So what exactly does an Occupational Therapist DO?

[AimeeM]

I hope nobody takes this the wrong way.

 

The Flying Marvelous Marco has now had several sessions with the OT. The OT was brought in, from what I was told, to help teach Marco how to be safer in his surroundings, and to curb some of the more intense "sensory seeking" (i.e. bouncing from couch to couch, running along the tops of couches, jumping from beds to hardwood floors, etc)....

 

but all she seems to do is HELP HIM to do these things. Today she helped him bounce (feet first) on the exercise ball she brought, which led to him wanting to jump on the couches, to which she said "no", talked him into coming to catch bubbles... and then picked him up to "swing" him to the bubbles, before throwing him (gently) on to the couch, and then encouraging him to climb the couch to reach the bubbles; then she wrapped his arms in a long scarf (kind of strait jacket style), which he then delighted in trying to get out (that was the point)... but one of the issues we were having with him was him trying to wrap himself in cords/jump ropes/whatever he could.

 

OT seems to just be giving him the "okay" to do the things we've been trying to STOP him from doing.

[Ausmumof3]

I have no idea about occupational therapy, but I know for my kids wherever possible I try to redirect an unsafe or unacceptable activity to something that fulfills a similar need in a safer or more acceptable environment. I.e. You're jumping on the couch. Couches aren't for jumping on but you have an awesome trampoline out there... Go use it.

 

So maybe she is trying to do something similar by giving him a safe alternative that provides an outlet for his need for movement.

[itsheresomewhere]

Ours was such a wonderful help.  She helped DS learn to function when his anxiety was getting to him, how to self sooth, how not to give me a heart attack by redirecting him to other options, along with writing/self care, etc.  She had him learn when he needed extra stimulation how to do other things.  For example- when he wanted to jump off the table she taught him how to apply himself in other ways and she taught me how to apply what he wanted (if that makes sense as it is kinda hard to explain).  When he was having a meltdown- how to calm down.  

[*Lulu*]

Our OTs have been wonderful resources. They have helped us deal with emotional control, sensory seeking and avoidant behaviors, social cues, fine and gross motor skills, and self care.

 

If you are curious, I would ask. Our OTs have always been very open to questions and willing to listen if, after a time, a strategy does not seem to be working.

[Storygirl]

I would ask this very question to your OT. She should be able to tell you exactly why each activity is meant to help your son. Sensory seeking children are sensory seeking for a reason (which may be different for each child). Sometimes they have a vestibular imbalance or need help with their proprioceptive sense. Sometimes they need a "sensory diet," which is a regular time of intense sensory input that meets that need, so that they are able to then function more appropriately without seeking stimulus.

 

My guess is that she is trying to fill his need for sensory experiences in a guided and appropriate way so that he becomes less likely to seek out sensory stimulus on his own. The trouble is that he will need this sensory input daily, so the OT should be teaching you how YOU can implement these techniques with him. Are you sitting in on the sessions? I would ask her to explain what she is doing and ask whether you should be doing each thing with him on your own.

 

Is she coming to your home? If so, is there a way that you can go to the OT office instead? It might help Marco to separate out that there are activities that are appropriate for the OT office but not appropriate for home.

[maize]

It sounds to me like she is trying to help him meet his sensory needs, but I can see your concerns about these activities feeding into the unsafe behavior when she is not there. I would discuss your concerns with her.

[Slartibartfast]

An OT works with life or work skills.

 

When we saw an OT it was to evaluate ds for nursing issues, he didn't have nursing issues but they were attached to the  nutrition office at the local children's hospital.

[AimeeM]

We can't go to their office. They do in-home (or school, or daycare). I really wouldn't be able to anyway - I only agreed (he has two other in-home therapies weekly, and I still have two other, older, kiddos to teach - and one medically fragile kiddo who spends pretty considerable time at the outpatient hospital with his specialists).

 

My problem is that he's trying to do the same things when she ISN'T here, and with other things. For example she had a blue square on wheels. She tried getting him to sit on it so she could pull him around the house, but he wanted to stand on it (skateboard style) - she did allow it (while she held him steady), but now all night he's been trying to do the same thing with a rectangular magnatile on wheels (part of a car)... and use it as a roller skate.

 

I will talk to her about it, and I'll ask his EI (Early Interventionist) when she visits next (she comes once a week as well, to back up with the OT and the ST are doing).

[redsquirrel]

She is trying to help him meet his sensory needs. If he is wrapping himself up (a common thing) then she is giving him a safe way to do it. You could try getting something similar to what she has and letting him use that himself, with supervision. If that is his chosen coping method then it might be easier to work with him than against him. 

 

Bouncing etc is a pretty common OT thing as well. Jumping provides a lot of feedback and many kids find it very soothing.

 

Talk to her, you are on the same side. If you don't want him every jumping on the couch then tell her that.   But what she does is going to be physical. I am not sure of a way around that.

 

All the OTs who worked with my son were always hoping that I would ask for ways to address the issues at home myself. They had a lot of ideas and options for meeting my son's need safely.

[Momof3littles]

All of us regulate ourselves up and down throughout the day.  I think many of us remember sitting in class in college lectures, tapping our foot, unwrapping some gum, opening up a soda or drinking a coffee, quietly drumming our pencil on our notebook, etc.  Those are pretty socially appropriate ways to regulate ourselves so we can pay attention to a lecture.  Kids with more intense sensory needs may need more intense ways to regulate themselves up and down, or sometimes they choose ones that are less socially appropriate (chewing on sleeves vs. some gum, kicking their neighbor's chair in school vs. lightly tapping their foot on the floor). 

 

So yes, OTs help kids who are sensory seeking and sensory avoiding meet their needs and modulate themselves.  They may provide a sensory diet to help them manage themselves throughout the day, attend to the teacher or other tasks, etc.

 

As kids get older, they work with them on learning to identify their needs and regulate themselves.  There are programs like How Does Your Engine Run? that are targeted to teaching kids to regulate themselves over time.  

 

She should have no issue addressing your concerns.  Just ask. eta: Agree 100% with Storygirl with respect to the rest of the week. Are they teaching you and working with you?  They should be working with YOU on how to help him during the week.  One session per week or so with EI really isn't enough in and of itself; the assumption in EI is that the therapist will work with the family and teach them the skills.  That's really the point of EI in the first place. She should be demonstrating things you can do to help him, how to set up a sensory diet, etc. Are you getting that from sessions?  If not, ask to sit in, ask questions about why and how, ask how to set up areas of your home to meet his sensory needs throughout the week, how to keep him safe and set boundaries with what is reasonable for him to do.