Help! Cutting OT?

[Guest guest]

gets OT twice a week for 45 minutes each time. He is working with 2

ts because neither of them has enough time to take him twice. Their

caseloads are huge and there are lots of kids on the waiting list.

One of the OTs, Christy, called this morning. She does not feel is

making enough progress to continue being seen twice a week. They have been

working on certain goals for a long time and he is not meeting them. He IS

making progress, but very slowly. She wants him to go to once a week, with

the other therp, Jen, and when he starts making good progress again we can

add the second session back in. He works better with Jen; he's more

" compliant " (or she's better at convincing him!) and shows more progress

with her. Christy has talked a lot with us lately about how tenacious

(read: stubborn!) is and how difficult it is to get him to work on

what she wants to work on, and how ABA would really help him get over that

" No, I don't want to! " attitude. (And I absolutely agree with her about

his...tenacity...and his attitude.)

I don't understand how cutting therapy time in half will help him progress

any faster. And I feel the sensory integration is very important for him,

and while I know we can do a lot of that at home, it just isn't the same as

a session.

On the other hand, he is making GREAT progress in other areas right now.

When he takes great leaps in one area, other areas suffer for it, and I have

no reason to think that working harder on OT is going to make any difference

there. I don't think dropping that session is going to harm him. We also

have the baby coming and it would be one less thing to drag everybody to,

and one less expense.

Oh I don't know. I guess if she doesn't want to work with him and they're

not making progress together, what's the point in pushing her to continue?

But he already gets so little therapy, I don't want to cut DOWN on it!

Especially with school ending...he'd be down to 30 minutes of speech and 45

minutes of OT a week. That's it. That's all the intervention he'd be

getting, and there's not a thing we can do about it beyond doing things

ourselves or paying for them privately.

Somebody tell me what to do!

-Sara.

[Guest guest]

> One of the OTs, Christy, called this morning. She does not feel

> is making enough progress to continue being seen twice a

> week. They have been working on certain goals for a long time and

> he is not meeting them. >

Two questions, Sara....do other kids have both therapists? Seems

like a strange way to do things for kids who need consistency, but

that's just my opinion. Second question: Are the goals he isn't

meeting realistic, or do they need to be modified? Is he meeting

them with the other OT?

> He IS making progress, but very slowly.

> She wants him to go to once a week, with the other therp, Jen, and

> when he starts making good progress again we can

> add the second session back in. >

I would sure as heck get this in writing...with specifics about

what " good progress " means, and who decides it.

> He works better with Jen; he's more " compliant " (or she's better at

> convincing him!) and shows more progress with her. Christy has

> talked a lot with us lately about how tenacious (read: stubborn!)

> is and how difficult it is to get him to work on

> what she wants to work on, and how ABA would really help him get

> over that " No, I don't want to! " attitude. (And I absolutely agree

> with her about his...tenacity...and his attitude.) >

Okay, here's my bias...and I'm not trying to diss your therapist,

Sara, because I don't know personally, haven't done any

testing on him, and have no clue what his version of " noncompliance "

looks like (altho I have an idea...LOL). To me, this sounds like a

personality clash...which can be a very real problem in therapy.

Sometimes client/therapist just don't mix well...and then it is good

to find a better option if there is one. Could the other OT give one

of her other clients to this therapist and take twice a week

instead of dropping the session? Or do they come on different days,

so that they are sharing several clients?

Another angle. is like, 4, right? At that age, sensory

motor therapy really shouldn't be about " compliance " ...done right, it

should be about getting safe, *therapist organized but child driven*

opportunities to receive appropriate sensory input so that he can

feel his body moving in space, and understand his body in relation to

himself and to the world around him...the idea is to get him to a

good place sensory-wise, so he can then move into structured

activities that are *age appropriate* at some point in the session.

For a preschooler, that may mean a simple puzzle, peg board, or it

could be that he would be more happy participating in a motor based

game where he follows simple directions, or doing a tactile game such

as hunting for toys in a bin of beans...bottom line at this age is,

if it don't look like fun, he ain't gonna do it...making the best use

of HIS MOTIVATION is the job of the therapist---it isn't the child's

job to do what the therapist decides *must* be done to meet a goal.

Flexibility and creativity...that is what peds therapy is about.

> I don't understand how cutting therapy time in half will help him

> progress any faster. And I feel the sensory integration is very

> important for him, and while I know we can do a lot of that at

> home, it just isn't the same as a session. >

In the summer, you do have a lot of opportunities for good sensory

motor play that isn't always there in the winter...could he

participate in swimming lessons (or even just a lot of pool time with

you, blowing bubbles in the water, moving limbs through the water,

learning to find the side of the pool and hang on), a simple tumbling

class, or just go to the park every day to move around (I'm writing

this and suddenly the words " running " , " harness " , and " three kids "

are dancing in my head...quite possibly all of this is totally

impractical if Matt isn't there to go with you).

> I have no reason to think that working harder on OT is going to

> make any difference there. I don't think dropping that session is

> going to harm him. >

This may be your answer, Sara...if it isn't really helping him, and

it won't hurt him....and the OT doesn't really feel she can help

him...

> We also have the baby coming and it would be one less thing to drag

> everybody to, and one less expense.

One thing to consider here is that the new baby is most likely going

to be very stressful for ...new person to deal with,

competition for Mom, upturned schedule, irritating newborn cry that

is totally unpredictable in terms of when it may be coming...he may

actually need the OT time more when the baby comes. To me that is

the bottom line; which is more stressful---taking the trip out to the

OT whose negative feelings may be coming across to him but who

provides a safe place to work thru some sensory strategies, or

staying home with new baby and mom? Sometimes a therapist has to

think in terms of not going backward...don't know how well that works

into the school therapy model, but since ESY looms large, and not

regressing is one of the criteria there, seems it might be a

consideration.

If you do drop the session, I would ask for an in-home sensory diet

that is followed by someone closely when the baby comes...he will

almost certainly need more support from somewhere.

Hmmm. This isn't helping at all, is it? I don't know the answer for

you...but maybe these are some thoughts that may lead you one way or

another?

Raena

[Guest guest]

I don't know what to tell you Sara. I tend to think that if she doesn't

feel he's progressing with her, then he probably isn't going to. I think

that if you can get the other one to pick him up for a second day as soon as

she gets an opening, you should go for her. He may not be progressing for

the other woman because he isn't clicking with her. Also, with the baby so

close, it probably would be good for you to have things cut back on for now.

I know it doesn't sound like much in services for the summer, but mine had

nothing during the summer when they were younger. If at all possible, take

the day off and try to relax and just do what you can with him at home?

Sue

[Guest guest]

Sara

There is NO WAY that he shouldn't be getting ESY. I think you need to be

calling an IEP. Dont let his IEP be changed to reflect less you need more.

An IEP is a CONTRACT and they are responsible for that.

Hugs

[Guest guest]

Um, I second what Raena says, Sara. She's got it going.

Maggie

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[Guest guest]

Is it common to decrease therapy if a child isn't showing improve or progress?

Re: Re: Help! Cutting OT?

Um, I second what Raena says, Sara. She's got it going.

Maggie

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[Guest guest]

If he isn't meeting the goals he needs more OT not less!!!!!!!!!!!!!!stupid

people

[Guest guest]

>

> If Christy feels she cannot get to

> *comply*...she should be suggesting that you get a

> different OT to replace her. should not get

> less services because she isn't getting results. It

> must be HER, since the other OT gets results with him.

>

I so agree. And as Raena, I think, pointed out, it doesn't even mean that

Christy is a bad OT; Christy might be fine for someone else, but she is not

for . It does sound a bit as if she is having trouble admitting it

though.

Salli

[Guest guest]

Well I don't know what to do either. But I've never hear a therapist

recommend less therapy due to lack of progress ... sounds strange ... is

something else going on? Maybe the other therapist would have some

insights?

(SAHM in GA)

MSN elizabethloht@...

n 33, mo, no formal dx

Phoebe, 12 wks

Help! Cutting OT?

> gets OT twice a week for 45 minutes each time. He is working with

2

> ts because neither of them has enough time to take him twice. Their

> caseloads are huge and there are lots of kids on the waiting list.

>

> One of the OTs, Christy, called this morning. She does not feel

is

> making enough progress to continue being seen twice a week. They have

been

> working on certain goals for a long time and he is not meeting them. He

IS

> making progress, but very slowly. She wants him to go to once a week,

with

> the other therp, Jen, and when he starts making good progress again we can

> add the second session back in. He works better with Jen; he's more

> " compliant " (or she's better at convincing him!) and shows more progress

> with her. Christy has talked a lot with us lately about how tenacious

> (read: stubborn!) is and how difficult it is to get him to work on

> what she wants to work on, and how ABA would really help him get over that

> " No, I don't want to! " attitude. (And I absolutely agree with her about

> his...tenacity...and his attitude.)

>

> I don't understand how cutting therapy time in half will help him progress

> any faster. And I feel the sensory integration is very important for him,

> and while I know we can do a lot of that at home, it just isn't the same

as

> a session.

>

> On the other hand, he is making GREAT progress in other areas right now.

> When he takes great leaps in one area, other areas suffer for it, and I

have

> no reason to think that working harder on OT is going to make any

difference

> there. I don't think dropping that session is going to harm him. We also

> have the baby coming and it would be one less thing to drag everybody to,

> and one less expense.

>

> Oh I don't know. I guess if she doesn't want to work with him and they're

> not making progress together, what's the point in pushing her to continue?

> But he already gets so little therapy, I don't want to cut DOWN on it!

> Especially with school ending...he'd be down to 30 minutes of speech and

45

> minutes of OT a week. That's it. That's all the intervention he'd be

> getting, and there's not a thing we can do about it beyond doing things

> ourselves or paying for them privately.

>

> Somebody tell me what to do!

>

> -Sara.

>

>

>

>

[Guest guest]

>>>>>

One of the OTs, Christy, called this morning. She does not feel is

making enough progress to continue being seen twice a week. They have been

working on certain goals for a long time and he is not meeting them. He IS

making progress, but very slowly.

<<<<<<

Huh? Are his goals set too high? Shouldn't " not enough progress " mean he

needs MORE OT?

>>>>>>>

Christy has talked a lot with us lately about how tenacious

(read: stubborn!) is and how difficult it is to get him to work on

what she wants to work on,

<<<<<<<

Sounds like a personality conflict. Maybe SHE needs ABA.

>>>>>>>

I don't think dropping that session is going to harm him.

<<<<<<<<

If that's how you really feel, then of course, go with that...You know best.

>>>>>

Oh I don't know. I guess if she doesn't want to work with him and they're

not making progress together, what's the point in pushing her to continue?

<<<<<

I agree with that. He just may not like HER attitude and may never do what

she wants. Nothing wrong with that in my mind.

>>>>>

Somebody tell me what to do!

<<<<<

Well, I'm sure I've muddied up the waters. No chance of a therapist

'transfer'?

What about calling an IEP?

Penny