.org/treatment-directory) where families can locate OT’s in their state. An assessment will determine if SPD exists, and what type of intervention  and/or home program is most suited to that child.

Lorna: Tell us about your private practice, Occupational Therapy Consulting, LLC. What ages are the children that you work with for sensory integration? What would a session for a young child with sensory processing issues look like? Do parents go home with “homework” to continue the treatment at home?

<<Kelly Beins: I’d love to tell you about our practice! At OTC we work with children of any age really all the way through to adults, depending on the situation.  The youngest we have on our caseload right now is 18 months but our typical age range is 3-11 yrs.  We do get some teens, specifically because of our feeding therapy program, and because we have a counselor who specializes in work with teens.

What does a session look like?  It varies with each child but the sessions usually involve play!  The sessions are often structured so that each child gets some kind of gross motor activity, followed by fine motor or sit-down games and if there are visual processing issues we try to incorporate visual challenges throughout the session.  The gross motor portion of the session may involve use of swings and large therapy equipment like a ball pit, ladder, crash mats etc. or it may involve a trapeze bar, crawling tunnel, or target toss.  Anything we can do to get multiple sensory systems working at once but in a way the child is challenged but having fun so they don’t realize it’s work. Sometimes we use a therapy program called integrated listening systems, so you may see a child wearing headphones that play music while they are doing their therapy activities.

Do parents go home with “homework”? Yes, at OTC we use what we call a “Parent Partnership Model” which means we work closely with parents.  Parents are in sessions, we have required parent education sessions for anyone receiving therapy, and all parents are given things we want their child to do between therapy sessions.  We have some children that come more than once a week and in this case there may be less homework between sessions and depending on the skills the child needs to learn, there may be more or less homework.

Like our therapy however, we try to make the homework fun and easy to implement for parents.  An example might be a child who moves a lot and can’t still still or avoids sit down activities and has low muscle tone, weak hand strength, struggles to use crayons and scissors and gets easily frustrated.  Some homework for this child might be to do log rolls and complete crawling games and to play floor time activities while lying on their tummy.  These games will help to build muscle tone and core stability while also promoting use of both hands in a supportive way.

For Children with Sensory Challenges - Ovis Has Trouble with School by Kelly BeinsLorna: Ovis has Trouble With School is the first in a planned series of children’s books that will address other activities that are hard for children with sensory issues. Have you plans for the next books?

<<Kelly Beins: Yes we do!  We have plans and already have a second book that is scheduled to come out in a few weeks.  “Ovis Has Trouble with Eating” will be on bookshelves, hopefully before Christmas!

Before I wrote the first book, “Ovis Has Trouble with School”, I wasn’t even sure what the title would be but I knew finding a way to describe the lived experiences and to make it relatable would be important.  I approached Christine, the illustrator, with my idea of simply doing a book and in our first official brainstorming meeting, we came up with a list of at least 8 topics we thought might make for good separate books. We’ve also had parents write to us, suggesting other topics and I’m always listening to what parents say to me in my private practice so that I can target the most common struggles we see.

OT focuses on strengths and functional skills and a guiding principle in my practice is “You can…(insert daily task).” I want the Ovis books to hi-light separate skills that kids with SPD might struggle with or need to learn.  Some other story topics to watch for include: playing with friends, sleeping, getting dressed, birthday parties, and sports. The more topics we have available, the more books there will be to choose from, for parents.  I’d love to think a parent could custom create their own set of books, based on whatever their child finds difficult because not all children with SPD are the same.   I’d also love to see Ovis products based on the books!  So there’s a lot more Ovis to come!

Lorna: We often hear that many children with autism also have sensory challenges. Temple Gradin explains in most of her books how difficult her sensory issues have made her life. I have a grandchild and daughter with Tourette syndrome and they have sensory issues also; therefore, your “Ovis Series” will be appreciated by many! How prevalent is sensory processing disorder (SPD)?

<<Kelly Beins: This is a great question and there is lots of misperception out there regarding sensory processing and autism as well as other diagnoses! Your example of your own grandchildren is a perfect example, and thank you!  We hope Ovis will be helpful to many and we know there is a need!

Sensory processing disorder (SPD) is not a medical diagnosis in and of itself (yet) but sensory symptoms do exist with other established medical diagnoses, including autism.  The most recent version of the DSM (Physician’s Diagnostic and Statistical Manual), the DSM- 5th edition, was just revised in 2013.  At that time, sensory symptoms became one of multiple primary diagnostic criteria indicating an autism diagnosis.  Research suggests that anywhere from 69% to 93% of children with autism have sensory symptoms (McCormick et.al, 2016).  There is some research that shows increased sensory symptoms in children who have ADHD, OCD, Tourettes and even anxiety but more research is needed before any firm conclusions can be made about true incidence with these other diagnoses.  There is definitive research that shows SPD occurs in anywhere from 5-16% of the general school-aged population (spdstar.org).  I keep citing the STAR Center because they are the leading treatment and research center for SPD.  Their website has a library of research articles and easy to read summaries if people want to understand more about SPD and how it’s connected to other conditions.

Lorna: Please give examples of treatment a child would receive to help him get used to things he can’t tolerate because of his sensory processing disorder.

<<Kelly Beins: I’m working with a child right now who is over-sensitive to movement and has touch sensitivity. She has a lot of anxiety and was refusing school, having frequent intense aggression every day, avoiding food to a large extent, refusing to have her hair brushed, and struggling to get dressed each morning.  In our sessions we have slowly added different games that require movement paired with sensations that feel good to her skin and her body.  I hung a trapeze bar above our ball pit and she could reach up and hold onto it while standing in the ball pit.  She has gradually initiated holding onto it to climb out of the ball pit and will now hold onto it standing on the edge of the ball pit before she flops in.  She is getting more and more comfortable having her feet off the ground and feeling movement in a safe and comfortable environment.

We’ve done lying backwards over a therapy ball to play “Eye Spy”, and crawling games where she crawls and rolls a ball forward with her forehead.  These games get the head in a different position and create the sensation of movement without having to take her feet off the ground. We’ve done many things and this is just one example, but OT paired with counseling means she is now not aggressive every night at home, she is getting dressed in the mornings, and she is going to school every day.

Touch sensitivity is a common issue we treat; the clinical term is tactile defensiveness.  This means that the skin receptors (typically light touch receptors) are “over-firing”.  When this happens, things feel badly on the skin.  I recently had a young girl say her pants were “shocking her”.  A treatment session I might offer to treat tactile defensiveness would incorporate a lot of activities that provide deep pressure to the skin, and input to the joints and muscles (proprioception).  Both deep touch pressure and proprioceptive input are generally calming.  So it might be we do jumping and flopping into the ball pit, or jumping off of a climbing structure onto a giant soft crash pad.  We might also play a game where we pretend she is a pizza or a burrito and we roll her in a heavy blanket to be the dough and then I roll her out and squish her arms and legs with pillows or a foam roller, to “kneed the dough”, followed by various types of touching with different toys (scarves, bumpy ball, netted ball, a damp cloth etc.) to “add the ingredients”.  The pressure from the jumping and crashing, the heavy blanket and pillows preps the body to receive and tolerate the other varied sensations presented in the rest of the activity.

We also introduce messy play in a gradual way for children who struggle with touching things.  We might use a bin full of beans and rice in the same way as other children might use a sandbox.  We may play with kinetic sand or “Bubber”, before playing with real sand because it’s dry and doesn’t stick as easily to the skin and we might hide shaped beads in therapy putty (like silly putty) to progress toward items that are of a stickier sensation.  We may then progress to making pictures in shaving cream, or we might make slime, all the while incorporating lots of deep pressure to the body before, during, and after the activity is over.  These sessions are coupled with parent education, home activities, and perhaps using adaptive strategies like compression clothing or use of a weighted lap pad, so the child can receive deep pressure throughout their day at home or school.

Lorna: Is Physical Therapy (PT) the same as Occupational Therapy (OT)? Can you explain in a simple way so our readers are clear about this?

<<Kelly Beins: This is one question every OT will hear at some point…No.  OT is not PT. The main difference is in the “modality” of treatment.  PT is called physical therapy because they use “physical modalities” as their primary mode of treatment; ultrasound, e-stim, massage, manual manipulations, etc.  OT is called “occupational therapy” because we use activity or occupations, as our primary mode of treatment; playing, eating, dressing, etc.

OT’s use activities that are motivating to the client to help them do required daily tasks or things they need to be able to do every day.  In this way there is some overlap, because both PT and OT help people function but they differ in how they address it.  A PT may help a child with SPD not walk on their toes but they may do it through ankle bracing, stretching the achilles tendon, and balance and strengthening exercises.  An OT may help the same child by playing a game where they stand with flat feet on a swing to balance while wearing a weighted belt or ankle weights playing a target toss game followed by marching games through a giant maze or crossing an obstacle course that incorporates stepping stones on which they need to balance.  Both can be important in the treatment of toe walking.  For some reason, many people think of PT for lower extremity challenges and OT for upper extremity (fine motor) challenges but this is not always the case either.  I will say, OT’s do a lot of work to address fine motor skills because people use their hands for a lot of functional tasks!

Lorna: Thank you very much for taking part in our Author Interview Series and for your guest post introducing your book. Please let us know when other books in your Ovis Series come out.

<<Kelly Beins: Thank you Lorna! I appreciate the chance to connect with your readers and will definitely share more as Ovis evolves!

Follow Kelly Beins:

Read Also:

Buy Ovis Has Trouble with School by Kelly Beins  Amazon.com  Amazon.ca 

This post was written by Lorna
Lorna d’Entremont: Co-owner of SentioLife Solutions, Ltd. the company behind KidCompanions Chewelry (2007) and SentioCHEWS (2013), mother of three, grandma of 5 and wife. She is a retired teacher and special needs advocate. Throughout she has taught all levels from grade 2 to grade 9. Lorna loved teaching and enjoyed seeing the students progress in the school system. During her 30 year career she took a few years off to raise her three children.
Quantcast