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.