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Help needed re OT report please

(14 Posts)
beautifulgirls Sat 22-Aug-09 11:25:08

I have just received a report on DD#1 who was 4yr 11mth at the time of assessment. She has verbal dyspraxia (ongoing with SALT) and we have had some concerns about her motor skills in general - whilst she is by no means severe in her abilities/inabilities we had some concerns none the less, hence she was referred to the OT.
The report is long but to summarise the parts:
1) The development of visual motor integration and Supplemental Test of visual Perception by K Beery and N Buktenica
She scored 3yr 11mth putting her on the 13th %
2) The Movement Assessment Battery for Children by Sugden and Henderson
She scored Manual dexterity 14 (2%)
Ball Skills 13 (9th%)
Static and Dynamic Balance 27 (25%)
Total score 54 (5%)
The comments with this section state that below 5% total score is indicative of significant movement difficulty and scores 5-15% suggest child is at risk of having a movement difficulty.

Anyway, they have sent some sheets of things to do with her which I am pleased about, but they have then stated that they do not plan to see her again and she will be discharged from the OT service. That part I am not so happy about. Does this sound like a reasonable thing for them to do though and am I just being too sensitive, or would you expect that they could at least follow her up in a period of time to assess progress, even if therapy wise they have nothing more to offer than the sheets of exercises?
Has anyone else been in this situation and what did you do from here?

Thanks for reading

moondog Sat 22-Aug-09 11:40:03

I would ring them, ask to speak to OT responsible and ask why they are not seeing her again. There may be a very good reason or (in your eyes) a not so good one such as staff shortages or prioritisation.

bubble2bubble Sat 22-Aug-09 11:56:38

I think that's outrageous - even if you follow all the things they tell you to do she should still be reviewed after a certain time at the very least

My DD1 has verbal dyspraxia - the NHS OT didn't feel any treatment was necessary, having only identified a few minor sensory issues hmm She was then reviewed a year later and referred for group therapy as she still has "borderline" difficulties ( though that was a couple of months ago now...)

In between she's had six months of private OT for severe gross motor skill difficulties, bilateralism, gravitational insecurity, auditory processing et al. All this has such a huge impact on speech.

I would definately ask for their reason for discharging her. Very angryfor you!

beautifulgirls Sat 22-Aug-09 12:11:51

Thank you - Bubble can you tell me how you went about finding a private OT please? If needs be we will follow that route if it can in any way help her. Meanwhile I will be calling them on Monday to talk this through and find out more about their reasons for the decision.

r3dh3d Sat 22-Aug-09 12:15:54

Yeah, ours does this. It's a work of fiction based on how their targets work. Basically they are only allowed so many kids in their caseload, and their performance is measured on turnover. It's because all the NHS targets are designed to reduce "waiting lists". The downside is that though you are seen more quickly, they then have to get rid of you. Which means that kids with more severe conditions that aren't going to disappear with a couple of OT sessions are booted off the books for spurious reasons.

They will say to you that the exercises they have given you are your treatment and there is no point in seeing you again till they have succeeded or failed. So you are supposed to go away and try them for 6 months and then if there is no miraculous turnaround hmm your doctor has to re-refer you. Back on the waiting list ...

I had the most STINKY row with our local OT and Physio about this: DD1 has all sorts of gait and posture problems (she's hemiplegic) and needs to be assessed about every 6 months to see if her orthotics etc. are keeping her straight and upright. But they discharged her saying that once she had problems (ie once it was too late and the damage was done) we could get re-referred and they would try to fix the problem. I asked for copies of the departmental docs that showed this was official policy, and funnily enough we reached an agreement after that, that she would be off the books (so not affecting their figures) but that they would assess her unofficially as part of their classroom visits.

bubble2bubble Sat 22-Aug-09 14:16:42

Hi Beautiful girls

We were lucky as our SLT actually knew the OT and suggested it would help, otherwise I've honestly no idea how I would have found one. A friend of mine did get a recommendation to a private OT through a local autism suppport group, so that may be one option for you - or there may be a dyspraxia group local to you?
Sorry, not much help - anyone else around who knows?

How does your DD get on at school - could they do anything - push for a programme to implemnet in school, for example?

beautifulgirls Sat 22-Aug-09 17:38:48

Thanks bubble - I'll hunt about and ask around. If anyone else reading has any info that would be great thanks.

Re school - She is only just about to start in reception this year as she is a September birthday. Meeting with the school prior to her starting has been a very positive experience so far re her speech issues so I am very hopeful the school will do anything that they can to assist her.

anonandlikeit Sun 23-Aug-09 11:07:58

we had similar with the SALT, identified problems but were going to discharge.
I think they just hope parents won't challenge & therefore reduce their caseload.

But i telephoned & said having identified problems & provided a home therapy programme I would like him kept on to review to see if the exercises were being effective.
They were happy to oblige & kept him on their books.

What is the set up in your area? It may be that when she starts school the current OT can transfer to the school age OT services.Ours are divided in to preschool (HA/PCT budget) & school age (LEA budget).

beautifulgirls Mon 24-Aug-09 21:08:50

I have no idea how the OT is set up around here to be honest. I have written a letter to question the decision and explain my thoughts and wishes with regards to what might happen next. I have asked for a reply in writing so we'll see what comes of this.
Many thanks to everyone for their input smile

ChopsTheDuck Tue 25-Aug-09 07:45:52

In our area, they didn't really feel that OT sessions were beneficial until children were a little older. We were sent away with exercises, but reviewed a year later, and then ds got a block of therapy.

I would ask for a review in a year, before considering discharging. Those scores show that there are issues, and you really don't want to have to go through the waiting lists again. With those movement ABC scores, have they said anything about dyspraxia? ds has dyspraxia and his scores were higher than that last time he was assessed.

Also, are they going to get in touch with the school? The visual perception issues are going to make certain things in school harder, such as copying off the blackboard, which the school needs to be aware of.

I'm now having that problem with physio - having waited a year once to see one, we were discharged, and we're now at the bottom of the list again and ds is in pain a lot of the time.

bubble2bubble Wed 26-Aug-09 14:51:16

Now that makes me really cross as wellangry!
DD1 started seeing the OT when she was 3 and a bit - I dread to think how bad things would be if we had done nothing until she was older - and she has achieved SO much in the last six months ( now 4 )
I also have a friend whose DS has just been diagnosed with visual perception issue et al - he is 7, and poor little thing told his mum he thought he needed glasses - he knew he had a problem copying from the blackboard but didn't know why
This is like saying DC don't need speech therapy until they are over 3 even though everyone recognioses there is a problem angry angry

beautifulgirls Wed 26-Aug-09 20:21:34

Sorry to hear that Chops, how frustrating for you to go to the back of the queue again. We've been down that path with speech therapy, but that is another story!
I have my suspicions about her being dyspraxic and that is why we went to the paed with her in the first place. She saw a physio for assessment last year who said after no apparent formal assessment that she was not dyspraxic, but she did have hypermobile joints and slightly poor muscle tone that would affect her ease of co-ordination. Anyway, we knew we had the paed to follow up so at that point we didn't push it, but then got the OT referral earlier this year after the paed saw her again.
She only starts reception this September, but we had a meeting with the school at the end of last term regarding her speech and concerns about her motor skills. So far the school at least sound incredibly supportive and reassuring and we can only hope they live up to this in practice. I have a copy of the OT report for them and will be able to speak to her teacher every day if necessary and also if needs be meet the head without too much difficulty, so my hope is that she will get all the extra support that she might need in class. We are also very lucky that they have split their classes up a bit more for reception and there are only 23-24 children in each class which will be a big help in them having the time for her more than they might in a class of 30.

I am waiting now to hear from the OT about my letter but will chase them up with a call next week if I need to.

beautifulgirls Thu 27-Aug-09 16:49:15

I have good news a call from the OT today who did her assessment for me, and apologising profusely about the situation. She was not too sure why I was told DD would be signed off, though could be to do with the fact our GP is out of that hospital area, even though we live in area (we are right on a boundary) Anyway, they are seeing her the week after next for the start of 6 weekly therapy session and will make further arrangements to review/provide therapy for her from there as required.
Thank goodness I didn't just accept the letter and signing off they had stated in it.

Many thanks to everyone who was kind enough to post for me to advise through this stress. I know many of you have a lot more stress than I do with regard to your DCs.

bubble2bubble Thu 27-Aug-09 17:04:33

oh that is great news - well done!

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