Please tell me how should a good sensory assesment look like and questions about walking- physio

[babiki]

After a huge complaint about NHS Children's services in our area, things are moving, ds is going to have a sensory assesment and feeding assesment (different dates). Please can you tell me how to see if it's been done properly...is there any checklist of what should be definitely done, e.g type of tests...Also, they still don't want to back down regarding physio and hydrotherapy, altough ds is on waitlist for Brainwave I feel NHS should provide at least some physio for him..ds started walking recently, but has got wide gait and quite unbalanced, his left foot turn funnily out and after 10-15 minutes walking he has a very slight limp on the left leg: surely physio could help with that? He can't do stairs yet or getting off chairs etc..Is there any other health professional who could help with looking at the way he walks? (Sorry if sounds daft but not from UK and everything is SO different here.) Physio just said he is walking now and therefore fine and hydrotherapy is only available for severly physically disabled kids (Essex)...so need some ammunition. Many thanks.

forgot to mention DS will be 3 in November, with GDD

What is the feeding assessment for? DS3 (5)had a videofluoroscopy done to see where the swallowing was not working properly. He has also had a feeding team from CAHMS - but that was more of a visual check to see his reaction to food.
DS1 had a Sensory Integration and Praxis Test (SIPT) - but I'm not sure what they class the optimum age for having that done. DS was 8 - which I think is the maximum (?).
The assessments might vary depending on age. There would be elements on the SIPT that my DS did that a 3 year old would not be able to manage - so I'm not really sure. Some tests have scales from 2 upwards (I know the Beery VMI does - visual motor integration)- but I don't know the current ones as my DSs are older now. Sorry

Thanks Auntevil, the feeding is with specialist salt probably similar to camhs one, as it seems ds issues with food are sensory based.

If I read you correctly there are 3 things here that you are mostly worried about: his gait/walking/gross motor development, sensory processing and his feeding.
In reality, all three will overlap and impinge on each other e.g. if he has sensory processing problems it will affect his reaction to food tastes and textures. If he is low toned this could affect his chewing etc.
Ideally he should be assessed by a multi-disciplinary team working closely together e.g. the Salt and OT should be looking at feeding together, the OT and Physio should be looking at mobility together, they should all be working closely with the Paediatrician.

A 3yo with GDD wont be assessed with the SIPT- more likely that you will be filling some sensory processing checklists. I would have as much information as possible put together beforehand i.e. all the things that you have noticed as being a bit 'off' or difficult.
So for something like feeding- what things does he like, how has his progession to solids been, how does he react to bland vs spicy tastes, his reaction to new textures (e.g. crispy poppadom vs slimy pasta?), does he tolerate things in his mouth (toothbrush) or is he a biter?

Is that what you want to know?

Thanks Porridgelover, yes we went today and it was as you said, filling in lots of forms while ds running around in a sensory room. Was told they do not use diagnostic tests for older children anyway... Yes we do have a team, however their advice and input has been minimal. For example the physio never actually touched ds, just observes him.. Today was told again we ( at home) are doing everything we can (swimming, trampoline..). It is very shocking to me as I come from a country with an long standing excellent physiotherapy hand on the child and various approaches, summer affordable residential programmes filled with various therapies... It's just frustrating, yes I know he has low muscle tone but would be nice to know which areas are the worst and get some targeted exercizes...

I have found OT the best source of information for sensory issues. Physio has not been involved with my DS1 - apart from being referred for issues related to hypermobility.
Sensory integration therapy seems to be done by OT on the NHS. They don't deal with the feeding issues though. Feeding teams in our PCT have the SALT, paediatrician, OT input, but, tbh, have been of little use. Once they had discovered that DS3's eating difficulties were mainly mechanical, and that his food preference was based on difficulty to chew and swallow, he was discharged. you will find that there are huge gaps in provision within the NHS, most parents end up having to look into private therapies where affordable.
I had already seen a private paediatrician with a feeding specialism before the NHS even stepped in. She had given me plans to encourage texture, and it had been relatively successful, so much so, that the NHS didn't add to it and said to continue with what I had already been doing.

We just spoke to the paed and she said 'that's sensory'. Then we got sent a booklet from OT (don't actually get to see a person round here) and we have to work out which bits of the booklet are relevent to DS.

Bit pants really!