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My 9 1/2 year old son had his occupational therapy assessment yesterday and he starts OT for his motor dyspraxia and hypotonia on the 25th. He saw the same OT that tested him two years ago and this time she said he definitely needs therapy because he definitely has motor planning difficulties. I don't quite understand why she didn't see this two years ago. Maybe she used a different test or something and I guess it doesn't matter now, but I spent many, many hours trying to figure this out and made myself crazy at times worrying about what was wrong with my son and doctors were not giving me any answers. My son even got upset about me worrying so much about it and thought I didn't like him the way he was. At times I doubted that there was really that much wrong if the doctors couldn't see it or didn't think it was that big a deal. Other people could see it. Some people told me he had to have Aspergers because he figured out how to read on his own at 2 1/2 and liked to use big words in his speech but had the sensory issues which caused some quirky behavior when he was very excited. My sister still insists that he must have Aspergers even though the developmental pediatrician and the OT and his regular pediatrician all say that he does not.

I am reading the book Sensational Kids and I see now that I am not the only one who has had trouble getting help for a child with sensory issues.

My son liked the OT. Not only did she test him, but she first talked to him and asked about the books he liked to read. He told her that he liked to read classics but that his favorite book that he read recently was The Giver. When she told him that she also read it and liked it and also knew all about Japanese manga and other things that he was interested in, he said he thought maybe she was a little "outside the box" too.

He said the testing wasn't that bad, but he said he fell once during one of the tests and hurt himself in a place that he didn't want to mention, but it reminded him of a line from a song--Goodness gracious, great balls of fire!

There wasn't enough time to talk to the OT about all the results of the testing so I will have to wait for the report she is sending me.

She says it is not too late for therapy to help him, but she didn't tell me what the therapy will be like.

Finally, I think he will get the help he needs.

Lori,
I am so glad that your son�s needs are finally being addressed. I share your frustration that the same OT could see the issue this week, but not two years ago despite your insistence.

When evaluating my daughter, the school educational team, not only were unable to identify any problem they were actually hostile to me and implied that I was trying to invent some malady with my own daughter. In our case, everyone with a PhD or MD thought I was on to something or confirmed that I was. Even though my concerns were eventually determined to be valid, the presumed needed speech therapy sessions would fall to one of the school district hostiles. We, for obvious reasons, choose not to pursue it as long as her grades and achievement levels remain strong.

Your son�s case seems like more of a socialization obstacle amongst people who are not well acquainted with him. It is important that he learn strategies for improved physical coordination. Despite the OT missing all this the first time around, she seems to have a positive rapport with him now, so maybe she will apply her skills twice as hard to make up for the miss earlier.

I think some of the difficulty goes back to the notion of non-linear (or conceptual) intelligence. Some therapists do not have the type of intelligence that allows them to connect seemingly unrelated concerns. They miss the subtle complexity and intricacy present in the less than obvious cases.

Good luck to your son with his OT.

Oh Lori!
What a relief - I sure hope it goes well. FWIW, when my son was being evaluated for NVLD, but the school, the OT, the PT and the gym teacher all took a 'quick look' at him and assured me and the 'team' that there were no problems. I got an outside eval and his gross motor was at the 5%, etc! I ended up crying in the Principle's office due to being treated like I was 'wrong for trying to follow my doctor's suggestions' even though now I question the diagnosis, and wonder how the doctor missed the giftedness, or didn't mention it anyway - those were the scores that got DS11 into YSP. So anyway, the Princ said: "Lets try him in the OT/PT groups" so they did, and within 6 weeks the OT saw me in the hallway and said, "I didn't see it at the eval, but now that I know him I can see that he really needs to be there!"

It sure did make me feel better. And the activities really seemed to help. My prayers are with you!
Grinity

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!