What would you do- OT

[mommyatty]

Some of you may remember when DD was in pre-k, her teacher recommended we have an OT eval to deal with her handwriting. After 6 months and a couple of thousand dollars, we spoke with an educational psychologist who told us we were doing more harm than good. We stopped OT, and just as the psychologist said, her handwriting immediately got better.

As part of her evaluation, they said pretty much EVERYTHING was wrong with her. Her balance, her fine motor, her gross motor. My kid who was ice skating, was hell on her balance bike, etc, was deficient. We thought that was crap.

So fast forward to DS. In pre- k, at our last meeting with his teacher, she indicated she thought he might be having some sensory issues around auditory stuff. He has trouble if there are loud noises (he covers his ears and says it’s loud) and he has trouble following verbal directions and finishing his work. She recommended an OT eval.

We just got the eval back, and it looks just like DD’s. Everything is wrong with him, according to them. His balance is bad, his gross motor is off, he can’t flip playing cards fast enough, he’s fastidious and writes too slowly. Hilariously, the sensory stuff was “inconclusive”.

Now, DS can stand on a “turtle shell” in tree pose. I can’t do that. His balance is fine. But he does have one thing that’s concerning. He’s developed a sort of tic where he scrunches up his face, sort of crosses his eyes, and puts his hands up by his face (like if you put your hands up when playing cops and robbers). This “tic” is the main thing we are worried about because we don’t want him to get teased. They indicated OT could help with this, but they didn’t list that in their 6 month goals. Also, his pediatrician says that is very common and he’s likely to grow out of it within about a year.

I’m torn. If it weren’t for the tic, I would be a hard no on the OT. I think my kid is fine. I thought my other kid was fine, and OT ended up doing psychological harm and no physical good. But the tic scares me. And reading over info on auditory sensory issues, I think DS may actually have those. But everything also says if he does, he needs a speech pathologist, not an OT.

So, if you’re still with me, what would you do? Go ahead with the OT? Get an opinion from a speech pathologist? Just ride this out for a little longer?

[mustardseed2007]

Did you go to the same place to get the OT eval as you did with your DD? Because it sounds like the suck and so I wouldn't go there again.

[xctsclrx]

I would forget OT and go to a child psychologist about the audio and the tic.

[waverly]

I think it was the place that comes to the school or was recommended by the school? I think they have a financial interest in getting patients, and I would not work with them anymore.

If I were to do OT my criteria are close to home, takes my insurance, has openings at a convenient time, and highly rated. This rules out a ton because they all want you to come mid day, and I had to find one that I could do a 3pm appointment and take off work for 10 months with intermittent FMLA. Independent or through a hospital network can work as well.

OT was great for DS but he clearly needed that and PT. He clearly had (and still has some) strength issues, hand strength leading to poor writing and balking at writing, poor balance, poor strength all over his entire body. He needed vision therapy, and motor planning. He also has/ had sensory issues including auditory. For auditory I would recommend the noise cancelling headphones. Otherwise DS outgrew it by 1st grade, so honestly I wouldn't worry too much about that. I see you already asked the pedi about the tic, and he said he would outgrow it. I would decline OT and go with the pedi. If I recall he was correct last time about the handwriting as well. Honestly, I would have thought neurology for the tic and not OT anyway.

[186momx]

Can you go back to the same psychologist your DD saw for DS and get her opinion before making a decision?

DD is 8 and still doesn't like loud noises. She runs into the house and closes her door when DH uses the saw or mows the grass. She hates fireworks even with ear protection so she is always in bed early and I give her melatonin or bedtime cold meds to help knock her out for the night. If we go anywhere that I know is going to be super loud we bring her noise cancelling ear muffs so she has the option to wear them if needed.

[campermom]

Jul 2, 2019 11:08:12 GMT -5 mommyatty said:

Some of you may remember when DD was in pre-k, her teacher recommended we have an OT eval to deal with her handwriting. After 6 months and a couple of thousand dollars, we spoke with an educational psychologist who told us we were doing more harm than good. We stopped OT, and just as the psychologist said, her handwriting immediately got better.

As part of her evaluation, they said pretty much EVERYTHING was wrong with her. Her balance, her fine motor, her gross motor. My kid who was ice skating, was hell on her balance bike, etc, was deficient. We thought that was crap.

So fast forward to DS. In pre- k, at our last meeting with his teacher, she indicated she thought he might be having some sensory issues around auditory stuff. He has trouble if there are loud noises (he covers his ears and says it’s loud) and he has trouble following verbal directions and finishing his work. She recommended an OT eval.

We just got the eval back, and it looks just like DD’s. Everything is wrong with him, according to them. His balance is bad, his gross motor is off, he can’t flip playing cards fast enough, he’s fastidious and writes too slowly. Hilariously, the sensory stuff was “inconclusive”.

Now, DS can stand on a “turtle shell” in tree pose. I can’t do that. His balance is fine. But he does have one thing that’s concerning. He’s developed a sort of tic where he scrunches up his face, sort of crosses his eyes, and puts his hands up by his face (like if you put your hands up when playing cops and robbers). This “tic” is the main thing we are worried about because we don’t want him to get teased. They indicated OT could help with this, but they didn’t list that in their 6 month goals. Also, his pediatrician says that is very common and he’s likely to grow out of it within about a year.

I’m torn. If it weren’t for the tic, I would be a hard no on the OT. I think my kid is fine. I thought my other kid was fine, and OT ended up doing psychological harm and no physical good. But the tic scares me. And reading over info on auditory sensory issues, I think DS may actually have those. But everything also says if he does, he needs a speech pathologist, not an OT.

So, if you’re still with me, what would you do? Go ahead with the OT? Get an opinion from a speech pathologist? Just ride this out for a little longer?

DDs OT place sounds super shady, and if you hadn’t mentioned paying thousands of dollars my next question was if there was a financial gain vs a service provided by school. I would never go to this practice again.

Onto DS. Is it the same place? Get a second opinion. When you say “everything is wrong” how far below average are the scores? I’m not talking about skill specific, what are the actual scores? What do you mean when you say “bad” or “off”. Is he deficient? If they aren’t far below average, then there is no way in the world I would pay out of pocket for OT.

You said you think your kid is fine. I urge parents to be wise consumers when it comes to outside (of school) providers. See if there’s anyway you can have a conversation with the schools OT to help you digest and break down exactly what that report recommends. Maybe an IEP meeting, but honestly unless the teachers felt he needed one I would start with a conversation. (OT isn’t usually a stand alone service anyway in school) Sometimes just talking it through is helpful even if an IEP meeting isn’t warranted.

I would give it way more time before hanging my hat on any auditory attention or aud processing terms, work through this next year of school along side your teacher to determine what the exact skill deficits are and ask what interventions are needed in the classroom.

I hear a lot of parents hear labels and research things and say “he would need X for that” or “if she’s has Y she needs Z” so if were to have auditory attention or processing issues, instead of paying someone to tell you what service they can provide your child for money, ask his teacher what he or she is actually seeing as a concern in the classroom. “What skills are affected in the classroom. Is it letter sound ID? Rhyming? Blending sounds? Is he far below? What interventions do you have for this? Is he even performing low enough to need extra help? If not, what can I do to strengthen it?”

Now let’s talk about the tic. I’ve been through this with my daughter. NO way would I pay for any service. Nope. They will be taking you.
Don’t draw attention to it, certainly don’t point it out to him when he is doing this unless it is truly bothering HIM. Then give him the language to understand what is happening. My daughter and I talked about them briefly but I tried not to dwell on it.

She said she had these movements that felt like a tickle or an itch.

Also I’m going to tell you this—very, very few times in her life have kids her age pointed them out. If anything, an asshole adult or two have. One older kid has. I armed her with the language in the event this happened. “Sometimes I get a movement in my body but its no big deal.” And I taught her to move on to what they were doing and change the subject. But at the K or even 1st grade level, most of these kids will not pick up on this.

Don be surprised if they morph or change, or get more complex or look like a cover up movement that becomes its own tic. Or if all the sudden they go away!! But then come back! this the nature of a tic disorder. They wax and wane. Have it on his medical info at school only bc you want the teacher to be aware. TELL them, “do not point it out, I simply want you to know I’m case other kids point it out and you can help brush it off.”

My end of this is: have the conversation with the teachers, but I wouldn’t do any OT or S/L at this point. PM me if you have questions or concerns now or in the future!

[twinmomma]

DD2 is what I call my "sensory kid." She LOVES texture and sensory input. She will gladly play with slime, rub sand at the beach on herself, etc. She's always been that way. She also hates loud noises and has always struggled with it. As she's gotten older, the sound issue has leveled out a bit, but we just make accommodations by giving her headphones when we know it's a setting that might bother her. Her teachers have done the same. For example, full school assembly with pumping music? They just give her headphones. We didn't even have to ask, they just noticed and did what felt right. It's never been a big deal or anything worthy of OT or special diagnosis.

[HeartofCheese]

Ride it out. Nothing you listed sounds major to me and kids really do grow out of stuff.

[mommyatty]

I love you guys.

campermom- on balance, where I honestly think he’s above average (he builds American Ninja courses that require him to jump from weird surface to weird surface, balance, then jump to the next) they say he’s “8th percentile”. Honestly, if they’d said he was slightly below average, I might have believed them, but having coached his tee ball team, and watching him with a whole group of his classmates, there is just NO WAY.

Thank you all for the gut check. I’ve also set him up to get tutoring the last 4 weeks of summer with the wonderful woman who will be his kindergarten teacher next year. He’s definitely having trouble blending sounds. He knows every letter and the sound(s) each makes. He even understands blended sounds like ch. He can sound out each letter but can’t then blend them all together. I want her to see his issues and see the tic so she knows it’s there. I also want her to pay attention to whether she thinks he needs speech pathology intervention. I trust her. She was DD’s kindergarten teacher too, and she was great to work with.

[sdlaura]

twinmomma that's so awesome that her school recognized she could benefit from something and just did it.

mommyatty , my 5-year-old DS1 has similar issues in terms of the auditory stuff. Also trouble with loud noises and gets overwhelmed easily by sensory stuff.  He has a really little kid voice and probably could use some speech therapy.  I'm waiting to see whether it becomes an issue in K starting in August. If it is, we'll talk to his pediatrician about how to address it/who to talk to.

Our preschool was very play-based.  What kind of "work" did he have trouble finishing?  Pre-K seems young to have defined assignments.

[mommyatty]

sdlaura- twice a day, for under half an hour, they would work on a letter or word family for one session and a number for the other session. Many days, he came home with a “completed with help” or an incomplete worksheet. And he was open about how he “hated work”. I think he hates it because he can’t follow what the teacher is saying. He needs to be shown.

[sdlaura]

Got it, mommyatty. My kids didn't do any worksheets in preschool, but I think my DS1 would have had issues with that as well.

[traveltheworld]

I wouldn't trust that evaluation. While I am a big proponent of therapy in general, I do think that a lot of places will point out problems that can mostly be resolved on their own as the child ages. If you've had the opportunity to observe him in a group setting with other kids and don't think he's behind, then I wouldn't worry about it.

In terms of the tic - maybe just wait it out. My DS was doing this weird hand motion thing for a few months; I was really worried and took him to see our GP, then pediatrician, then a neurologist. Turns out it was just a nervous habit - a tic is something they can't control; whereas a nervous habit is something they can control. Interestingly, our pediatrician recommended that we point it out to him (he was 6 though) - not in a shaming kind of way, but just to make him aware of it and ask him to stop. He did stop after a few months. He's now onto another habit...oh well.

[campermom]

Jul 2, 2019 13:33:09 GMT -5 mommyatty said:

He’s definitely having trouble blending sounds. He knows every letter and the sound(s) each makes. He even understands blended sounds like ch. He can sound out each letter but can’t then blend them all together. I want her to see his issues and see the tic so she knows it’s there. I also want her to pay attention to whether she thinks he needs speech pathology intervention.

I’m gonna ask some questions...Has anyone told you that not being able to blend sounds together in PreK is an issue?

Also, why is it important to you that she sees the tic and knows it’s there?

When you say speech pathology intervention...what specific issues do you see..his ability to make speech sounds? (Articulation) or was it the auditory attention piece you mentioned before?

[waverly]

You can request a speech eval from the public school district for free. They might push you off until school starts. You can drop off a letter and they have 60 days to test. However, there really isn't anything from your post that says speech therapy to me. Blends come in Kindergarten, so I think he is just a few months too early with probably not a ton of instruction in that area.

Our speech therapist did not work on anything auditory with DS. Since DS has hearing loss, his auditory issues are addressed by a hearing itinerant teacher who provides assistance with learning about and caring for his hearing aids and FM system, self advocacy (asking to repeat things), lip reading/ speech reading, and other attention strategies. He has an IEP that specifies placement in the classroom closer to the teacher. He also sees an audiologist annually. This is all provided for free by the public school district.

[mommyatty]

Jul 2, 2019 15:38:53 GMT -5 campermom said:

Jul 2, 2019 13:33:09 GMT -5 mommyatty said:

He’s definitely having trouble blending sounds. He knows every letter and the sound(s) each makes. He even understands blended sounds like ch. He can sound out each letter but can’t then blend them all together. I want her to see his issues and see the tic so she knows it’s there. I also want her to pay attention to whether she thinks he needs speech pathology intervention.

I’m gonna ask some questions...Has anyone told you that not being able to blend sounds together in PreK is an issue?

Also, why is it important to you that she sees the tic and knows it’s there?

When you say speech pathology intervention...what specific issues do you see..his ability to make speech sounds? (Articulation) or was it the auditory attention piece you mentioned before?

His teacher hinted that his reading was behind. I’m taking that with a grain of salt because honestly he wasn’t yet 5, and he’s young for his class. I don’t think it’s fair to compare his reading progress to kids who are a full year older (or more) than he is. But I think it’s a little peculiar that he knows every single sound and can go “c-a-t” but then can’t speed it up to go “cat”.

I want her to see the tic so she isn’t alarmed by it and she knows to ignore it. The pediatrician told us it’s not “involuntary” but it’s “unvoluntary “ like not scratching your nose when it itches. Also I want her to be on the lookout for any teasing.

The speech is mostly attention, though I’m a bit concerned that he talks very softly and he can’t say his “th” sounds. Like he calls “Thor” “Four” and I’m not sure he can hear the difference. If I tell him to watch what my tongue does, he can make a “th” but he looks confused if you say “not Four, Th-th-Thor”. I’m giving him time to grow out of that since he was a late talker. Not outside of the norm late but on the latest end of normal late.

The kid is just a mystery to me in a lot of ways. He said “trapezoid” in the correct context before he said “mama”. But he’s incredibly social and charming, with what everyone says is a very high EQ. And his vocabulary/literacy readiness test scores were off the charts. He’s a whiz at games, video or board or card. He loves to be read to but isn’t really into the idea of reading himself. He can manipulate tiny marbles for Chinese checkers, but he wouldn’t dress himself until just after he turned 5 when the pediatrician told him he was old enough to. He can explain his strategy for checkers but will act confused if you tell him to put his checkers in the box so we can put the game away.

[waverly]

We used the Reading Lesson teach your child to Read in 20 Easy lessons. DD did start out with C-A-T and then eventually sped up to cat. Maybe it took a month or so, but I thought the book was good (or your tutoring) for that purpose. Blends do come later in the book.

DS also talks very softly. It is more of a projection (shyness?) thing. I would encourage him to speak up and project, use more strength and use his diaphram. DS is much louder now, but we still have to ask him to talk louder in situations like the car.


I was going to say the Th might be the only reason, but I know sounds come at different times and according to the chart Th can be as late as 7. mommyspeechtherapy.com/?p=754

I wonder if the dressing was he just didn't want to/ manipulating you. DS is also the super smart (90-99% in math, reading and language) but also a complete space cadet. Absent minded professor? Possible ADHD for my DS? Grow out of it? Who knows? But I can't really address it very well until it becomes an actual problem.

[sdlaura]

mommyatty, I think it's crazy that a kid's reading could be behind when they're not even in K yet.

[mommyatty]

Jul 2, 2019 16:26:28 GMT -5 sdlaura said:

mommyatty, I think it's crazy that a kid's reading could be behind when they're not even in K yet.

Me too!!!! I was the only kid in my kindergarten class who could read!

[traveltheworld]

Jumping in on the reading aspect - I know that every school has its requirements, but I really wouldn't worry about it. My DS couldn't read at all at the start of kindergarten, got to "average" by end of kindergarten, and then is now at a grade 4 reading level (he just finished grade 1). He was very much like your DS at that age - had a big vocabulary, had some speech issues (a lisp, which we did do speech therapy for), and loved being read to but had no interest in reading himself.

[sunbutter]

I would ride it out longer.

Not sure if it is related but DD has a stereotypy that was present at birth and persists to this day (she is 7). When stimulated or excited she tenses up, looks down, straightens and twists her arms.

She can stop if asked to do so.

Her pediatrician has never been concerned and has suggested that she will grow out of it when she becomes self conscious about it. I think that may be happening a bit although her peer group is remarkably accepting so her self consciousness may be a slower onset than others.