Evaluations for dd8??

[jkl]

  My daughter turned 8 in October.  She has always been quirky.  When she was a baby, we joked that she just barely tolerated us because she seemed very detached. She was late in gaining speech, but now her language is normal--she is a chatterbox.  For several years, she has shown an age inappropriate need to chew:  First all of her toy(legs and ears and wheels chewed completely off!)  and now that she is older, her body (she bites her toes and there are raw areas where the skin has come off, the sides of her mouth till there are swollen areas, etc.)  She has been tested for pica and all vitamin deficiencies.  She goes around smelling everything and seems to seek out smells that most people would find unpleasant (a dirty diaper, for example).  She is a hand flapper and spends lots of her free time walking around flapping her hands and whispering or singing to herself.  She can't quite explain why she's doing this, and only says that it "helps me think better".  She used to have lots of problems with anxiety (extreme fear of dogs, etc) but that has gotten much better this year.  Lately she is saying that she can't stop thinking "3 things at one time" or that her thoughts are going "too fast".  The other day, she asked dh if there was some kind of surgery a person could get so to make a thought go away.  She is extremely shy, and has a hard time expressing herself when I ask about any of these behaviors.  She seems happy most of the time.  She still holds her pencil in a fisted grip and often switches hands because her wrist gets tired.  She is working about a year behind grade level in everything but reading--she is now reading on grade level.  Yay!  She has a hard time following directions and seems distracted a lot of the time.  I often have to repeat my requests to her multiple times before she seems to "get it".

  Last winter, she had an OT eval.  It was determined that she needed services. She was seen for 6 sessions (half of these were rescheduled or canceled at the last moment).  After the last session, the OT told me she was putting us on a consultative basis, told me to use a pencil grip to address her handwriting issue and showed me some things on her laptop I could order from Amazon to address her sensory needs.  She said she'd check in with us periodically but we never heard from her again.  I have been working on hand strengthening activities with her and have made her a sensory box.  I used to work in special education, but my students were all severely language delayed, so I'm a little out of my comfort zone with this.  I need more direction!  

   I'm certain she has some fine motor delays and probably some type of sensory processing issues (she is a sensory seeker for sure).  We have an appointment with a different Occupational Therapist after the fist of the year.  is there anything else I should be looking into?  I'm wondering what I should expect from an OT?  Surely more than we got the last time!  Anyone have any advice?  Thanks!!

[OneStepAtATime]

Yeah, the OT you went to sounds like a waste of time.  That stinks.  Definitely try to find a better one.  I would look at a broader evaluation, though.  Can your pediatrician recommend someone?  And I would post this on the Learning Challenges board...

[jkl]

Thanks--I just cross-posted it over there.  As for a broader eval--I'm not sure what type to pursue??

[AggieMama]

I would look into doing an Autism evaluation. Many of the indicators seem to be there, but it is a very broad spectrum.

[maize]

You've got potential flags for autism, ADHD, OCD (intrusive thoughts, possibly some of the chewing/biting/muttering), sensory processing disorder, anxiety...

 

A neuropsychologist or a developmental pediatrician would be a good place to look for evals; your pediatrician may be able to give you referrals and insurance should pay for evaluations as these are all medical conditions.

 

Best wishes! Some kids are complicated but the more information we have the better we can help them develop to their full potential.

Edited December 31, 2016 by maize

[displace]

I second a developmental ped eval and probably a Neuropsych (because you mention she's behind grade on things).

 

Developmental ped can diagnose autism spectrum, sensory (if the OT eval lists enough symptoms or the interview is clear), and refer to services. The Neuropsych can diagnose if there are learning disabilities, what may need to be changed with regards to teaching. They can also maybe diagnose autism spectrum disorders, so it may be worth starting there instead. But, Neuropsych Evals are $$$, and developmental ped should be covered by your insurance.

[Tanaqui]

I agree with everybody else here - just glancing at your post sounds like autism (flapping is the big one there), OCD, and the sensory processing and anxiety issues you already know about - both of which are frequently comorbid with either autism OR OCD (which, of course, can be comorbid with each other). Also maybe ADHD or even an auditory processing disorder - honestly, it looks like a lot. Which isn't surprising - when you're neurologically atypical in one area, it's pretty common to be atypical in other areas as well.