My oldest child started OT, Speech, and Developmental (this was for self help/self care and to pick up slack in other areas, such as PT which he perenially ALMOST qualified for but not quite).
When he started therapy, his fine motor and sensory integration issues were huge. He was almost three years old when he started OT and had not developed a pincer grasp. That is a 6-9 month fine motor skill! He could not feed himself, except by shoving fistfuls of pasta in his mouth which smeared the sauce all over everything and every bite was followed by a screaming panic over the sauce being on his hands. Him feeding himself was a big production that involved several washcloths on standby to wipe his hands off after every bite. He also wouldn't eat anything that didn't have an absolutely smooth/soft texture. He couldn't stand movement. Even being placed on one of those swinging boards that OTs have was cause for a screaming overstimulation based fit. He did not want to be carried, rocked, in a bumpy car, etc. He couldn't tolerate the textures in clothing basically at all. Sounds above typical speech sent him to the corner with his hands over his ears. Too many people, too many sights were similarly overwhelming for him.
He started off, with I believe 1 1/2 hours three times per week of one to one OT. He needed more, but that was the max his state based insurance would allow. He also had three hours of the Developmental therapy, and I believe maybe 3 45 minute sessions of speech a week. His receptive language was within normal limits at that age, but his expressive was mildy delayed and his phonology was severely delayed. It sounded like he was speaking his own language. Some of the words he used were bizarre. We had to literally catch him making a physical association before we could translate. One example I remember is "Ga'ull" was him saying "apple". We did see some improvements immediately, but the main thing was the progression over time.
He was then and has always been an extremely cooperative kid with adults. I believe this was the single biggest factor in his response to the therapies. The first prediction about his future was that he would be spending elementary school in self contained special ed due to the delays and sensory issues. They started him on a program to desensitize him. They worked him up slowly from not being able to tolerate even getting on the swinging board to loving being swung while spinning on it. The spinning was the key to desensitizing the swinging for him. He always loved spinning in circles, so they used that on the board and then added swings to it. We used those fingernail scrubby brushes that surgeons use to brush him down all over to desensitize his skin enough that wearing clothing wasn't painful (though he was 6 before we got much more than underwear on him at home).
He had A LOT of therapy over the 3 years that he was in early intervention. He went from the state he started in that I described to the point that I had to fight the school system to even get him a 504 plan in Kindergarten! He was in fully mainstream Kindergarten with only 1 hour of OT pull out (He needed more, I think). We have tried (And the school has tried) several times to stop his OT, and he just does not progress on his own. At the various times that he has tested out of OT, they wait the required 6 months or a year, and re-test him. He always then tests at either the same level as when he tested out or at a lower level. Either way he is then older and re-qualifies.
I do not doubt that if he had not had the early intervention that he WOULD have been in the self contained special ed in elementary and that he would not be anywhere near as functional as he is now. I see it as the difference between us looking at ways to transistion him to completely independent living as an adult, and someone that would require special housing his entire life.
12 Mar 2013, 12:32 pm
