Meet Anika, the 6 year-old who stopped talking

Anika is 6, and by every account she's an easy kid at school. Rule follower. Loves routine. Thrives when she knows exactly what's coming next. No concerns in the classroom at all.
At home is a different story, and that discrepancy is what prompted her parents to reach out.
Here's what her parents shared about Anika:
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Always been a picky eater, prefers dry, crunchy textures
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The dentist is a nightmare, and so is teeth brushing
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Has long meltdowns at home when things “don't go her way”
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She has strong reactions to daily sounds like sneezing or coughing
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Did a round of OT for emotional regulation last year, discontinued when the OT felt she had the tools she needed
But the most pressing concern was related to two recent “episodes” where Anika refused to talk.
“Anika recently bumped a loose tooth during basketball, then she stopped eating and talking for days, holding her tongue away from the tooth, terrified of losing it, until she was too depleted to fight a dentist visit and had it extracted.”
“Days later, a stomach bug brought the exact same pattern back: no talking, tongue held at the back of her mouth, barely eating or drinking.”
Her parents just got her into play therapy for her anxiety and are looking into other therapies, hoping to brainstorm the right support team with me through our work together.
My initial thoughts:
It seemed clear that oral sensory aversion and anxiety felt like the biggest areas of need for us to explore. The extreme shut down and avoidance of eating after a traumatic incident made me glad that Anika was already going to be working with a mental health specialist in play therapy. But I wanted to learn more about her meltdowns and other behaviors at home to determine if occupational therapy would be worth going back to.
Coming up:
Over the next 3 weeks, we’ll unpack Anika’s story and dive into:
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Her oral sensitivities and explore why her response was so extreme, plus how to safeguard against that for the future
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Anika’s emotional regulation challenges and how they fit into her other sensory needs, plus some things her parents can start doing at home
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Discussing what Anika’s care team should look like moving forward, and whether or not OT should be part of that.
Disclaimer: These case studies are inspired by real-life clients I have worked with, with permission from their parents to share. Some aspects of the case are authentic, and other details are added to include more variability for our discussions. None of the strategies and advice here substitutes medical advice, diagnosis or intervention with an Occupational Therapist.

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