Question about OT for 2.5yo with possible ASD

[mamma3486]

Question about occupational therapy for my 2.5yo who has some sensory issues and possibly ASD.

We started OT and ST last week - we totally buy into why both are necessary and found therapists we are very comfortable with and know how to engage with our son.

After our second OT session we weren't too sure. Her gym is well equipped to make lots of variations of obstacle courses, and she was trying to get our son to work through them and complete multiple rounds, going at his pace, letting him lead but also trying to push him a bit to do new things. His attention span is everywhere so he kept getting distracted and running off to do something else.

Both my husband and I were suddenly not sure - it felt quite similar to the playgroups we take him to anyway or playing around at home, but at 200 dollers an hour! I think what we got from the session was a little more awareness of what we are doing and why, about pushing him a bit to do new things and experience different types of movement but being mostly child-led.

I'm going to talk to the therapist more next week about our doubts and I'm sure she'll reassure us that it is all going to help. I just wanted to ask here if this is the typical experience of OT.

Would it be possible for the OT to write a report with recommendations/a sensory diet for you to complete at home with your son? In my experience (school based so a little different) OT support is valuable but the recommendations can often be carried out by someone else and then reviewed at a later date by an OT when they need updating and a new programme put in place.

My experience with the occupational therapist was that they carry out various assessments and then make recommendations that others carry out. They don't really work with my child themselves.

So in our case, for example, the OT wtached him at nursery and gave the nursery a list of things they could do to help him. He started school a year early as that's what the OT suggested. She also ran a course for parents on how to work with you child with social stories, did his referral to see a physio and a sleep specialist, and helped us apply for carers benefits.

Is it a Ayers sensory integration OT? Because that does look like play and it should be great fun and appear very child led. But a SI OT is adjusting all the time and challenging the vestibular, tactile and prioperceptive senses. 8 sessions of that were utterly amazing for my similar aged child. Didn't look like much was happening but she was gaining prioperception and vestibule sense. She couldn't climb or swing and 6 weeks later she could climb a sheer playmat against a wall and swing like a crazy woman. But more importantly, because she had a better more regulated sense of her body, she was less anxious.

@Legoroses

It's some kind of sensory integration OT. We spoke to the OT again and she said that it was about getting DS to try new things and experience different kinds of movement. The gym is superbly equipped with slides, hammocks, swing, trampoline, blocks to scramble on, balance beam, bumpy mats, toys, tubes to roll in. And actually DS can do all this stuff, it's similar to the play centres we visit where he has great fun. So I was questioning a bit what he was getting out of it that he doesn't get in a play centre.

The OT does gently push him more to try things or keep at things because he had such a low attention span he can lose interest before he even starts. And she is getting to get him to initiate jumping forwards. We asked what we need to do at home to help and she said again to get him to try new things, but we don't have to replicate what we are doing at therapy - once a week is enough.

We are also using the Wilbarger brushing protocol, so both she and the ST have said we also have to wait for the effects to kick in.

I mean to say DS has great gross motor skills - is already a great climber, loves swings, knows how to balance on a beam and walk. He just lacks to attention span to keep at it. We are trying to build up the number of rounds he can complete in an obstacle course (his choices).

I'm tempted to try another OT, maybe a home one, alongside our current sessions. But we're only two weeks in - want to give the current OT a fair shot.

Sounds like you could do a lot of this yourself without paying for a weekly session. Unless your kid has big sensory issues and not all ASD kids do, OT might not be that necessary - of course no OT will tell you that - speech therapy may be a much better use of resources (certainly that’s what we’ve found with our five your old ASD son).

We've been told that DS has a lot of sensory issues - tactile defensiveness, vestibular and proprioceptive - this is blocking him from taking anything in, making eye contact and learning new things. This is apparently the reason why his language and communication skills have nose dived, and we have to address this first before making any real progress with ST.

The STs we've spoken to have suggested similar (though most won't do an assessment without a big fee). But those that have observed him briefly have agreed OT is the first course of action.

I think we have to continue. I'm not confident we can do this on our own, at least I don't want to risk it. DH does a lot of physical play with DS that's quite similar to the OT and it hasn't helped at all. We are seeing little things that are encouraging, but it's too early to say if there's any improvement.