OT- What does it do .. how does it work and does it work..

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squirrelflight-77
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21 May 2011, 6:36 am

Well thats pretty much my question.. LOL Jordan is being evaluated for sensory processing issues and I'm just wondering what the goals for OT typically are and does it help with aspergers or not? I just never understood it and I still dont .. LOL So what are your thoughts, experiences or opinions on OT therapy for asp kids...


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Phonic
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21 May 2011, 8:21 am

I talk to my OT every week and she deals with sensory stuff and motor coordination problems, or if you're dyspraxic she can tell you, she gave me sensory profile tests and motor skills avaluations.

So if you have aspergers and your sensory problems are quite difficult then you need an OT.

Right now I feel like the only progress I'm making is with her.


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DW_a_mom
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21 May 2011, 12:24 pm

My son's OT worked on the muscular issues and, eventually, keyboarding. Even though he has sensory issues it was not worked on in OT. I think the obvious reason for that was we only did the school provided OT, and sensory issues weren't a major barrier to learning for my son. We had no trouble getting the sensory issues mitigated by using basic accommodations. So, sorry, I can't help much.

I will note our pediatrician was pretty blunt in letting us know he thought OT for sensory issues was hocus pocus and not something he'd encourage us to spend money on, and it's so hard to know. That was, however, 10 years ago. A friend did it for years and swore by it; we skipped it and saw great leaps simply honoring the issues. Kids do grow and change on their own, so what is therapy and what is development isn't always clear. My net take home is that if the OT is available, affordable, and something your child seems comfortable doing, you go with it. If not, you don't worry about what is being missed. I have zero " what ifs" on having skipped any sensory therapy, but my son's issues there were always mild. I do sometimes wonder "what if" on if there are been more hand work younger, however ...


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21 May 2011, 1:43 pm

DW_a_mom wrote:
I will note our pediatrician was pretty blunt in letting us know he thought OT for sensory issues was hocus pocus and not something he'd encourage us to spend money on, and it's so hard to know.


I've heard many people rave about how important the various types of therapy are and I don't doubt some people benefit a lot from it. However, my experience hasn't been remarkable. All the progress I've seen in my child over the last year has had little to nothing to do with therapy though they'd love to take credit. (Really, if I had to give credit to something it would be the TV for teaching him the most!) I just go through with it every week because it's not costing me anything and it's a chance for my son to socialize with people who aren't Mom and Dad.



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21 May 2011, 2:51 pm

We've had a lot of support and understanding from J's OT.

The biggest thing I think we've gotten out of it all is explanations as to why he does some things and why he wont do others. Some of the exercise's I've been meant to follow threw with at home, but being home is very different to being in the OT setting, so the follow threw hasn't always been fantastic.

I to thought things like sensory diet were hocus pocus, but I have to admit it helps. Sometimes just knowing why he is acting a certain way is enough of a help in itself.

Our OT was also able to add recommendations to J's school re; seating, writing, movement, the need for some of his stims and explanations to teachers as to why he may be stiming (her explanation held more weight than mine)


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momsparky
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21 May 2011, 3:09 pm

At least occupational therapy is one of the therapies that has been studied: http://www.latimes.com/health/bs-md-aut ... 4721.story Here's what the quoted institute says about OT: http://www.iancommunity.org/cs/ian_trea ... al_therapy - if you read through to the bottom, you will find that their research is not yet complete.

At any rate, we are waiting for our son to be evaluated by an OT for problems with proprioception http://en.wikipedia.org/wiki/Proprioception He was evaluated by the school's OT for motor skills problems (which, if given enough time, he does not have) but she did note that he has difficulty planning use of space on the paper, which is one indicator that proprioception is a problem. (Our major concern is that DS has real trouble walking down the sidewalk without bumping into other people or things - he got stitches this year because he ran into a pole on the playground that was less than 3 feet away.)

It has struck me that most of the therapies for autism that have been effective for us essentially offer opportunities for our son to "practice" behaviors, skills or strategies in isolation, meaning, for instance, he can practice just playing a board game without having to deal with a social situation, noisy classroom, uncomfortable chair, etc. as well. DS can learn almost anything if he's given the opportunity to learn ONE thing at a time.

I'm guessing that effective OT is going to be much the same: what I'm seeing on the 'net for therapy for proprioception is working with wobble boards, yoga balls, etc. (it mentions juggling, yoga and Tai Chi as well.) We have already discovered that the wobble board and yoga ball are important tools. I've also heard of a therapy where kids "crash" into padded objects. I can see where there is a direct link between these activities and figuring out how your body works in its space. There are lots of other types of occupational therapies offered to kids on the spectrum, each deals with a different area of impairment.

I do think, however, that ANY therapy, even a well-proven one, can be applied well or badly, and this goes triple for therapies for autism. I know many of my friends' kids (many of whom are not willing to have their child assessed for autism) see OTs, and over the years, I'm not seeing a lot of improvement; I hear about letting kids "hang" from monkey bars and wear weighted vests - and while those things can be valuable, they seem to be missing the critical learning component, nor do the parents seem to know why they are doing these things.

Obviously, I don't have the whole story and I'm not those kids' mother - but I think a good general way to assess a therapy is if it is specific, has a clear goal, and periodically checks your child's progress towards that goal, even if by tiny strides, or two-steps-forwards-one-step-back.



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23 May 2011, 2:42 pm

We have had experience with one OT and I cannot say enough good things about him in particular, though I suppose that doesn't tell you a lot about OT in general. Our OT asked us to set measureable goals at the beginning and we all worked together to meet those. A couple of goals that I remember off-hand were:
Reduce aggressive behaviors (biting, kicking, hitting his teacher) by at least 50%
Improve pencil grip to tripod grip from fist grip
Accomplish transitions with fewer meltdowns

When I say we all worked together I mean the OT worked one on one with our son, the school implemented the OT's suggestions about the classroom environment, warnings for transitions, calming techniqiues... and at home we followed the OTs advice about a sensory diet and other things. We have seen a great improvement at school and at home. While I will admit that I cannot definitively say that it was absolutely the OT that was the reason for all of it, I think simply more maturity and development has played a part, I am certain that we would not have seen this degree of improvement without our OT. He taught us things that I suppose we could have learned elsewhere but honestly we probably wouldn't have learned as quickly. I can see the difference on a daily basis if we miss the sensory diet time in the morning before school and how doing some sensory things when he is just starting to get agitated can really help him calm down.

Whether or not OT works for you really depends on your child's particular issues and, I think, your level of awareness about how to deal with those issues. My husband and I are very grateful to have found our OT at the time we did, which was at the beginning of the process of getting a diagnosis when we were totally clueless about what to do for our child.



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24 May 2011, 2:27 am

aurea wrote:

I to thought things like sensory diet were hocus pocus, but I have to admit it helps. Sometimes just knowing why he is acting a certain way is enough of a help in itself.


Back 10 years ago I think sensory diet was less common than it is now; I really don't think that is what our pediatrician was thinking of when he called it hocus pocus. The techniques my friend was given back then were, well, weirder, lol. I'm thinking they've now had some time to sort out what actually works, and what is a total waste of time. And ... one of the doctors big points was that he didn't think OT could tell us anything that an in-tune parent wouldn't pick up on on their own. Which is true in a way, I picked up on sensory diets without ever using the term but, maybe, as several of you have pointed out, you can get there faster with someone pointing you in the right direction!


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cutiecrystalmom
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24 May 2011, 11:33 am

One of the main reasons I found our OT consult to be particularly helpful was that it identified our son's difficulties with manipulating his body in space. We always thought our son was quite good at that - he loves to jump, run, skip around, etc, however, when he was asked to copy some simple finger movements without looking at his hands he was unable to do so. He even had a very difficult time copying those movements when he was looking at his hands. Interestingly, he has the most difficulty manipulating his fingers on his right hand, the hand he writes with (we have checked to see if he is left handed, he is not). It also identified he wasn't completely crossing his midline, so laterality is an issue. It also identified tactile issues that were more extensive than what we originally thought. The OT consult led to a consult with a developmental optometrist who identified that our son experiences some visual perception issues as well, specifically around visual memory, so he provided us with some activities to work on at home with him.

We have been doing the OT for several weeks now, while I can't say there is a huge difference, I can say this is the ONE place he will not complain and get anxious about going to. She does the right amount of pushing/encouraging him when working on his fine motor skills. She is having him do physical activities to work on how he can self-regulate. She has also recently written a brief summary of her observations to help us advocate to get support in place at school, and for us to provide to the clinicians we see when we go for assessments.

So, while it has been an expensive run (but thank goodness for generous grandma!), it has been very useful in many ways in our situation. I really thought I knew pretty much everything about my kid before that consult, and learned that I really didn't. It was an eye opener for sure.



squirrelflight-77
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25 May 2011, 7:53 am

Thanks everyone!! That helps to get an idea of what to expect and if it helps others. We are giving a try since its covered with her insurance and all. She will get her evaluation tommorrow and then we will get the full report next week.

I know she has sensory issues mainly just a complete inability to tune anything out. She has always been very easily overstimulated and overwhelmed by everything. I think that is where a lot of the frustration comes from.


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