OT Evaluation

Exhale........Inhale......... Exhale................................ I feel a bit of weight lifted off my shoulders after our appt. today. I was told recently that it does not seem that he has any 'sensory issues' at all. There are things that have made me question that. The extreme pickiness of food. The way he is so delicate with pages. The way he wont allow one tiny morsel of anything that he isn't putting in his mouth to be on his hand, fork, or near his hand or fork. I can't think of them all right now... but I questioned it. So, today the OT specialist came to evaluate his sensory needs and see if he was functioning near the level of a 2 year old. The way she explains it is this: We all have sensory needs. We all have little quirks and likes and dislikes. Some of us dont like a certain texture of food or maybe its the smell or maybe its the taste. Some of us need our pants to not to be too tight or we dont like a tag in our shirt... but the difference is that when we have those needs, it doesn't affect our ability to function in the outside world. The world is full of different things that impact our senses. You know... Sight..Sound..Smell...Taste...Touch... Those are our senses. So, most of us fall somewhere in the middle. Most of us are either sensitive to light or sensitive to certain smells or need a little extra personal space. Then there are those who are either UNDER sensitive (meaning nothing bothers them... well beyond the norm) or OVER sensitive (meaning things overly agitate them... well beyond the norm). So, in her evaluation, there were a lot of questions. I made sure to tell her that I wanted to be as detailed as possible in answering the questions... but I didnt want to make anything out to be more of an issue than it really is. Is it pretty normal for a 2 year old to throw a fit and not want to do something? YES. But... there is a lot more going on than that. So, she asked a lot of questions to get a feel for how he functions when he's playing outside, playing inside, with a group of people, with other children, at home, at the store, etc & so on... But she also played some games with him that really showed her the bigger picture. Example 1: Spidery looking balls. Some are slick, some are sticky, some are prickly. They are all squishy. They are not like anything he already has to play with on a daily basis. He was interested in her new game. He pulled them out of the bag one by one - sorting them by color and size as he pulled them out - but as he felt of them he kept looking over at me, 'Mommy, is this ok? Mommy, why does this feel like this? Mommy, Im not too sure Im enjoying this new game'. He became very whiny very fast and went to find a game that he was more familar with. Ok. Her evaluation of this: It is normal for a 2 year old to seek approval from mom. It is normal for a 2 year old to not be too sure of something. But the normal reaction would be 'gung ho', dig right in, dont care if the sticky stays on the hands. She said he was very overly sensitive to these little balls and instead of just exploring and figuring out what they did, and how they squished and being interested in the balls... he was more interested in the residue it left on his hands. Example 2: Fingerpaint. Also, a new thing for him. She poured out several colors. Let him decide what colors he wanted. Allowed him to open the caps and help. Then she put HER fingers in the paint and rubbed them around. She mixed colors and encouraged him to also do the same. We finally got him to put his hands in and he spent the next few seconds whining and tryng to wipe it off on the carpet, his shirt, etc.. The normal response of a 2 year old would be more so of what does it look like when it mixes? Ooh..its squishy. Dive right in and explore. But he was so cautious - didn't want any part of this sticky slimy stuff on his hands. Within about 10 seconds we were at the point where we had to go wash his hands and be done. Example 3: Silly Putty. She has hidden some little colored disks in the silly putty and shows him how to retrieve them. She encourages him to find the little disks. We tried telling him to find circles (something he loves), we tried telling him to find the green (also usually loves colors). And, as long as he didnt have to touch the silly putty... he would pick the disc out. But, when we asked him to find it himself - you could see how bad he WANTED the little discs, but he refused to touch the silly putty whatsoever. I even tried to put his hand on the silly putty and he just yelled and refused. When we would ask him to touch the silly putty in any way he just looked up at me and asked me for 'Help.' Again, a 2 year old should have no problem at all at least touching the silly putty. Most of our conversations revolved around what foods he would and wouldn't eat. I had been advised recently that he eats enough variety of food that as a 2 year old, it was probably just him being picky. This was disappointing to me because it #1- hits me as something I have done wrong and #2- makes it MY problem to try to fix even though I feel like I have done EVERYTHING UNDER THE SUN to try to get my son to eat nutritious meals. She said that the 2 major textures for food would be crunchy and mushy. He will eat chips/crackers and he will eat Yogurt. Some people stop there when they are evaluating sensory needs. However she said you really need someone who specializes in these things to see the deeper issue. She sees that he will eat chips/crackers but wont eat fresh veggies (carrots, broccoli) as an issue. She sees that he will eat yogurt - but stops at the sight or even taste of the tiniest bit of strawberry or blueberry as an issue. He wont eat mushy banana. He will eat spaghettios, but sometimes refuses to eat noodles covered in sauce. She said we cant get inside his brain to see why he is refusing those things...but that it is well beyond the point of a normal 2 year old response to refusal or control. Her recommendation: She feels that a lot of children benefit well from OT coming to the house and doing therapy. She thinks that in our case, he would benefit much more from an outside setting. She is going to try hard to find him an outpatient OT session that he can be a part of and really work on him functioning in outside environments. She said there are more options when he turns 3, so if we need to do in-home OT until then, that will be more beneficial than nothing for now. She sees that he is functioning quite well in his home and normal settings - with his normal toys and people. However, the conversations we had about the way he reacts when we get out of our normal setting, our normal routine, our normal activities is beyond normal for a 2 year old and she thinks they can help. I wont pretend to totally understand this OT thing yet, or the sensory issues yet. But Im excited that maybe there is some hope at the end of a very long tunnel. Especially for feeding him.