Can we talk OT (Occup. Therapy)...

[OhElizabeth]

Is a lot of stuff the OT does stuff we could do at home if we just had a clue? I've read some people around here suggesting horseriding did as much good or was roughly equivalent. The OT I talked to today didn't seem to think that was the case, which of course was her prerogative when raking in $100 an hour, lol. She also said IM is a higher level therapy, working on executive function, and that you HAVE to work on the lower level stuff first, that it doesn't stick well otherwise. This makes sense and fits with some comments I had heard (irl).

How do I sort out the value of OT, when to jump in, how much to try to do at home to eliminate easy stuff I could have knocked out myself, etc.? For instance, I don't need to pay $100 an hour to have someone play putty and games with small pieces with my kid; I can do that. Am I crazy? Any wisdom here?

Oh, and just to be clear, I think what I have here is some degree of dyslexia. But the more I unpeel it, the more I keep finding things. I thought I could just sign her up and get her going with the IM this summer on top of the horse riding and VT, so that really threw me for a loop when she said we needed a $400 evaluation with fancy write-ups and $100 weekly sessions.

[KarenAnne]

My daughter did OT as a younger child, when it was mostly games-based. A lot of the games were regular old toy store ones I could easily play with my child myself; what was helpful to me was sitting in on the sessions and seeing how the OT taught my daughter to use her body. I saw that she needed direct verbal instruction at a level of detail I had never thought to use, and that she also needed hands-over-hands help much of the time to learn a pattern of motion. It was also very helpful to see that rotating among activities, having to use your body in a slightly different way several times over the course of a session -- whether it was for gross motor function and balance or fine motor skills -- was the general plan rather than achieving "mastery" on any one particular thing.

Some of the things the OT did were "real-life" skills such as teaching my daughter to knit (sort of), teaching her to balance on stilts and how to aim a racket (this did not really take off, though, until vision therapy). You can do a lot of these activities at home with the help of books like The Out-of-Sync Child and the like. You can also google OT on the web along with a phrase like "balancing activities" or "fine motor skills" or "handwriting help" and you will find some pretty detailed write-ups of activities to try.

Riding works, in my opinion, because it forces a child to constantly adjust balance in response to the horse's motion or change of gait, much as different balancing apparatuses do. There is some scientific evidence about its effect on the vestibular system, and also the contact with the horse leads to the release of relaxant chemicals into the brain. Grooming strengthens arms and core muscles, as does lifting and carrying heavy saddles, raking out stalls, and carrying feed buckets. Buckling buckles on bridles is fine finger work. All these are the same types of activities OT either incorporates or recommends. The bonus is most clear for an older child -- there is not yet another therapy with "work" attached, but a fun and totally engaging activity with a social element and a connection with an animal on top of it. My daughter was re-evaluated for OT at age twelve, but she had grown resistant to this type of work, whereas she would joyfully spend all day at the stables if she could, doing exactly the same sort of lifting, carrying, manipulating, balancing, etc. -- but for a real-world purpose. Also, OT is, as you have found, mind-bogglingly expensive if your insurance will not cover it. If you ride where you have to fetch, groom, and tack up a horse -- plus go through the same things in reverse when you are finished riding -- you're getting a good hour and a half of work for less than half the cost of a single OT session.

Either OT or riding -- or perhaps another activity altogether -- will work on similar areas and deficits. It's harder to replicate the benefits of riding at home, or on your own. None of us can do or afford everything. Nor should we try; we'd wipe out our kids and our bank accounts. From hard experience I'd say go for no more than two different activities or therapies at a time, and make them as different as possible so you're not paying for duplicating games or actions.

[Cindyg]

I think it's like a lot of things that look easy when a professional does them. And, yes, if you could do it at home consistantly exactly like the professional does, then, yes, it would be just as good.

But she's got all the incredible equipment that you can't afford, some of which won't fit in your home. Some of it is heavy and requires constant readjustment. (Our OT said she had to have the rafters of her facility reinforced to support the equipment.)

And she's got an expertise in knowing what your child needs now and what she needs next, what's not enough and what's too much, when to push and when to back off, what's normal and what requires intervention.

And she's not mom. She's an outside authority who can't be cajoled or put off. Now please don't be insulted. I'm not saying Moms are in anyway incompetent to deal with their own children. But this is not like a ps teacher dealing with your child among 30 others. This is one-on-one attention with an expert.

I will admit that I would not have been able to get my kid to lie on his stomach (just so) on a swing and catch balls tossed (just so) with a grip (just so) while I swung the swing (just so). If I had tried that at home, a free-for-all would have insued. DS would have been spinning the swing and throwing the balls all over the house. And within 45 seconds he would have been out of the swing and showing me something he could do much smarter than what I wanted him to do. Then I would have gotten frustrated...

With the OT, none of this happened. DS laid on his stomach (just so) and caught the balls (just so) happily and proudly for 15 minutes.

DS was so used to arguing over food with me that there's no way we could approach it therapeutically. The whole topic of food has become a hot button in our family. But for the therapist, he was so proud to show her that he could try a new texture. I'm sorry, but it just wasn't the same as if I had done it.

And, if I told DS we needed to do an additional handwriting worksheet, sitting in just the right chair with just the right posture, using just the right writing tool for his hand....it might not have happened. We were already arguing over handwriting. But, ds wasn't going to argue with the adored therapist who was carefully charting his success.

I could give you a thousand examples like this, and I'm sure you know what I mean.

Our OT was a fine, encouraging, professional person who was an important adult in DS life.

Did it change DS's life? It's hard to say since you can't do it once with OT and once without; but DS is doing very well, and we've never regretted the time or money spent in OT. I'm only sorry we couldn't stay with her longer. (We paid for two years out of pocket.)

I would say do OT if you can. If you can't, well, you just do the best you can at home; and, of course, there is a lot you can do at home. And, of course, I'm totally in favor of all the horseback riding a kid can get! Therapeutic or not! :)

[OhElizabeth]

Karen--I appreciate this! You're right, the horseriding and OT overlap right now. I think what we should do is do our riding, which does involve the hands-on, and then pursue the OT thing at the end of the summer as riding winds down. I think that's what was bugging me, that there was NO acknowledgement on the OT's part that the skills could overlap. She said it would work the core and not help much else. But maybe she didn't understand about the grooming before and after? Hehe, my dd's arm got SO tired, and she ended up doing a 1/2 job, simply because she didn't have the endurance and arm strength to carry it through and get the whole horse properly. And this was a small horse! And yes, it has a lot of buckles and things to work the fingers!

Cindy--That's really interesting to hear your story. I can see why your OT is so beloved! I don't have issues with compliance, and my dh can build me things I need. I think it might be financially more expedient for us at this point to do the horseriding, do the VT, and play games and do things ourselves in a concerted plan. Then in the fall, when the weather changes, we could switch over to OT. Did you visit them first before chosing your OT? I haven't even seen their facility or anything to have a sense of what it's like. It sounds like it could really vary from one practice to the next. And you're right, seeing things I CAN'T do at home would be a lot more reassuring.

Karen--I think you're right that there's a window to openness to this.

[momtotkbb]

Well, I do think that OT can be very valuable --and if you have any insurance that will pay then it's GREAT. We had our now 11 yo and our now 6 yo evaluated a couple years ago ---each eval was around $800. In both cases they rec'd OT ---different things were to be done w/ each ds w/ writing being more addressed w/ the older ds. Both therapists sat down w/ me and created a sensory diet of things that I could do and things that they would do. In the end when we finally got moved up in the wait list I was ready to begin, esp w/ my youngest, until I asked price ----our insurance if we met our deductible for the year of $5150 then our insurance would pay $1000 for OT in a calendar year. The price per hour was $385 and would go up to over $400 an hour of Jan. I almost fell over --they admitted that most of the people they see are ones on Medicaide or that have employer insurance that pays the majority. The therapists were very nice when I told them I just couldn't justify spending $770 a week on therapy.

I think an eval is very helpful and a plan developed --I'm glad that we did that part. The things they rec'd for us to do ----we began w/ skin brushing, we worked on times for requiring "dirty" play w/ glue, paint, dirt; climbing --they highly rec'd a play-yard so we purchased a large Rainbow set that has the monkey bars, climbing wall, tire swing, etc. that they were going to use in therapy; we already had a trampoline and a mini-tramp; large exercise balls; a squishy seat; squishy balls; chew sticks;rolling boards; etc. Our therapists even rec'd certain places where we could purchase some of the items. They even said that a gymnastics class for the little one would help --we had to work up to that but we did it last year when he was 5 and he had no problems.

It does require a commitment to implement it as part of school at home --you have to do it on a continual basis and not look at it as "just play".

[Laurie4b]

Is a lot of stuff the OT does stuff we could do at home if we just had a clue? I've read some people around here suggesting horseriding did as much good or was roughly equivalent. The OT I talked to today didn't seem to think that was the case, which of course was her prerogative when raking in $100 an hour, lol. She also said IM is a higher level therapy, working on executive function, and that you HAVE to work on the lower level stuff first, that it doesn't stick well otherwise. This makes sense and fits with some comments I had heard (irl).

How do I sort out the value of OT, when to jump in, how much to try to do at home to eliminate easy stuff I could have knocked out myself, etc.? For instance, I don't need to pay $100 an hour to have someone play putty and games with small pieces with my kid; I can do that. Am I crazy? Any wisdom here?

Oh, and just to be clear, I think what I have here is some degree of dyslexia. But the more I unpeel it, the more I keep finding things. I thought I could just sign her up and get her going with the IM this summer on top of the horse riding and VT, so that really threw me for a loop when she said we needed a $400 evaluation with fancy write-ups and $100 weekly sessions.

I could not have duplicated what the OT did for my child for the most part. The equipment they had was nothing we could duplicate without shelling out the same amount of money or more that therapy had cost and building a separate room to keep it in.

One of the things you are paying for with OT is the constant professional evaluation of what is going on. What may look like games-playing is playing the game, yes, but it is also a diagnostic session, all the time. The OT is collecting data with every interaction with the child and that is informing her next choice of activities and her recommendations to mom. My 10 min. sessions with the OT were invaluable for interpreting ds's behavior at home and for her figuring out what would be best to do next in tx and at home.

Given that you're doing the horseback riding and VT now, I'd suggest waiting before adding another therapy. (A lot of people buy into the OT before VT model on the same basis that the OT suggested waiting on IM. So you might want to ask your VT about that or at least keep really tuned in to whether progress is being made.) The horseback riding is doing some of what OT would do, so that's excellent.

So while it can look like you can do OT at home, I think that is misleading if you are working with an experienced OT.

[OhElizabeth]

Laurie-So is the standard to do OT first *then* VT? See the VT people won't tell you that, lol. They just want you to come in and get started. That's what I've sort of assumed, that you wouldn't make progress with the one till you worked on the other. I've been having her crawl, march, and now skip to work on cross-body motions. I guess that sort of sounds pathetic compared to OT.

I don't know, it's just so frustrating, because there are SO many angles and approaches. Everyone is willing to sell you a piece, and nobody has pulled it into a coherent whole.

[KarenAnne]

I don't know whether there is a general "rule" about which comes first, OT or VT. I would think it depends on your child's profile of strengths and weaknesses. Looking back, I wish I would have first done the extended, huge, fullscale neuropsychological evaluation we eventually went for, because that laid out a working plan for me. We did OT first, a number of years earlier, but as I mentioned briefly in my earlier reply, the target and hitting practice did not work well because there were unresolved vision and eye-body coordination problems that OT did not fix (in fact the OT recommended we have her eyes assessed after what she did was not helping my daughter make progress in that area). OT was great for general balance, but did not help my child's writing/fine motor skills or ball throwing/catching. It took the sports vision therapy to accomplish that, a few years later, and also the riding and stablework.

There is interplay between all these therapies, as you are discovering. No one can do it all, and as you go you find out things about particulars that lead you off in other directions. I don't think it's possible, or even desirable, to try to make too rigidly specific of a plan in advance. As with so much else in life, it's all a process; things change as you go along; your child will cooperate with one therapist and not with another, or hit a stage where any and all therapies become a process like that of pulling teeth and it's just not worth it.

Also, therapists differ greatly in their skills and in the degree to which they can work successfully with your child. The private practice OT who worked with my daughter was really, really good with her in certain areas and not at all in others (the most spectacular failure came when she tried to introduce social skills through a Carol Gray-type program).

If your purse and your psyche can stand it, I'd meet with someone in each of the therapy areas you are considering and milk that initial evaluation to the max. Ask all kinds of questions about what they'd do, what you could expect, what else your daughter might need, etc. Ask about all the elements you've researched and whether they incorporate any of them. As anything and everything you can think of that fits into your evaluation time.

I guess what I'm saying is: don't look for a magical, perfect combination, or order of therapies, or miracle-working therapist. You do your best, do what you can at home, follow a few different areas you think will be most helpful. It's like the search for that perfect curriculum: you gradually come to realize that what you really need is just something that works for you and your particular family circumstances and your child at the moment. Hard to do when you have a limited amount of time and money, and feel you need to hit the right things the first time around with no wiggle room. That's why the more specific, professional assessment of your child's needs and abilities you have going in, the more you talk to these people about the specifics of what they would do and why, the better prepared you will be to judge priorities.

[OhElizabeth]

That makes a lot of sense! You know the OT I talked with yesterday gave me a 1/2 hour of her time, which was very nice. Honestly, I think part of what I'm missing is what you see by being in their office. The stuff you see lying around clues you in to what they do. I felt much better about the VT after I saw their office.

You're right, I've been deeply afraid this wouldn't work. (the VT)

You know, I think your plan of attack is right. I could do everything we can do this summer, then in the fall, as horseriding and whatnot slows down, go in for the OT evaluation. She said she could do a short version, $200, which is the same evaluation but without so much fancy write-up. (1/2 price, my language!) So anyways, that might tell us better where we're at.

And you know, that thing you're describing is what I've been feeling. Some things need to change just to be functional, but some are like the 3 leg or having a conjoined twin; they're just how it is. There's a sense in which I *like* her how she is, *accept* her how she is, and I don't feel this need to be in this constant struggle over her or turn her into a medical problem to fix. She's WONDERFUL! She's social, pleasant, and incredibly good at certain things. I just need to make sure she *can* do the things she needs to do. But it seems like these OT's are almost like orthodontists, wanting to be perfectionist and fix everything, hang the cost or the pain or whether the body is bound and determined to be that way and will put it right back.

BTW, do you have any opinion on the Davis approach to this? Apparently he's the author of that Gift of Dyslexia book and has sponsored a treatment model. I don't really get it, but apparently you view your problems as distractions or obstacles, go through a week of counseling, and they go away. I know, sounds crazy, eh? But why would people recommend this guy's book so highly if he's a nut??? So I was confused on that. And it brings me to what I'm saying. I think some of these practitioners really think that if they could just keep treating your kid long enough and hard enough, eventually the problems would GO AWAY. I don't mean to be short-sighted, but that's like the orthodontist who thought I was meant to have straight teeth. You can straighten them for a while, but they'll go right back because that's how they're meant to be. Am I crazy?

[butterfly113]

Well, we are currently doing OT and Speech. Our ds10 was dxed with Aspergers. We started Speech in the fall for pragmatic language, and all the social stuff he struggles with.

We had a full neropsych eval done, and it was worth it. We started speech first. He needed to be able to recognize his emotions and learn how to express them. Learining to deal with anger and frustration. Things would either be at one end or the other. Completely content, or completely frustrated... and alot bc he couldn't express himself or understand what he was feeling. In six months of speech, he has grown leaps and bounds. I am constantly amazed at the changes we are seeing now.

Speech lead to OT. We began seeing more sensory issues and motorplanning issues. SO now we are doing both. We are working on Interactive Metronome and other activites in between. I could never do all that the therapists have done with him. However, I am learning along with him, and ways to help him more at home and we practice various things. So while we still work on speech and OT things at home, it reinforces what he has learned, and enables him to make more progress.
In 5 sessions of IM he has cut one of his scores in half! I am seeing more fluid movements, activity tolerance, endurance and so much more.

As Karen Anne said, there is no magic formula. We do what we can, as we can, and what is best for our kids. I am just learning this myself. For the last month I have been extensively researching RDI and neurofeedback. I want to do it all. I want to fix it... I am a fix it fox Momma! :lol: But I can't... and that's hard!

For now, it is speech and OT. We are considering neuro feedback in the summer months... IF we can swing it. I am going to get the RDI book, and go from there.

Not really sure what my point to you is... but trust your momma instincts, and be encouraged! I offer you big hugs!

[OhElizabeth]

Thank you butterfly! :)

[Laurie4b]

Laurie-So is the standard to do OT first *then* VT? See the VT people won't tell you that, lol. They just want you to come in and get started. That's what I've sort of assumed, that you wouldn't make progress with the one till you worked on the other. I've been having her crawl, march, and now skip to work on cross-body motions. I guess that sort of sounds pathetic compared to OT.

I don't know, it's just so frustrating, because there are SO many angles and approaches. Everyone is willing to sell you a piece, and nobody has pulled it into a coherent whole.

I wasn't specific enough with what I said. I'll try again: I think sensory integration issues (which are treated through OT) are core issues and other stuff (including much of the rest of OT and VT) is built on that foundation. So if the foundation of an organized nervous system isn't there, you keep trying to build something that is collapsing. That's a different question than should you do OT first for motor skills or VT first for visual skills in the case of a kid with visual motor problems.

And yes, the VT we initially spoke with said we should do VT first. I am so glad that I didnt listen to her, but to people on this board, who advised OT first for the sensory issues. My son had severe visual tracking problems and difficulty with focus. By addressing the core issues of the vestibular system and the proprioceptive system, the vision stuff got close to normal. Then we did need to go back to address some of the visual-perceptual skill development that lagged behind during the years when he couldn't process that.

Another reason, imo, for recommending OT first is greater acceptance among other professionals of the research base for OT ; you will find very few professionals outside of optometry who accept the premises of VT. Now, anecdotal evidence is that VT works for some people, but it is a long, expensive rabbit trail if it doesn't work. OT is usually paid for by insurance, or at least partially paid for, so there are some practical reasons to start with OT as well. The initial evaluation may be paid for in VT, but only a tiny number of insurance companies will pay for it unless there was an injury.

[OhElizabeth]

Lauri, I've been reading more and what you say makes sense. (Or at least I recognize the words!) When I talked to that OT for a 1/2 hour, she said it sounded like my dd's vestibular system needs work. The more I thought about what she had said, the more I agreed. I don't THINK she has a sensory integration disorder, at least not like what I've read about (tactile problems, etc.). But that vestibular issue, definitely.

So you're saying you worked on the vestibular and sensory through the OT and the vision problems about went away??? We THINK what we have going on with the eyes is fine focusing and convergence. So would THOSE things improve by working on the vestibular system??? When I asked the OT which should come first, she pretty much put it in the fix the most pressing problem category. The eyes are hindering her schoolwork, so fix those first. But I'm absolutely open to wisdom here.

I'm researching vestibular stuff right now and found a website with all kinds of detailed info on how to work on things yourself. Dd is game, so this is definitely something we can do. I'm going out right now to pick up some things for it! http://www.developmentaldelay.net/page.cfm/209

[KarenAnne]

I don't think anyone can know, beforehand, whether a child's vision problems will be resolved to a large extent through OT, sensory and vestibular treatments. I suspect it varies greatly depending on the child's particular difficulties and the neural connections. Sounds as though OT did most of the work for Lauri's child; for mine, it was the exact opposite.

I don't mean this in any way to take away from the work OTs do. My daughter benefited extremely from the vestibular therapy and I learned a huge amount about how to work with her better on a number of motor issues. But OT had little to no effect on her visual problems or fine motor handicap despite a whole lot of effort in these areas.

[mamato3 all-boy boys]

OhElizabeth --

Not an OT, but a speech therapist.....There is value in a thorough evaluation IMHO.....but a good OT (like a good speech therapist) will be able to design a home program for you and provide parent education so that you can get the biggest bang for your buck. Unless the OT is going to live with you and do therapy with your dd daily, there is an amount of parent follow-through via a home program that is essential for nearly any therapeutic activity to override learned (bad) patterns or habits. Two half-hr. (or two hr.) sessions a week just isn't going to work. Well, I take that back, it may work. eventually. but it'll work better if you are active in your dd program from day one (I'm saying that knowing you would be).

If you approach your OT with honesty about what you can and cannot afford, a good OT will work with you. I've done it with former parents of my speech patients before (a long, long time ago!) and have seen amazing --and fast! -- results.

Sometimes, professional pride gets in the way and we therapist think we're the only ones who can do "it" right.... Oops, sorry, I just realized I was starting to climb on my soap box.

I'm stepping down and moving away from it now....

[gingersmom]

If you are not happy with the OT you saw then I would look for another one. If you can't afford them to write up a whole report then tell them.

I don't put much stock in therapists reports anyway. I want them to get to work and then after working with my child for a year or more they can write up a report.

My son started in private OT at 3 years old (we did early intervention prior to that) and I don't remember them doing any written evaluation.

I could not put a price tag on the difference OT made for my son. He spent 8 years in OT (5 years I paid out of pocket).

[Laurie4b]

Lauri, I've been reading more and what you say makes sense. (Or at least I recognize the words!) When I talked to that OT for a 1/2 hour, she said it sounded like my dd's vestibular system needs work. The more I thought about what she had said, the more I agreed. I don't THINK she has a sensory integration disorder, at least not like what I've read about (tactile problems, etc.). But that vestibular issue, definitely.

So you're saying you worked on the vestibular and sensory through the OT and the vision problems about went away??? We THINK what we have going on with the eyes is fine focusing and convergence. So would THOSE things improve by working on the vestibular system??? When I asked the OT which should come first, she pretty much put it in the fix the most pressing problem category. The eyes are hindering her schoolwork, so fix those first. But I'm absolutely open to wisdom here.

I'm researching vestibular stuff right now and found a website with all kinds of detailed info on how to work on things yourself. Dd is game, so this is definitely something we can do. I'm going out right now to pick up some things for it! http://www.developmentaldelay.net/page.cfm/209

Well, I'm neither an OT nor a VT, so in this area, I'm just sharing our experience and what we were told. Our OT said he needed OT first and our VT said he needed VT first. What the OT said and her reasons made more sense to me and fit with the advice I got on this board. The handouts our OT practice gave me essentially postulated a pyramid of cognitive function. The vestibular system was on the bottom, supporting other cognitive functions. The vestibular system of my ds was really messed up. He didn't get dizzy when he should have, for instance. He needed very intense vestibular input to "get it." His eye tracking problems and ability to hold his eyes in one place were severely deficit. Once the vestibular system got what it needed and we intensified proprioceptive input, the visual stuff improved to "almost" (but not quite) normal. Prior to OT, the eye doctor couldn't get a look into his retina because he couldn't keep his gaze in the same place for even a second or two. His regular optometrist couldn't believe his eye tracking afterwards. He called it "almost normal" though he said it was clear Ds had to "think about it". The VT cleared the rest up (supposedly--I saw no difference with ds skipping words and lines while reading for instance; however his score on the test of visual motor integration improved hugely. His first VMI score was like 1% --almost rock bottom. After the first round of OT is was 15%. It stayed there until VT, when it came up to 45%, which is solidly in the average range.)

Anyway, that was our experience.

[OhElizabeth]

Lauri-Do you still have that handout to tell me what the levels of that pyramid were? That's EXACTLY what I went to know.

Alane-I appreciate your comments on this! At this point I've decided to go ahead and do everything *I* can figure out to do with her by researching online, building things, etc. and do it 1-2 hours a day, 3-5 days a week. That's way more than an OT would get in, and surely it will have SOME benefit, maybe even a lot. I mean, I don't have to get paid $100 an hour to have my dd throw me beanbags from a wobble board. We have the proper hanging swing at the park, so we can go there on nice days. I CAN do these things. I just needed the words for what I'm looking for. And you know what was really weird? As I walked through the stores tonight, gathering little things to use (weighted ball, small marshmallows, etc.), so many things started coming back to me of things my dd had REFUSED TO DO over the years. So now it's time to go back and do those things, one at a time, starting with the most simple. She avoided puzzles, even toddler and simple puzzles. She wouldn't color. I realized it isn't rocket science.

Anyways, that's my little epiphany. I'm pretty excited about the stuff I'm pulling together! And what's funny is SHE'S excited. I don't know if it's contagious or if the things actually interest her in a subliminal, challenge sort of way. I got her house building sets of legos, little beads you can arrange and melt together, a weighted ball to throw while swinging in the various positions, squirt guns, water balloons (I'm thinking you throw them while swinging, hehe!), marshmallows to sort with tongs. Someone gave us a CornHole game (which y'll probably don't know, think beanbag toss for grownups, a MidWest thing, lol), so we can do that while standing on the wobble board. My dh made me a wobble board tonight, and I got the lazy susan attachment for him to make me a spinning board next. We have access to the proper swing very close, but soon I'll have one in my yard. It's all coming together, and I can do a LOT of this stuff myself. I just need to make my checklist with what things work on what category so I can keep them balanced and go in the right order. Oh, and tomorrow I'm going to try to get a trampoline from my MIL.

I need to read about that Sensory Integration issue, but I don't think we have that going on. Other than vestibular symptoms, upper body weakness, and headaches from the eyes, I think we're good. She doesn't have any issues with tags or anything like that at all. In fact *I'm* the one who has had those issues, not her. I've told her anything I do to her, she can do to me. She liked the revenge idea, hehe. :)

[OhElizabeth]

Ok, I went through the checklist here: http://printables.familyeducation.com//tv/applets/print-pay.php?confirm_url=%2Ftv%2Fapplets%2Fprint-pay.php&direction=&action=PUT&page=%2Ftv%2Fprintables%2Ffe%2Fpc%2F0%2C%2C33724-1565%2C00.pdf&source_id=1248&app_id=50&property_id=2&email=etclaggett%40roadrunner.com&submit.x=0&submit.y=0&submit=submit which may or may not be any good. She had a ton of red flags in the vestibular category. She had just a couple for vision, which of course makes sense. She had 1 for proprioception. What surprised me was the number she had (3 out of 11) for touch. But you know, even there, I might be missing the root causes. For instance, she needed to be rocked REALLY HARD as a baby and STILL likes to be rocked. (This is only mind-boggling if you know that my dd is 5'3" tall!). She often goes out to swing and she likes me to rock her to sleep or at least cuddle with her. She was just always really intense about that need, still is. And she's sort of neatfreaky (by my standards, haha) about her hands while cooking. She seemed bothered by polyester as a child, with all those sleepers and stuff. She doesn't find tags or clothing problematic now. But that's not really that many things, 3:11. In any case, there you go. What do you think? I guess if you consider the clothing thing was years ago and not an issue now, then it's really only 1 or 2 out of 11. But the vestibular, that had 7 flags out of 9 symptoms. Guess we have something there, lol.

So you're saying the key is to work on the senses and those categories of senses where she has weaknesses, then move up to strength, processing, etc.? Interesting. Well we can book it on vestibular. That's definitely the plan. I got a whole page of great vestibular therapy ideas for us to work on, and I can find more.

[OhElizabeth]

Laurie- I did some more reading tonight, and now I get what you are saying. There's a reflex (actually several) connecting the vestibular system and the eyes. So that explains why my dd sees fuzzy all the time and has to choose what to focus on. Her vestibular system just isn't holding it quite in place! And of course that's why she falls a lot and bumps herself a lot.

She has no issues with tracking though, at least not that I know of, and her eyes open just fine. In other words, even though it's an issue, maybe VT will still work just fine? I can't even get IN with the OT I called until June, a whole month. That would push things off by months, and I need her ready to do schoolwork without headaches come fall!

So I guess we just need to do a lot for the vestibular system and some of the exercises to work those vestibular/vision reflexes. Any other thoughts? I mean I'll be SICk if OT would have resolved it and VT was unnecessary. And if I wait around for OT when I really need the VT, I'll be sick too. These things are so stinkin complex!

[Twinmom]

I don't know if this is helpful or not, but I did VT first, then OT with my DD who has sensory/vision issues. I'm in total agreement that the underlying vestibular issues and neurological connections build the foundation for good vision and that it would be best to address those first. However, since we had a severe vision issue, we saw that first in school and addressed it first. We only figured out the rest of the sensory issues after the vision cleared and we could see what was left. So, essentially we did it backwards but, low and behold, it worked anyway! She's made tremendous progress. Right now, she's in OT for sensory integration work, is addressing a few leftover, minor vision issues there and is also involved in horseback riding to great success (and pleasure...she's crazy about everything she's doing now!).

Essentially, the reason this worked for us, IMO, is the fact that we chose sports vision therapy. Our VT actually worked on some of the underlying OT issues while doing VT, and I think that made a big difference. Our vision issue was causing such severe school and social problems that it became critical that we address it...she was falling dramatically behind in school, couldn't stand it when I moved around the house, had big fits over school work, etc. We had to stop everything and do just concentrated VT for a three and a half month period...double sessions, 3x a week, nothing else. She jumped 2 1/2 grade levels of reading in that amount of time, stopped having headaches, calmed down at home and could perform in school. The underlying, remaining sensory issues became more clear, we realized we needed more and went for sensory integration work with a great O.T. The OT work is ongoing, but we don't expect it to go beyond a year and a half as we got so much done in VT and have horseback riding as an ongoing interest.

So...if I could do it again would I flip the order? Yes, absolutely...that would have been ideal. However, I learned about her issues in the order that I learned about them and we addressed the most pressing, obvious problem first. God was watching out for us and the sports VT was perfect. Now, we're knocking out the rest and are thrilled with the progress.

HTH in some way. I'm sure you'll make the right decision for your child!

[OhElizabeth]

Jennifer, that's very interesting! It frustrates me that none of the sports vision places I've called have a vision for using it for kids. They all want to train athletes. Maybe because we have so many sports teams here? So I think about the best we're going to get is whatever this VT place does and me doing things at home with her like what people have told me. And that's about the best description I've heard so far, that sports vision can merge the OT (kinesthetic, vestibular, sensory) side with the eyes. I'm absolutely concerned that regular VT views it too disjointedly. I don't see how regular VT alone could resolve the focusing problems if the real issue is the vestibular system. I guess all I can do is see what happens. I CAN do the vestibular things here at home concurrently, no problem. We have metal floor joists we can access in the basement, so my dh is going to hang me a single line swing. He made me a wobble board, and he's working on the spinner. So I think we'll get there. I'm just very nervous about the whole thing!

[Laurie4b]

I know. I wish it was all more straightforward, too. You just have to do what seems to make most sense to you at the time.

I don't have the handout anymore--that was 6 years ago.

[Twinmom]

Elizabeth, it sounds like you are on the right track! Good luck with all the therapy equipment!! If you are anywhere in NC and want my sports VT's name, just let me know.

[OhElizabeth]

Thanks for the encouragement! I've got to just settle down now and do what I know to do and hope for the best. We're in Ohio, so the sports vision therapists all have football on the brain, at least the ones I've called. (Football is the unofficial religion here. )