Ever underwhelmed with OT for low tone and SPD?

[hands-on-mama]

I mentioned some on the other board, but thought i would post here. My 5 year old has been going to OT for about 6 months. I have been less impressed. Typically during a visit, she swings on a barrel swing, practices mazes, practices using scissors, and sometimes does some practice with a balance ball. That's pretty much it. Nothing is really done for the SPD. They gave me a brush and told me to buy a vibrating toy. :/

 

Well, the girls are starting gymnastics. They offer open gym twice a week on top of their lessons. I'm thinking that instead of OT, we would try doing our lesson each week and then an open gym session every other week (we drive 40 mins away).

 

Idk. What do you think? Those who have been there, what would be most worth it for our time?

[PeterPan]

Are you paying for it? Our OT sessions were $100 an hour. She accomplished more, but dd was older. That certainly doesn't sound like what I'd pay money for. I don't think the problem is the idea of OT but the particular OT. I just have a really bad attitude about this though. Ours was good but hairbrained, and we finally quit. It might be interesting for you to contact another OT in a totally different practice, say someone who does Interactive Metronome, and see what working with them is like.

 

The gym time isn't really replacing the OT. In our sessions you could tell she was going through a list of types of things and just changing up HOW she worked on them. You have tone, vestibular, weight-shifting, bilaterality, etc. Gymnastics won't work on that stuff specifically. You can install a single line swing in your house and make your own weighted collar.

 

After we stopped, I found some more options for OTs who were open to doing once a month with homework. That would have been a much better situation for us. I think sports are *good* for these kids. I just think you can also develop pickles down the road if you don't realize the things the OT was helping (or could have helped) and nip them. My dd still has issues with handwriting, etc. that could have been nipped if they had been caught at 5. So I think when you can find an OT (or PT) you like who actually teaches you a lot and gives you good homework and isn't just checking off boxes, then you've got something worthwhile.

[hands-on-mama]

The OT is paid by our insurance. She has mentioned the metronome, but we have never done it with her. Handwriting was the first reason we sought out an OT.

 

The OT told us she had low tone, she's stronger on one side, and agreed with my thougjts on SPD. We don't have many options for therapy around here. My husband works for the hospital and insurance will only pay for the facility that is associated with them. I'll see if there is anyone else though.

[Jennifer-72]

I agree that it may just be the OT you are seeing. Our OT and PT have always set very measurable and functional goals that we check progress on every 12 weeks or so.

 

I do think that gymnastics is a great addition to OT. It does provide for lots of vestibular input and great work for overall locomotor function.

[texasmama]

My son has received OT for the better part of 9 years, specifically for SPD, though it addresses handwriting and other fine motor skills in addition to the SPD. Not all OT's are skilled at working with a child who has SPD. Also, what I have learned is that sometimes very simple exercises which appear to be nonsense on the surface are actually quite effective when done over time. My son's OT has been very invested in helping him overcome his SPD, and he has made amazing strides under her care. OT has been the number one best intervention we have ever done with him, and he has had plenty! I say all of this to encourage you not to dismiss OT out of hand. Also, OT is often a "long haul" program. My son received years of quality OT before his retained primitive reflexes were greatly diminished. So I would encourage you to seek out an OT who is passionate about and knowledgeable in the treatment of SPD. We found our wonderful OT through the public school system, so his services are free.

[hands-on-mama]

Thanks so much for the input. My daughter also has some retained primitive reflexes. I'm going to start being more diligent in fitting fun exercises in our day as well. I may put a call in to the school system and request an evaluation from them.

 

I also found what looks to be like an awesome therapy location about 40 minutes away. I may call just to get some information.

 

Thanks again!

 

[texasmama]

OP, the curriculum that my son's OT uses is called "Ready Bodies, Learning Minds". I don't know if it is available for non professionals to purchase, but it has many exercises with diagrams on how to do them correctly. It would be worth looking into.

[Crimson Wife]

The problem may be that SPD isn't a recognized disorder under many insurances. Because of this, the therapist has to be very careful in how he/she writes the goals to make sure that there are enough ones the insurance will consider legitimate. We have a fabulous OT and he really tries his best to make sure that DD gets the sensory treatment incorporated into the sessions he does with her. There is another OT clinic that specializes in SPD treatment, but we'd have to pay something like $150 per session out-of-pocket on top of the gas to drive 40 min each way. So unless things change dramatically in terms of our budget, that's not going to happen.

[Dmmetler]

DD was helped more by gymnastics than by OT. Having said that, though, my insurance would only cover a few visits for "Evaluation purposes" for OT, so we had short bursts where the OT would mostly suggest things I could do with her at home, so I was doing all the work, and for the most part, most of what she was suggesting was right out of the "Out of Sync Child" books. And DD was able to get into gymnastics with a coach who was in grad school for OT and was doing her master's thesis on using gymnastics as a form of inclusive therapy, and was selected as one of the coach's study participants, so she essentially got OT at gymnastics. The coach has long since graduated and moved on, but she's been able to have a series of coaches who, for the most part, are interested in special needs and in working with kids professionally (majoring in things like pediatric nursing, special ed, early childhood education, and so on) and are at least somewhat aware of sensory integration issues and in working with them.

 

I will say one caveat-open gym at our gym doesn't work well for DD because it's too loud and chaotic. She loves being in the gym, and works hard to be there, but it's just too much for her. I have her in classes currently 2x/week, at times of day when the gym is less active and where there are fewer people there.

 

This isn't a concern for you for a few years, but at about age 7 we found that we needed to change the kind of classes, because the classes DD had been in were, through level 2, basically just a feeder for the competitive teams, and DD was getting passed, regularly, by kids 2 years younger than she was. We moved her, instead, into a program designed for kids who were cross-training but did other sports or dance, where they were focused on developing strength and flexibility, and where a lot of the girls are in the 10-16 yr old age range, and that's been a great fit for DD for the last year.

[texasmama]

Sports and gymnastics of any type are great for kids with SPD. My son has played basketball since kindy and has added baseball recently. His OT worked with him to improve his batting swing by taking his batting gloves and weighting them, which gives him proprioceptive feedback. I will be forever grateful that we landed in a terrible school district which happened to have the very best OT services for my son. His therapist has worked tirelessly for years to help him, and none of the services have cost us a dime. Also, the school district is small and I know the special ed department staff so they have worked with me to qualify him for services when he really doesn't qualify by school district standards. My SIL is an OT with a local, large school district, and she hates doing SPD therapy and avoids it whenever possible. My son's OT just happens to have a true passion for it and will quote research on how motor labs improve kids' reading skills. She is a true believer. I get emotional when I think of the benefits that her services have provided my son. This is his last year of OT. He will "graduate" in May. I will write her, the special ed department and the superintendent of the school district letters about her and the services we have received through the years. In the entire county (large-ish one), this particular school district has the bottom of the barrel lowest SAT scores - but it was exactly what my son needed in terms of special services, and he would not have gotten it anywhere else. (Please excuse my lack of paragraph breaks - IE will not allow them on this website...)

[PeterPan]

OP, the curriculum that my son's OT uses is called "Ready Bodies, Learning Minds". I don't know if it is available for non professionals to purchase, but it has many exercises with diagrams on how to do them correctly. It would be worth looking into.

 

Interesting stuff, thanks for sharing!

[laundrycrisis]

I think the individual therapist makes a huge difference. They have to be doing more than just going through the motions of a therapeutic exercise. The OT who sees both of our kids is intent on pushing the envelope with each of them - every session she has them push to the limits of what they can do in a certain skill area.

[hands-on-mama]

 

 

Interesting stuff, thanks for sharing!

 

 

i will look this up!

[hands-on-mama]

Sports and gymnastics of any type are great for kids with SPD. My son has played basketball since kindy and has added baseball recently. His OT worked with him to improve his batting swing by taking his batting gloves and weighting them, which gives him proprioceptive feedback. I will be forever grateful that we landed in a terrible school district which happened to have the very best OT services for my son. His therapist has worked tirelessly for years to help him, and none of the services have cost us a dime. Also, the school district is small and I know the special ed department staff so they have worked with me to qualify him for services when he really doesn't qualify by school district standards. My SIL is an OT with a local, large school district, and she hates doing SPD therapy and avoids it whenever possible. My son's OT just happens to have a true passion for it and will quote research on how motor labs improve kids' reading skills. She is a true believer. I get emotional when I think of the benefits that her services have provided my son. This is his last year of OT. He will "graduate" in May. I will write her, the special ed department and the superintendent of the school district letters about her and the services we have received through the years. In the entire county (large-ish one), this particular school district has the bottom of the barrel lowest SAT scores - but it was exactly what my son needed in terms of special services, and he would not have gotten it anywhere else. (Please excuse my lack of paragraph breaks - IE will not allow them on this website...)

 

 

I think I will definitely call.the school district and see what they have to say.

[texasmama]

I think I will definitely call.the school district and see what they have to say.

 

You may be able to get an evaluation (and services). Laws vary from state to state, but in Texas, homeschoolers are able to access "walk in" services if they qualify using the same standards that a public school student would use to qualify. Also in Texas, the school district must evaluate the child if a parent makes a request in writing for a "full and complete individual evaluation". I would encourage you to google up the laws and rights in your particular state prior to approaching the local school district so you are coming to the process informed. Texas has these available online, and I would imagine that other states do, as well. Special education services can be quite a tangled mess to understand and navigate for the average person with no experience with the system.

[Barbara H]

Every kid is different. just to add our one little data point - therapeutic horse riding and physical therapy accomplished a lot more for us. We had very good OTs, it was just that the specific activities of PT and riding were better for core and trunk stability and those turned out to be most fundamental.

 

I do think if you aren't seeing the results you expect it is good to question what's working and consider trying something new. If you have not shared your concerns with the OT I would encourage you to do so.

[IceFairy]

Molly has hypotonia and SPD. I pulled her OT last September because there was no progress. The OT was not doing anything I didn't/couldn't do at home...except she was getting real snippy with my kid and threatening to take her lovey away for not focusing and pushing me to put her in Headstart. I kept her in equine therapy and work with her intensely myself and her improvements have been huge. Her sensory issues, especially her fears of noise and her aversion to smells are getting milder and she is now writing her name!!!!!!

[hands-on-mama]

Molly has hypotonia and SPD. I pulled her OT last September because there was no progress. The OT was not doing anything I didn't/couldn't do at home...except she was getting real snippy with my kid and threatening to take her lovey away for not focusing and pushing me to put her in Headstart. I kept her in equine therapy and work with her intensely myself and her improvements have been huge. Her sensory issues, especially her fears of noise and her aversion to smells are getting milder and she is now writing her name!!!!!!

 

 

That's awesome! I have never thought of equine therapy!

[AngieW in Texas]

The OT I used for my middle dd was wonderful. She actually came out to our house 2x/month for 3 hours to evaluate my dd, come up with what we needed to work on for the next month, and then teach me how to work on it with her. She was a brand new OT who had just gotten her license. I did the vast majority of the work, but I never would have been able to figure out the steps to get her from where she was to where she needed to be. The OT was a genius at finding just the right intermediate steps that were challenging but doable to get her skills heading in the right direction.

 

I think your issue is the specific OT you are seeing.