Emma's OT Assesment

As you all know, Emma has been extensively assessed and tested in regarding to her developmental and sensory advancements.   Of course, our primary concern is her feeding, but as I have mentioned before, there are some severe sensory issues behind her non-feeding.

Emma is hypersensitive to all sensations of feel, sight, taste, balance and smell. As well as being hypersensitive to all of the above, she also showed "decreased tactile discrimination" - which basically means that she finds it difficult to determine the "specific properties of tactile input entering her system, whether in her mouth or on her skin".  

Of course, when she gets these sensations that she cannot identify or comprehend her body goes into shutdown mode, becomes agitated, worried and stressed.  She just does not have effective methods of regulating her responses to sensations.

To defuse the influx of information and sensation, Emma shows avoidance and withdrawal behaviour to help avoid becoming overwhelmed.  Emma has got a stutter, and this presents itself prominently when she is in this shut down state. She is unable to verbalise her emotions, and this lack of communication can make it very difficult, and has been making it difficult for us, to read her non-verbal cues as to what is worrying her and stressing her out.  So we are learning to read her cues to help eliminate this stress during sensory activities.

Another major issue, of which I have also touched on previously, is her posture and stability while feeding.  She has no stability or strength or endurance in her little body which enable her to maintain a stable and solid sitting position. As stated in the report 

"with a strong and stable postural base of support, it is difficult for Emma to focus on and plan the isolated movements required to move her tongue, teeth, lips and hands in order to effectively get foods into her mouh, and to adequately manage foods from an oral-motor standpoint."

But, regardless of this, Emma is extremely bright and passed her mental tests with flying colours.  She is struggling functionally due to her global sensory processing issues, but with all this intensive therapy we are going to improve her tolerance with sensory stimuli.  

We have set up a plan of attack.   Over the next few weeks we are going to be working on making things more tolerable for her.  She is aware that she is heading towards eating foods, so we need to decrease her anxiety and awareness and give her an escape outlet.   We will be working on decreasing her sensitivity to taste and smell, and of course, working on her posture.  We need her to learn how to verbalise her discomfort and get away from her aversive behaviour.


Her OT is a young, active and extremely enthusiastic therapist who is excited at the challenges that Emma has presented her.  Since the report, we have had several OT sessions, and I will go through these in more detail later on.