Occupational Therapy: What is it?

[LovingAbbey]

Maybe I'm just not that well informed about some types of therapists, but what is an Occupational Therapist (OT)? My difficult child is finally getting evaluation by the sd. The first of which is by an occupational therapist. Abigail is very bright and has no fine or gross motor difficulties. No speech problems. No hearing problems. What do they do, how can they help a BiPolar (BP) kid, what are they testing or looking for?

 

[wincha]

Are they doing a full evaluation where they are looking at fine and gross motor? There is also sensory testing where they will do with my younger son. I am confused to. Did you ask why they are having an Occupational Therapist (OT) evaluation? Usually the sd is so cheap you have to fight for evaluations.

 

[Sheila]

Your sd is being thorough. That's great!

Occupational Therapist (OT) = occupational therapy. It is performed by an occupational therapist.

An occupational therapist evaluates for fine and gross motor skills. Some are also qualified to evaluate for Sensory Integration Disorder (SID) and perform Sensory Integration Therapy.

Fine and gross motor skill delays can be very subtle, yet cause huge problems when it comes to learning. These type delays can only be discovered by a qualified evaluator.

Short personal story. I knew difficult child had fine motor skill problems, Auditory Processing Disorders (APD), Sensory Integration Disorder (SID), and receptive/expressive language disorders before he was evaluated. I knew he was having trouble comprehending what he read -- didn't know it had a name. lol But you could have knocked me over with a feather when gross motor skills were included. I didn't see any of the "symptoms" that are so commonly listed on websites. After further research and watching him more closely, then I could see it.

I didn't realize the significance of the motor skill delays. It's the basis that all future learning is built upon. If I had it to do over again, Occupational Therapist (OT) would have been the priority.

difficult child's motor skill delays are formally identified as Apraxia (motor), aka Dyspraxia and Coordination Development Disorder. It's also impacted his perceptual skills.

You'll find some info that might be helpful at and in the Special Education Archives.

https://web.archive.org/web/20050207150153/http://sbm121693.homestead.com/apraxia.html

Ruling out potential problems is an excellent idea in my opinion. If needed, the sooner Occupational Therapist (OT) therapy is started, the better.

Hope this helps.

 

[SRL]

I missed the motor skills problems, as did my son's preschool teachers. Because he was writing letters very clearly at such a young age it was very deceptive. It wasn't until I had a daughter with excellent motor skills that I realized how far behind he really was and I was shocked at how much I missed

I regret not getting a full private Occupational Therapist (OT) evaluation with someone who had experience in sensory issues right away. We knew there were some minor issues but the doctor felt he compesated well enough that it wasn't a problem. That decision came back to haunt us later.

 

[LovingAbbey]

Thanks, I guess this is important even if only to rule out, hopefully there aren't problems with motor skill too. She does have some sensory issues, loud sound especially, they seem to cause both physical pain and anxiety. this has been so since she was born. It's gotten better, now the sound has to last for more than a couple of seconds to have the extrreme effect. Everything from hair dryers to motorcycles, to alarms and snowing tv screen. She loves low humming sounds, like the ever so quite sound the vcr makes when it it on but not playing a movie, it helps her sleep. If I turn it off she wakes up, and turning it off is the only way I noticed the sound. Wow, I just realized that fire drills at school will be a huge problem for her. Can that be written into the iep, maybe she is out of the building before it starts?

 

[SRL]

It's really good to have someone with expertise in an area take a look at your child because they may see things that you don't. If you are suspecting sensory then I really urge you to get a private evaluation done in addition to the school district. The school will only help with things that impact a child in the educational setting and if there are sensory issues involved then there is much that you can do on the homefront. A coordinated approach between home and school is best and you won't be able to learn what you need to know except by sitting in on private therapy sessions. You won't be able to sit in at school.

Fire alarms scare everybody--they're supposed to. The idea here is for your daughter to learn to handle the things that she is going to encounter in her world. For her own safety she needs to understand what a fire alarm is and know what to do when she hears it. You will want to talk it through with her team/teacher about how to best go about handling all of the noisy parts of school: fire alarms, cafeteria, gym.

 

[Abilene]

I have had the opportunity to observe students with autism during a fire drill. Usually they cover their ears with their hands. It's important that supportive adults help them exit the building quickly, so they "get away from" the sound of the alarm. This also teaches the appropriate behavior for a fire drill--quickly exiting the building.

Abilene

 

[LovingAbbey]

I thought about the fire alarm thing after I posted it and thought-even though this will cause her anxiety and pain, if she doesn't participate in the fire drills , what would happen to her in a real fire? she wouldn't know what to do. I guess the school will have to handle it, I just wish I could protect her from everything that causes her anxiety. I know that's not practical though.

To get a private Occupational Therapist (OT) evaluation, would I need a referral from her psychiatrist or pcp? Her psychiatrist is at a child psychiatric hospital (Bradley Hospital, if you ever heard of it) and I would think there would be Occupational Therapist (OT)'s there. They even have a theraputic day school on the grounds. I guess maybe I could call my insurance to find out.

One more question, how does one find out if they specialize in sensory issues, are there special letters after thier names? (you know, like a doctor is MD etc.) :confused:

 

[Sheila]

I wish I could remember how I went about sorting through all the Occupational Therapist (OT)'s qualifications, but I don't. I'm pretty picky about who evaluates my son.

Things that I remembered that were on my "required" list were:

Occupational Therapist (OT) also must be certified in SIPT evaluations.
Experienced with children my son's age.
Perform evaluations for parents (not IEEs) as well as school districts.
Agree to accept and read my Parent Report via email or fax prior to the appointment.
Produce a comprehensive, written report with-recommendation.

Short over-view of SIPT testing from https://web.archive.org/web/2006051...thpawenterprises.com/resources_helpcenter.asp

6. 6 Question:
What is the Sensory Integration and Praxis Test (SIPT)?

Answer:
The SIPT is a standardized test used to help identify difficulties in various areas of sensory processing and functioning. It the only measure of its kind aimed specifically at the different areas related to sensory integrative dysfunction. The test is designed to test children between the ages of 4.0 years/months to 8.11 years/months. The test consists of 17 different standardized subtests and is administered in 2 to 3 two-hour sessions. The SIPT is a fairly expensive test, not usually covered by insurance providers. The only providers who are qualified to administer the test must be SIPT certified. SIPT certification does not address any treatment planning nor treatment strategies. SIPT certification implies only the ability to administer, score and interpret the results of this specific test. SIPT certification, although a helpful compliment, is not necessary for an occupational therapist to be able to successfully treat DSI.