OT assessment report - help

[MissDuke]

Hi everyone! Me again, sorry! So I posted last week to say that the ASD team ended up diagnosing my almost 9 year old dd with ADHD.

We also just got her OT report through, at last, the assessment was in July. I don't understand it at all, and have left 3 messages with the OT and still not heard back. She has said she cannot provide any OT for dd as the resources won't allow it, but that she will do a school visit. Yet she won't speak to me about the report... I don't have a lot of confidence she will ever go into school!

So here goes - The Developmental Test of Visual Motor Co-ordination.

Visual Motor, standard score: 69, percentile: 2, age equivalent: 5.2 years (very low).

Visual perception, standard score: 68, percentile: 2, 5 years (very low)

Motor co-ordination standard score: 58, percentile 0.6, age equivalent 4 years (very low).

It goes on to say 'Low scores in all 3 parts of this assessment would indicate a flat learning profile, rather than motor planning or praxis difficulties being the main cause'.

I have no idea what any of this means. Does anyone know anything about this, I have read so many things but don't recall coming across these terms before :-(

Thanks xxx

I'd read that as meaning she's behind across the board which suggests a global developmental delay as opposed to dyspraxia or another specified issue.

But I am not an OT so that's just my take as a parent who's had to wade through far too many of these assessments.

Hopefully someone more knowledgeable will be along soon to interprete it for you.

{hugs}

She may or may not be dodging calls, but the fastest and best way to get a clear response is to write a letter to her. Make a paper trail. Put in the letter that you have received the OT report but that you do not understand it. Also point out that from what you can see, it seems to indicate that your DC is behind in all areas assessed, and you do not understand what she meant by "resources won't allow it." You can indicate that while she has stated she will visit your child in school, you are requesting a meeting with her to discuss specifically what this report means and what support she plans on providing to your child.

Promises over the phone are somewhat empty. Get it in writing so you have a paper trail.

ds1's assessment was similar; sensory profile, fine motor assessment (several pages of copying increasingly complex designs and some cutting out and glueing), gross motor skills tests (throwing catching, jumping, etc) and she assessed his muscle tone. She was also wonderful for behavioural stuff and helped me realise how much of his 'bad' behaviour was sensory or hypermobility related.

He has ADHD and PDD (a form of ASD) as well as some hypermobility. He scored reasonably well on the assessments you've mentioned but struggled with fine motor, sensory (he's a sensory seeker) and has very poor muscle tone.

Has your dd been assessed for any of those or was it all just gross motor skills and visual perception she assessed? I agree with Polter, you're entitled to a detailed and complete assessment, if she hasn't done that then ask for a second opinion.

Sadly some OTs are fantastic (ds1;s community OT was one of those) and some are much less so (like his CAMHS OT he's under now), yours sounds like the latter

I think the report means she's useless and wouldn't know how to help... and she only has the resources to provide utterly inadequate help to anyone, anyway. That was certainly my experience of an NHS OT.

Thanks for all the replies, I really appreciate it!!!!

She has a page in the report on sensory stuff, but she basically just repeats what I wrote on the questionnaire and didn't seem to do anything in addition to ask me to complete it?

The conclusion says 'Has a range of sensory processing difficulties that are impacting on her function - a combination to oversensitivity to input and under registering sensory information. An unusual presentation and would query that 'dd' is overloaded by the demands being placed on her.

All assessments are scored around the 5 year level, indicating that 'dd' has delayed development which will affect her learning.

She has poor proprioceptive awareness and therefore has difficulty grading her movements.

Fearful of vestibular input.

Triggles I like the idea of a letter, thanks for that idea. Poltergoose, apologies for drip feeding, but didn't want to overload my op, the OT says she also did the 'Good enough Draw a Man test', which dd scored at 5.3 years. Also the 'ABC Movement test' which wasn't so bad, 16th percentile, no age equivalent given for it.

Summer Rain, thanks for that. The word hypermobile isn't in there, but I am sure she is - as am I! It does mention that she 'overextends' her elbows and knees though, which I guess causes the low muscle tone?

Thanks again everyone, I guess I just needed to talk it out, I have shown the report to a couple of people but they have been as flummoxed as me! I will send a letter off tomorrow.

Did your dd have an IQ test? How is her memory? My ds1 has low muscle tone, hypermobility, poor visual-spatial skills, odd visual perception, but an astoundingly good memory (whether working, short-term or long term). He benefitted hugely from physiotherapy, which helped with the low tone, proprioception and hypermobility (which have a huge impact on motor co-ordination) and has rote learned an awful lot of movements required in daily life (and also rote learned how to draw people!)... without the help of an OT... In our area, therefore, physiotherapy is worthwhile and OT a waste of space.

She had some physio in school, but apparently that is her 'quota' for the year :-/ It is seriously crap here! Yes, she has an ed psych report, it says:

Verbal Comprehension 112 75 High Average
Perceptual Reasoning 104 55 Average
Working Memory 110 75 High average
Processing Speed 97 42 Average
Full Scale IQ 109 73 High Average

It also says: NB Full Scale IQ score is 100 and there is a discrepancy of more than 15 points between the Indexes of Verbal Comprehension and Processing Speed. However this may indicate the presence of a specific learning difficulty.

I have private med insurance for us all, I don't know if it covers OT but it def covers physio - I think I will give them a shout tomo! Ta!

Oh no! Sorry for the rubbish cut and paste!

The numbers have all run in together, but basically the first 3 digits are her standard scores and the last two are the percentile

Hmm. Did the OT bother to talk to the Ed Psych? Seems pretty amazing to get a perceptual reasoning score of 104 when the visual motor co-ordination scores done by the OT were so low, if motor planning and praxis issues aren't a huge part of the problem. It is normally quite hard to separate out visual-motor issues from perceptual reasoning, anyway - a child with visual-motor problems usually finds this affects their perceptual reasoning score somewhat, because the perceptual reasoning tests have a motor element to them.

There are several things that would jump out at me here

1. She's been assessed by the Psychologist as having a 'High Average' IQ

1. The psychologist has taken the time to highlight that she has a statistically significant difference between her Verbal and Performance components.

To an OT that should immediately scream movement/praxis issues.

1. ''Low scores in all 3 parts of this assessment would indicate a flat learning profile, rather than motor planning or praxis difficulties being the main cause'' ...this just does not chime with the Psychologist's assessment. One or other of them is wrong IMO.

1. The Movement ABC is one of the major movements assessments used by OTs; being on the 16th percentile indicates that she has movement ability well below average.

1. With that profile, an (motor free) assessment of her Visual-Perception would also be indicated. Did they do one?

Going back to your OP, the scores would indicate a child who has significant difficulty co-ordinating their hands and eyes together. the question then has to be, WHY?
The other assessments would be to try to answer that question...is it a perception, motor, or sensory issue?

I dont think you have had an answer and I would investigate it further, in writing.