moomin, I agree that looking at everything in your dd's schedule and cutting back where you can is a good idea. I'd also suggest simply looking at *when* her different therapies etc take place. Trying to "work" (which therapy can be) at the end of a long day, especially for a child who has to put in effort to fit in at school, is tough. I think from what you posted above she's going on her playdates before the OT etc too - so that's even more energy she's drained of before going into therapy. I know you work, so I'm guessing scheduling OT etc earlier in the day is out of the question (?) - but if it's an option, I'd seriously consider it. She's still so early on in school that I can't imagine it would be a concern to take her out of school during the day for her therapy appointments. I still do that with my dds who are going through vision therapy, and they are much farther along in school. The way I see it, the gains they are making from therapy are more important at this point in time than what they miss out on at school.
Monday OT is for sensory integration. I honestly have no idea whether this serves any purpose whatsoever. When DD started she seemed to have a huge number of sensory seeking behaviors... and now she has slightly fewer... but much of that progress could just as easily be attributed to maturation and self-control.
Sensory OT is something that you can fill in a lot of at home. My suggestion here is to talk to her therapist and consider possibly stepping back to every other week for awhile, with you adding in some sensory work at home. For anyone who balks at that word "work" - the sensory "work" my dd did in therapy was actually a lot of fun and calming for her. I'd also, before cutting back any of the sensory OT, look at how she seems to feel and act *after* each session - is she exhausted, or is she happy, calm, etc? Have you watched her during the sessions? That might help give you an idea what the goals of the therapy are and whether or not they make sense. I was allowed to sit in the room with my dd during each of her sessions and her OT explained everything to me as well as making suggestions for things we could do at home.
Tuesday OT is for gross motor skills. During her time in this setting DD has made great strides in her coordination and physical strength... but she still LOOKS the same, because she actually never really had a gross motor deficiency, she's just physically careless.
I'd be really careful to assume she's just physically careless. She must have had some type of gross motor challenge or deficit to have qualified for an OT course of therapy, and you've noted she's made progress. It's possible there may be something else behind it other than simply gross motor delay etc - my dd who has a vision challenge looks completely klutzy and careless at times - but she's not, it's due to her vision. She also had low muscle tone in her trunk when she was your dd's age.
Wednesday CBT is for anxiety. I was unclear in my first post, DD only has one day of CBT. Her therapist says that she has never worked with an adult or child more clearly in-touch with her emotions and motivations than DD, and that DD seems to innately know what the correct course of action will be... but at 5 she just can't apply those skills. I've seen no real progress here.
I think that I'd drop a therapy that you aren't seeing progress in unless you understand the goals of the therapy and feel there's a reasonable explanation for sticking with it longer (for instance, perhaps the CBT therapist predicts it usually takes 6 months to see improvements in a child similar to your dd, but she's only been in CBT for 3 months).
Thursday Social Skills class. This is an odd one. There is no question at this point that DD is socially precocious, and that she has no trouble with social interaction; often at a much higher level of sophistication than her peers. She also has no real trouble "dumbing down" to interact with her same age peers. The major social problems that they're dealing with are, a) accepting that peers are not judging or thinking ill of DD, b) not overwhelming peers with love and attention, and equally not expecting absolute reciprocity and fidelity in relationships, and c) not acting out of fear or social anxiety in complex and dynamic social situations.
It's a bit tough for me to understand, given what you say your dd is working toward re social skills, how she is "socially precocious". From what you've written here and in previous posts, it sounds like social skills is an area that is worth focusing on. It's possible this isn't the ideal group for that work, but it's not something I would let go of without some serious consideration of finding another way to work on her social skills.
As to playdates... the reason that there are so many at the moment is simply because DD has so many friends from so many settings. She has two or three school friends who she loves to be able to monopolize in a one on one playdate after school. I feel like having this outlet makes DD more able to share her friends with others during the school day. Then DD has intellectual peers that she has accrued in different settings who she's able to talk and play with at a level that her school peers can't really match. These peers are generally 1-3 years older, and aren't able to interact with DD during the school day.
What about saving a few of the playdates for weekends? I'd also consider whether or not you're really seeing benefit at school from having the school playmates over for frequent playdates.
My last piece of advice is to look carefully at where and when stress is showing up and/or meltdowns are occurring. Is she a mess before therapies, or after playdates? Has she had a snack recently? Is it before dinner? If a therapy follows a playdate and she seems to be having a tough time transitioning into therapy - maybe therapy isn't the problem but the *timing* of therapy is the problem. It might be that overscheduling in and of itself isn't the issue, but instead the challenge is finding an order to the activities that makes transitioning easier. I'd also question - if she's going into her therapies already worn out from school and possibly a playdate, and you're questioning whether or not the therapies are working - it's possible she's not getting anything out of the therapies simply because she's tired.
Hope some of that helps!
polarbear
