5.21.2009

The one with OT #3, Third Time's a Charm

Bottom line, he's got qualitative differences in Sensory Processing, among other things listed here.
All the way around, it was yes.
Yes. Vestibular
Yes. Proprioceptive
Yes. Motor Planning
Yes. Bilateral Coordination/Crossing Midline
Yes. Tactile (this is the mildest)
Yes. Fine Motor
Yes. Low Tone
We got our FULL evaluation & I am very pleased. I am not pleased that DS has these difficulties - I would gladly take them all away and give them to myself if I could - but the next best thing is Knowledge and good hard WORK.
I feel like I ALMOST understand all of this, and where we're headed with it. But she really perplexed me too (below).
She did a very thorough eval. She explained things to me well, explained her plan of action - which doesn't have specific written goals as of yet because she wants us to find the top 2 items we feel are his biggest concerns this week and she will go from there. The good thing about a good OT is that they are fully capable of incorporating multiple issues at the same time. But, she wants to get the ball rolling as fast and furious as we can because we have SO LITTLE TIME.
Why? I didn't think we had so little time. Come July, I thought the plan all along was to move directly from EI to Private OT, even though it would mean a bit of a drive.
So, when she said that - my antennae went up and I asked her if she felt he was a good candidate for continuing OT in the private sector after July 3? I kind of understand what she said, but I still feel really uncomfortable about it. She said that most kids who's parents are ACTUALLY following through with them only really need either 'tune-up' appointments to discuss progress and implement new techniques or maybe monthly check-ins. The parents who don't follow through - end up with kiddos who need more therapy. I felt a little KICK in the GUT when she said that. But, on the other hand, once we implement a plan - a sensory diet, etc... for him.... maybe we WON'T NEED weekly OT??? I think I am just confused. I plan to ask more questions next week.
Thoughts from those of you with GOOD OTs in place?? DS seems to have quite the load of issues to be addressed. He turns 3 on July 4. That gives us 5 more one-hour sessions.

5 comments:

Anonymous said...

Charlotte started private OT 2 years ago this month and we'll be discontinuing it in August when she starts Kindergarten. She has been going weekly for this entire time. Her SPD was considered "mild to moderate" and, to tell the truth, I can't remember what all her sensory issues were, but it wasn't a short list either.

We have an excellent OT at a top notch facility and I have never for a second felt it wasn't necessary and have felt that it was always and absolutely the best thing that we did.

It's important to consider the facility? Do they really know SPD and have a good reputation?

Another thing to consider is what kind of services will his preschool provide for SPD? Charlotte's school has a sensory room and she is part of sensory group that is pulled out 2x a week for sensory based activities. That will continue in Kindergarten except probably 10 mins a day instead of 20 mins 2x a week. Some schools don't have any knowledge at all - if yours doesn't I'd definitely do the private sector.

If your insurance covers it, I'd definitely do weekly OT in the private sector. Weekly because his therapist will really get to know him which will help her tailor the therapy to HIS needs.

It's more than just a sensory diet. It's a lot of work on us Moms to keep that sensory diet up at home (trust me) and having a resource like an OT who really knows your kid is worth its weight in gold.

Good luck.

Brenda Rothman (Mama Be Good) said...

I wondered the same thing in transitiong from EI to private OT. JBear started OT at 8 months old and he's now almost 5 and we still have a long way to go. However, JBear's sensory issues are severe in every area and his fine motor skills are behind. I'm not sure what qualitative difference means though; did she mean significant or mild? JBear's issues are severe, so I do lots of OT work with him, but I also need OT weekly to give me progress updates and ideas (ditto goodfountain's comments about worth their weight in gold!) We have a wonderful OT who has done an amazing job and we are in OT for the long haul. Did your OT give you any ideas of severity or a scale or something?

A little boy just 3 years old said...

I used that terminology b/c that's what the report stated. I think 'Qualitative' refers to the fact that he DOES have issues that need to be addressed. Each area scored different, but for the most part each one scored 'moderate'. He was around the middle on all but tactile, which was mild.

When I filled out the sensory profile, I was fairly conservative on my answers - he was ONE point away from the more severe column with sensory issues. There was certainly ONE question on that thing that I should've scored more severely, so he is on the upper end of moderate.

I 100% hear and agree with what both of you are saying. I think I needed to hear it that way - b/c I am still quite confused at why she has been so supportive up until now.

Her findings weren't small. There's a lot to work on. I wanted to at least entertain the idea that what she told me was the 'norm', but I guess not.

I'm so frustrated. Once I get the report in my hands and I can advocate on certain issues - based on her findings - I'll be better at doing what needs to be done.

Thanks for your words - I really appreciate the personal experiences. I keep hearing that OT is the best/most important therapy.... so maybe I can say the right words and get DS what he needs.

A little boy just 3 years old said...

Brenda,

Can you give me an idea of a couple struggles your child has that are severe & maybe what the OT does to help? I am a very visual learner.

Laura said...

k, here's the deal: HMOs or managed care dominates health insurance. HMOs negotiate discounted rates with the providers (here, the OTs). In exchange for the discount, the OT gets to stay in good standing with the HMO. So what does that have to do with anything? Well, my OT told me she doesn't want me to go forward with my insurance appeal and that if I did she couldn't support me because she needs to stay in good standing with the HMO. Nice, huh? I don't blame my OT - this is her livelihood. But the lesson: the providers (OTs) are under pressure from the HMOs to pacify us, the patients (or the patients' parents). Blech.