What should I do?

T

TeDo

Guest
I don't remember if I posted about this some time ago or not but difficult child's Occupational Therapist (OT) (I'll call her One) left for another job a couple months ago. Her co-worker (I'll call her Two) went on maternity around the same time so there was no one for difficult child to see. One had just begun a very thorough assessment of sensory issues difficult child has. We only got to see her 3 times because of the tons of snow most every day all winter and the hour drive we had to make to get there. Anyway, so now Two is back from maternity leave so we made an appointment to get the evaluation resumed.

We got there RIGHT on time (I'm habitually early so this bothered me). Two took difficult child into the "gym" and said he had to brush 5 areas on his body before they could start. Now, One realized right away that brushing is one of difficult child's issues. He HATES the feeling. difficult child stormed out the door and wanted to leave. I sat there and explained to Two that difficult child HATES it so she finally went outside and told him he didn't have to do it. He agreed to come back in and they got to work. He was very cooperative with all of her requests for over 1/2 an hour.

As our time running out, she told him he had to do 3 kinds of exercises then they could play a game before we left. She said she gets to choose the first one, he gets to choose the second, and she gets to choose the last. He agreed. She told him to do sit-ups. He laid on the floor and she asked if he wanted her to hold his feet and he said no. As he was doing them, she asked if he could do them on "this ball" that she showed him. He said "I don't know" and continued his sit-ups. She said "you know you're going to have to do it if you want to play a game". He walked away from her and stood at the far end of the hall.

I went to talk to him and explained that she was doing some testing and needed to know if he could do it or not. He became very upset because "first she said I had to do sit-ups and then she changes it and says I have to do them on that stupid ball if I want to play a game. She didn't say that! She changed the rules! I'm not doing it! Let's go home!" and he stormed out again. This time, I tried to explain to her that I have to remember not to change my expectations midway, I have to go with what I said in the first place. She didn't address what I said but instead asked if difficult child is seeing a therapist or psychiatrist. I said yes but our next appointment isn't until August because of his vacations. She actually gave me the name and phone number of another agency to see if there was a psychiatrist we could get into sooner. It didn't matter to her that we are pleased with our psychiatrist and have no desire to change AND that his "meltdown" (she apparently has no idea what one looks like) was in response to her imposing a change midstream with a kid on the spectrum.

How much energy do I put into trying to "educate" her on working with difficult child? What more do I say to her? I know they work with many kids on the spectrum so this shouldn't have been such an issue. Obviously Two didn't read through One's notes so she set the tone of the appointment with the brushing thing. I am very proud of difficult child for going back and working with her.

And yes, I did talk to difficult child on the way home about taking a short "calm" break but then going back to tell her what he was upset about. This is one of his biggest issues. When he gets frustrated or feels unheard or misunderstood, he walks away. He won't try to speak for himself. That is one of the things I am working with him on since I am the only one even he says he feels comfortable enough to talk about this stuff with. I need for him to learn to advocate for himself and not rely on me ALL the time to do it for him but I also know the level of anxiety he feels when faced with these kinds of things. He's been unheard and misunderstood (because he can't put his thoughts into the "right" words) for so long that he gets extremely anxious just thinking about it.

Sorry this got to be so long. I just don't know what I should do to "teach" him AND her. Any ideas?
 

DammitJanet

Well-Known Member
Im not exactly sure of his age but could he maybe use a color coded system he carries with him, either cards or something as unobtrusive as three different colored rubber band type things on his wrist. If he is getting anxious he could either lay the card or the band on his desk or in the case of this exercise, he could simply hand it to her.
 

lovelyboy

Member
I'm also an Occupational Therapist (OT)....but from what you are telling me...sorry to say...I agree with you: Either she didn't plan her session well/ didn't read his file or don't have much experience in treating this diagnosis. Also: Therapist ONE should have givin her more info on the pt's.....

The other thing that bothers me: Usually the therapist, musn't give treatment while assessing. You first do a thorough assesment and then start therapy on the 'just right' level. First try and build a relationship with the pt, before treatment begins. Maybe you need to look around for an Occupational Therapist (OT) that specializes in SI?

Strenghts.....this is a very tricky situation......Maybe, in my opinion, you can explain to your son that she didn't mean to upset him but wants to help him and for that to happen he must try and help her to understand him better by giving her some feedback? Or maybe use a picture chart?
 

exhausted

Active Member
Wow so sorry this happened. I do think it be worth a call to PT. She kinnda came in their like a "bull in china closet". Who knows why? I think its worth explaining your child. It's worth asking where she thinks she may be going with therapy. I would also ask about her knowledge base of Autism Spectrum Disorders (ASD). She's human-but she may not be the person for your guy. Maybe getting to know her a little on the phone and she getting to know you (i.e. we like our psychiatrist) would help everybody.
 
T

TeDo

Guest
Dammit, difficult child's 13. We're working on him telling his side instead of walking away.

Lovelyboy, they are still doing the assessment. She is not doing therapy (at least she's not supposed to be) He will be receiving services through the school Occupational Therapist (OT) based on these guys' recommendations. I am having my own Occupational Therapist (OT) evaluation done because the school one was not very thorough. I have no idea what notes One left OR if Two bothered to read anything.

My question is what to say to the Occupational Therapist (OT) (beyond what I've already said and had dismissed) and how "much" educating I should do. I really need this assessment done. There is no other place around here to do the thorough assessment I am looking for. As it is, I am driving an hour to this place. The next closest place is on the other side of the state. I can't realistically go that far.
 
T

TeDo

Guest
Thanks exhausted. I will just have to assume that since it was her first day back and she was alone that she didn't have time to read the notes One made. I guess it won't hurt to explain what happened so she hopefully won't make that blunder again. I will also have to stay in closer proximity so I can see/hear exactly what is going on so I can hopefully "head things off at the pass".
 

Hound dog

Nana's are Beautiful
TeDo

Forgive me but I forget difficult child's history. Are you doing the Occupational Therapist (OT)'s evaluations to pin down the Sensory Integration Disorder (SID) issue or is it to help him with certain behaviors, or maybe both?

Many OTs don't think Sensory Integration Disorder (SID) kids are receptive to the brush thing after a certain age. At 13 difficult child would be past that age. If I remember right it's around 6-7. That came up with me because both Travis and Nichole have Sensory Integration Disorder (SID) issues, both tried the brush at an older age. Nichole was 10, Travis 13.......and neither could tolerate it even after many attempts.

You're lucky with the Occupational Therapist (OT) at school. Travis was assigned an Occupational Therapist (OT) 3 years running via his IEP and never met the woman/man. It was an on going war which I finally gave up on. Our SD went through OTs like water, so I doubt it would have done him much good.

Travis also couldn't change tracks like that. Actually, he still can't. Instead, we've gotten used to giving him one direction at a time and sticking to it, if something needs to be added it's not done until the first task is complete. It's frustrating to him because it becomes confusing. He doesn't multi task well. Trying to push him to do it only makes him overwhelmed and can make him angry. (less now that he's older)

I guess since you need this to be done, I'd attempt to educate Two. But in all honesty, she should know better......just by his responses if nothing else.

Keep working with difficult child on speaking up for himself. If he's willing you can have practice exercises where you can role play and he can practice appropriate ways to respond. But it may take a long time for him to finally get it. Travis is still working on this area, he's gotten much much better, but it still needs work.

Hugs
 
TeDo,

I would be uncomfortable using this Occupational Therapist (OT) but given the circumstances, I agree with Hound Dog. Try to educate her as best as you can. I'm hoping that maybe this was just an "off" day for her as it was her first day back and she was by herself.

difficult child 2 is 19 years old and still won't speak up for himself. Instead he gets very passive aggressive and although he doesn't "melt" in public as much as he did when he was younger, if extremely stressed and his anxiety level is over the top, he will "lose it."

difficult child 2 is unable to multi-task and if given too many things to do at once, will become overwhelmed, frustrated, anxious, angry, and passive/aggressive all at the same time.

We've been working on these issues for almost his entire life and while we've noticed some positive changes, difficult child 2 still has a long way to go.

Hope your school system is much better then ours! Our SPED director(s) (It was like a game of musical chairs - They left one town after a few years, went to another, and eventually retired or left the area altogether) totally ignored all the independent evaluations we gave them.

Sorry you have to go through this! SFR
 
T

TeDo

Guest
Hound, yes we are trying to pin down all the sensory issues with the hopes that it will also help with some of the behaviors.

Thanks everyone for the responses. I will try to do more educating when we go back this week.
 

whatamess

New Member
It really stinks to have to educate the ones who are supposed to know. I feel like I've been doing that for the last 9 years! If you have no other alternative than this person, then I would prepare difficult child for the inevitable switch in expectations this person hands out. I would also stay close to help difficult child advocate, while educating the Occupational Therapist (OT).
 

InsaneCdn

Well-Known Member
We usually shorten her name to Janet not Dammit.

Maybe...

<tee hee hee>

Maybe she meant to type "Janet" in front of the "Dammit"... as in, she's REALLY frustrated that she's still dealing with this stiff, with a difficult child who's a teenager! (I mean, that's what it would have been if it was MY thread...!)

:choir:

Thanks for the giggles!
 
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