question for the wise ones

Last year when Tink was in K, she was very well behaved WHILE in school. Nobody believed it when I told them that she was diagnosis'd ADHD/ODD/Sensory Integration Disorder (SID). I asked them at that point for an IEP and an Occupational Therapist (OT), but was denied because she had no problems IN SCHOOL.

When she was home from school, she was a monster. Over the summer, she got worse. psychiatrist & I think it may be bipolar, and are treating it as such.

I asked Tink's psychiatrist for a referral for a multi-disc evaluation or a neuropsychologist evaluation. What he gave me was a recommendation to give to her school for a case study evaluation. It says "to address Tink's emotional and academic needs. As part of this evaluation, I believe Occupational Therapist (OT) evaluation (and treatment as indicated) is also needed, specifically for sensory integration problems." I presented this to the school, and am getting much of the same: She did not show signs of problems in school, there is not much that we can do.

Do I have a leg to stand on?


Under IDEA, the school district can't offer services to a student unless the student qualifies for an IEP.

One of the requirements to qualify is that academic or behavioral problems impede their learning or the learning of others.

If the psychiatrist feels the evaluation(s) need to be done, you can ask for the evaluation (in writing via Certified Mail). I sure wouldn't dismiss the recommendation. But as you know, the CM kicks in timelines.

In the event Tink doesn't qualify, you'll have the evaluations as a baseline.

However, I'd want private evaluations done also, so if you need a referral for insurance purposes, I'd ask the psychiatrist for a private referral.

Fine and gross motor skills and Sensory Integration Disorder (SID) are two things that can be permanently improved with appropriate Occupational Therapist (OT) therapy. I wouldn't wait -- the earlier the treatment, the better.


New Member
one thing to remember is that while all children with IEP's and 504's have a documented disability, not all children with disabilities require assistance and services through the LEA in order to benefit from a Free and Appropriate Public Education.

In other words, if the behavior is not observed nor documented as impacting her ability to benefit from her educational environment, the school district is not required by law to provide services.

As a school Occupational Therapist (OT) I have been involved with many students who have sensory issues or motor issues, however the primary impact was outside of the educational environment. I've had students that can "hold it together" during school hours and need the structure that school provides, but they are so exhausted from the effort that when they get home their behavior falls apart. Unfortunately, because these students were able to participate and benefit from their educational environment, they did not require Occupational Therapist (OT) services in the schools.

As an Occupational Therapist (OT) I would strongly recommend that you get a private Occupational Therapist (OT) evaluation at this point. If there isn't observed or documented educational impact (which at such a young age is not uncommon) then you'll have wasted days and days. Schools have a time line to consider an evaluation, time line to evaluate, etc. If an evaluation team takes the full time, it's well over 3 months. If the main concerns are at home you'll want a private Occupational Therapist (OT) evaluation.

1. Generally you'll have faster results regarding scheduling an evaluation and receiving a completed report.
2. School based OTs can legally only make modifications/accommodations and provide support for the educational environment. A private Occupational Therapist (OT) can work with your family and your daughter for ALL of the environments she is in. When you consider that she is in school only 6-7 hours a day, you need to recognize that the other 10 hours a day and weekends aren't going to be addressed by a school based Occupational Therapist (OT).
3. If your daughter has fine motor or gross motor delays, there are other areas of her daily living skills which are affected that schools do not have to address, for example, riding a bike.

With the push that most school systems have for inclusion, getting students ready in the classroom, etc, most school based OTs these days are pressured to only provide 30 mins of direct services 1x week. A good private therapist can complement that with 45-60 minutes once a week and you'll have much better results.

Best of luck!
Thank you for taking the time to share that information with me, Babbs. I so appreciate it.

Here is my situation. We are on Medicaid. I have not been able to locate an Occupational Therapist (OT) that takes that. I realize that my difficult child is holding it together very well in school and saving her GFGness for me. She did have an issue last year, where she had to be put in a "special" reading class because she was behind the other students in letter recognition. This was not behavioral, but one could argue that her sensory overload prevented her from learning in the class like everyone else. A stretch, yes, but I thought I'd give it a shot.

This request for an Occupational Therapist (OT) evaluation was actually done at the end of last school year. Now, at the beginning of this school year, I am asking for a complete evaluation. Not because I think she has problems in the school, but because I think that her diagnosis is incorrect or incomplete. I asked difficult child's psychiatrist for a referral and this is what he gave me. The scholl finally told me yesterday (her first day) that they would observe her and call me in for a meeting in 2 weeks.

See, I really have no idea what the heck I am doing. Thank the good Lord above for this site.