About the Provider
Name: Deana Lesher
Discipline/Credentials:Â Occupational Therapist, OTR/L
Modalities: MNRI (Reflex Integration), Bal-A-Vis-X, Safe and Sound Protocol (SSP)
Client Background
Name: Holly (pseudonym)
Age and Gender: Nine years old, female
Diagnoses and Conditions: Trauma
Program Delivered: Safe and Sound Protocol (SSP) (SSP Connect, Hours 1 through 4; SSP Core, Hours 1 through 5)
Holly has been having difficulty with emotion regulation in school, which appears to have been triggered by a racist comment and ongoing bullying from another student. As a result, her behavior ranges from hitting and kicking peers, as well as her teacher, yelling out, throwing things, and hiding under her teacher’s desk on a daily basis.
Holly was adopted from China when she was 23 months old. She currently lives in a stable home but suffered early trauma from abandonment, living in an orphanage, experiencing malnutrition, and undergoing open-heart surgery at about six months old. She has been doing well in her adoptive home with her family and plays well with friends outside of school, but faces difficulty in class. Prior to starting occupational therapy, she has had a few sessions with a play therapist, and had begun a treatment protocol called MNRI (Masgutova Neurosensorimotor Reflex Integration) for several months before the SSP.
Goals with the SSP are improved emotion regulation, especially at school, so she can function socially and improve academic outcomes.
Implementation of the SSP
The SSP was delivered to Holly remotely, as she lived over six hours away from the clinic and only made two visits for in-person therapy. Holly has a very supportive family and her mom offered co-regulation during SSP delivery. She went through four sessions of SSP Connect, immediately followed by five hours of SSP Core, delivered over 10 days. During this time, Holly’s mom continued to implement a home exercise program with MNRI techniques as part of her daily routine.
Response
After the SSP, Holly has shown significant improvements in emotion regulation. She is not only making great gains academically this year compared to the previous year, but at her recent 504 team meeting at school, her teacher reported that her emotion regulation is nearly the same as her peers and that she now needs very few accommodations.
Observations
“I was very pleased with the consistency and commitment with Holly’s family,” Deana shared with us. “They are amazing advocates for her. I was able to virtually meet with her school staff, including administrators twice to educate [them] on Polyvagal Theory, connection and safety, and to provide recommendations that they implemented into her school day.”
Next Steps
“We have found that when we implement both MNRI and SSP intervention strategies in conjunction with each other, we have better results with nervous system regulation overall,” Deana said. “Our clinic is in the process of starting a research study with our local university OT doctorate program to collect and analyze data comparing these interventions.”
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