Hi Lori.
I'm so glad that you found some success this time. As a parent I certainly know how frustrating it is to be sure that there is *something* going on and yet no one else sees it or they all see something else.
Speaking as an OT again, I think that I can shed some light on why the same OT missed the signs two years ago. Here are some reasons I've encountered in my professional experience:
1)the OT has two more years of experience - in testing, observations, analyzing and synthesizing information, in knowledge and clinical skills. She may have taken more classes or had clinical experience that has improved her abilities.
2) your son is older and now can no longer compensate for the deficits. Sometimes in a brief OT evaluation session I have to REALLY push a child to find what the parents are reporting. By that I mean that the child can compensate and so "looks good" on most of the typical stuff I have a child do. I sometimes have to really listen to the parents and then adapt my eval to have the child do certain things in the clinic that weren't evident at first. This is very true for smarter kids who are able to use vision, auditory input, logic and reasoning and/or cognitive processing to compensate for deficits. It is also true for me, after 18 years of practice, that sometimes I don't see the level of impairment until I've worked with the child for a few sessions and then built a rapport with him/her.
3) OT is based on the "art of therapy" as it is called in our literature. That means combining the scientific knowledge of neurological and other medical conditions along with the knowledge of behavior, social issues, cultural issues, emotional issues, etc. It does not occur in a vacuum and you can't isolate things out. It takes a certain amount of expertise and ability to combine it all successfully. Perhaps your therapist just needed to build her "art". She may have missed other kids two years ago as well.
I know it is hard to let go of the sense of "lost time" but try to focus on the fact that he is now getting the help he needs. It isn't too late and I'm sure he'll have a good response. Sounds like he and the OT are off to a good start!
