Another OT Question

[MicheleB]

We live in a very small rural town (pop. < 4000). However, the local hospital does have two OTs, one of whom deals with sensory issues.

What questions do I need to ask to ensure that she is qualified to truly deal with SID (or whatever it is called now)?

[Kathy in MD]

We live in a very small rural town (pop. < 4000). However, the local hospital does have two OTs, one of whom deals with sensory issues.

What questions do I need to ask to ensure that she is qualified to truly deal with SID (or whatever it is called now)?

the full certification includes several parts, including managing a clinic. You would be most concerned with her clinical certification (I may have forgotten the correct term)

However some good SID OT's don't have any certification. In that case, ask how much hand's on training she's recieved in SID. Also were the people she trained under certified?

I'd ask how long she would expect theapy to last. Some OT's will treat forever, or so it seems. Other's plan on a year or so. Also ask if you can talk to some of her clients, current and past. And you also want to see what sort of chemistry she has with your child. Some OT's have great credentials, but they may not work well with a child like your's. I interviewed a well trained OT that couldn't deal with a hyperactive boy. What she was doing in the field was beyond me.

I wouldn't worry about how much fancy "stuff" she has. She will need some equipement, a net swing is probably the most important item. But a lot of other things can be improvised.

[MicheleB]

One of my concerns comes from talking briefly with another mom whose son has Aspergers. He received OT at school (same therapist) and she said he "just ran around the room with a giant ball." Kind of sounded like she felt it was a waste of time. And since I really have NO CLUE what an OT would do, I just wanted to be prepared.

For example: My son has clothing issues, food issues, and probably some handwriting issues. I'd like to at least know if what the OT did for treatment was off-the-wall.

Thanks for your answer! I'll see if I can find some others that have used this OT and maybe this other woman would be willing to give me more in-depth info about her ds's experience.

[Kathy in MD]

One of my concerns comes from talking briefly with another mom whose son has Aspergers. He received OT at school (same therapist) and she said he "just ran around the room with a giant ball." Kind of sounded like she felt it was a waste of time. And since I really have NO CLUE what an OT would do, I just wanted to be prepared.

For example: My son has clothing issues, food issues, and probably some handwriting issues. I'd like to at least know if what the OT did for treatment was off-the-wall.

Thanks for your answer! I'll see if I can find some others that have used this OT and maybe this other woman would be willing to give me more in-depth info about her ds's experience.

There should also be a lot of variety, but if the therapist didn't explain things, the play could look like a waste of time. Even if this particular therapist was doing a good regime, she apparently was extremely poor in educating and involving the parents. You may want to consider another therapist for that reason alone.

My ds's first OT was very much into parent education, so I learned a lot about the purpose behind the "play". For example, my ds played a lot of ball and racket games. Some of the things this did was work on hand-eye coordination, crossing the midline, sound reinforcement of the physical impact of the ball and racket, muscular control, etc. A swing was used to relax my ds, to push his inner ear stability, to strengthen his core muscles, desensitize him, etc. Other activities included motor planning. This included lying in a swing and announcing the order he would pick up various things and then doing it. It also included hopping along a maze. There was a lot more activities and variety, but almost all looked like play. And that's why the kids love it. We had to switch OT's because our first moved, so we saw very different materials used in for similar results. That's why I can't say that your OT should have the following equipment and do a, b, & c ..

A few more commens. Some OT's wouldn't touch your ds's handwriting until he was near the end of the therapy. Other's would address it much sooner. My ds didn't have eating problems, but I know one OT who went to a patient's home to help her learn to eat (she had severe problems)

One other thing that the therapist will probably teach you is how to do "brushing". This is literally taking a plastic brush with a very specific texture and "brushing" your child's arms and legs with it. She may also include a "compression" aspect to the brushing. If she lets you use any brush or hands you a brochure and says to follow it, run. Doing brushing incorrectly or using the wrong brush can make things worse.

Forgive my rambles. I'm tired and can't make this post coherent, but I thought that you might glean something worthwhile.

[Claire]

For example: My son has clothing issues, food issues, and probably some handwriting issues.

My dd had hypo-sensitivity of the lips and tongue, and she was a very picky eater about both tastes and textures. The OT showed me how to run a finger (encased in plastic finger glovey-thing) around dd's mouth and inside her mouth to "wake up" the nerve endings there. The OT also had a structured, sequential protocol for taste. She would place a lemon drop, for example, on my dd's tongue for a few seconds. Cinnamon hots were another. Each session the length of time was extended. This was, I think, designed to extend the range of tastes and intensities that my dd could tolerate.

For hand strength, the OT hid tiny dinosaurs and marbles in a big glob of silly putty type stuff (it comes in different consistencies from weak to strong) and had my dd dig them out one by one.

There are a *ton* of different activities an OT might implement. A lot depends on the individual child. Mine did not need the swinging activities or any of the gross motor type activities. We did do brushing for awhile.

[Laurie4b]

Our OT experience was similar to Claire's with regard to the brushing (that would help with the tactile defensiveness) and the exercise with the mouth for food sensitivities. OUrs didn't do the taste thing, but that might have helped.

[Claire]

I forgot to add that you probably can't judge the OT by that one person's school experience. Schools typically do not allow OTs to address sensory integration issues unless they are directly interfering with learning (something that can be hard to prove). So, schools may not stock all of the equipment for sensory integration therapy, plus OTs may be instructed not to provide that kind of therapy in the school setting. Traditionally OTs in schools have been more oriented to strengthening gross and fine motor skills, teaching how to tie shoes, how to hold a pencil, how to form letters, etc.

[MicheleB]

It turns out it was a different therapist anyway, but I think part of the problem was this woman just didn't know what she should expect out of OT. She said it was obstacle course type stuff, which would make sense to me depending on the issue....

[Kathy in MD]

It turns out it was a different therapist anyway, but I think part of the problem was this woman just didn't know what she should expect out of OT. She said it was obstacle course type stuff, which would make sense to me depending on the issue....

I agree with you. I could see this used in many ways for my ds, starting with motor planning. Depending on just what items were included in the obsticle course, balance and building core muscle strength might have been part of it.

[tonygirl]

I sat in on the OT sessions for a yr or so. I learned alot by watching and asking a ton of questions. I made a list of concerns and asked my OT and she was able to give me a reason for 90% of my concerns. I don't rcommend sitting in for that long I had no choice with my child but I think watching really helped me. I have a therapist that treats each of my kids as indivduals no one size fits all method I really think that is important. I think have a peds OT that specializes in Sensory Disorder as well as regular OT stuff is a must for our kids