Shocked and confused by OT report

[MummaBC]

Hi,

I have posted previously about DD 5 with speech and fine motor skills delay. We recently had an occupational therapy assessment, at our 2nd session she handed me the report at the end with no explanation.

I wasn’t at all familiar with percentiles so had to research myself and I’m really shocked.

aiming and catching - 37th percentile
balance - 5th percentile
manual dexterity - 1st percentile

I’m shocked because I thought she did really well in the assessment, when asked to balance she did so on one leg for 15 seconds and the other for 10. She threaded beads onto string, posted coins, used scissors.

I’ve since emailed to ask for a bit more clarity. She said DDs scores were influenced by her being easily distracted, not always following adult instruction oh and only being able to sit for 20mins.

School have never mentioned that she is easily distracted or doesn’t follow instruction which I’d like to think they would have. And honestly the session was in no way fun, I’m surprised she managed to sit for 20 minutes and wasn’t more distracted! Also the table was full of distractions (perhaps purposefully so) and the therapist albeit nice wasn’t particularly engaging. I just found the whole thing very frustrating.

Sensory issues were also suggested, which wasn’t something I had any concerns over. My husband, sister (who came to appt with us and is a pre-school teacher) mum say I shouldn’t give the report a 2nd thought and that she has totally misjudged dd.

However I’m aware she is a professional and feel I must take it seriously for dd’s sake, I will go down any avenue I can to help her.

I don’t know what I’m hoping for, perhaps people who have been in similar situations, any more clarity on percentile scores, any advice on where to go from here….

Thank you in advance 🤍

Percentile scores are straightforward, like in your baby book.

If you line up 100 girls the same age as your DD in order of their aiming and catching, worst first, then your DD will be 37th, with 63 children better than her, and 36 worse.

Given she was being assessed for motor skills delay I'm a bit surprised you are surprised. it is hard as parents to judge where children 'should' be, as we only see 1 or 2 children, whereas teachers / OT see hundreds.

It may be your DD under performed, but more likely she is on the poor side. You can get her reassessed when older.

Both my DDs have dyspraxia. DD1 has poor proprioception so doesn't know where her limbs are, and isn't too safe with knives etc in the kitchen. DD2 has poor balance, struggles still with stairs, but is safe using knives. DD2 saw a 'balance doctor' when she was in reception / y1 for a while and school did exercises with her.

DD1 formally diagnosed with dyspraxia aged 15, DD2 at 17.

It's good to be aware, you can focus more attention on important skills, get adjustments in place for some other things, and try hobbies/interests where motor skills maybe matter less.

Much better to have issues recognised younger. I kept flagging things for my DDs but allowed myself to be fobbed off too much.

Also re sensory issues.

As parents we tend to adjust our parenting to the child we have. So you may find your DD likes quieter places, so you just tend not to take her busy ones. Or she prefers soft clothes, so you don't buy her ones with lacy or furry trim. Or maybe she's not keen on baked beans so you don't give them to her.

But all of the above could be 'sensory'.

Swimming is very good for core strength.

Thank you for your reply 🙏🏻

I think I’m surprised because she has made great improvement since we were referred a year or more ago.

Thank you for simplifying the percentiles for me.

I agree, I’m glad things are being recognised earlier rather than later which hopefully means she will get all of the support she needs. Just a lot to digest when I wasn’t necessarily expecting it.

That is interesting to hear about the sensory issues, I hadn’t thought of it like that. I’m going to attend the parenting course on it to hopefully learn further.

Can I ask was there anything in particular that helped your daughters when they were younger? I have just signed up to swimming lessons as this was suggested by the paediatrician….

Thank you

Oh I just read the swimming comment after I posted 😊

Teen’s posts are excellent.

Personally I would take note of what has been raised.

Have you spoken to the school? I wouldn’t rely on them raising concerns, sadly sometimes they don’t. What support are they providing? Do they offer any interventions such as Jump Ahead, Fizzy, Clever Hands? Mention the sensory issues to them as well as they can support those.

There are lots of things out there to help improve fine and gross motor skills.

For fine motor skills, threading, cutting & hamma beads come to mind. Also e.g. lego. DD1 hated all of those as she wasn't very good though .... and that is the wall you may hit.

We focused on swimming (life skill) and handwriting (helpful for school). DD1 ended up doing her GCSEs as a mix of typing for essay subjects and handwritten for maths/science.

Both mine needed help with academic stuff too, and we tended to focus time on that rather than eg throwing and catching. You can't do everything.

Sensory issues can be a symptom of dyspraxia. (Dyslexia, dyspraxia and autism have overlapping profiles.)

I got my DD assessed for sensory issues and she came out with similar aiming & catching and balance scores (they assess everything). I was quite surprised as while I'd noticed she stumbled a bit more than others during gymnastics I'd put it down to her being at the younger end of the class. It did at least explain why she hated PE. Incidentally gymnastics was mentioned as being a good activity to help.

Thank you.

School should receive the report soon and I am going to request a meeting with them to discuss.

She has some 1:1 support for speech and language, is in a group for help with maths and involved in the SPARK programme - which at the latest parents evening her teacher said she had caught up really well and no longer really needed it.

So school either aren’t seeing what the OT has or are choosing to ignore it 🤷🏻‍♀️

I’m still unsure of what sensory issues she has if any (certainly none that are glaringly obvious to me) so I need to learn more about this to try and figure it out 🙂

Thanks @Jules912 Can I ask what sort of sensory issues your dd has? Just trying to figure out more about it.

Was your dd offered further help due to her scores?

Gymnastics was 2nd on my list after swimming, going to see how that goes first, I don’t want to bombard her with too much all at once. She is still so little, and school tires her out enough.

She's very sensitive to noise, smell and touch (mostly oversensitive but does crave some stuff) and has issues with vestibular system and proprioception (not sure I spelt that right). She is also awaiting an ASD assessment so that may be relevant.
The assessment was private so the OT was all to happy to offer further help. School were already doing most the recommendations, and try to do the rest though can't reliably do the ones that she needs adult help with.

Thank you @Jules912 good that school are on it!

I can’t think what sensory issues dd may have, she is fussy with food but I’m not sure it’s to do with textures. She used to hate hand dryers but has mostly outgrown that. Doesn’t seem to have any troubles when we are out in busy, noisy, bright places. No aversions to clothing.

Can I ask what sensory seeking looks like with your dd?

the OT mentioned perhaps she was distracted due to sensory regulation, have read a little about it, but can anyone shed anymore light? @FloatingBean @TeenDivided

Sorry, I can't help re sensory regulation.

Just because DD doesn’t seem hypersensitive to some sensory input doesn’t mean sensory differences aren’t present.

Things that might help with sensory regulation are sensory movement breaks, sensory circuits, fidget toy, weighted blanket/lap pad, wobble cushion, sensory bands on chair legs or even a peanut ball/rocker chair to sit on. The sensory environment in an assessment and school is very different to that at home/in the community.

Have a look at proprioception and vestibular activities e.g. trampoline, wheelbarrow walking, moving ‘heavy’ objects, skipping, spinning as these may help DD’s motor skills too. This and this resource might be a helpful starting point.

Thank you @FloatingBean as you can probably tell this is all very new to me. Keen to be as informed as possible to help dd as much as possible along the way 🙏🏻

Really the OT should help you decode all of this stuff (parents can't be clinical experts in EVERYTHING, ALL THE TIME as much as we seem to need to be!) but our OT recommended the Out of Sync books (first one is The Out of Sync Child, followed by The Out of Sync Child Has Fun, etc) to better understand sensory issues. They are written in a parent-friendly way and explain a lot about how sensory issues can impact the development of the skills that your DD was assessed for.

The books take a really positive slant too - they're not all focused on describing all the ways in which your child is "failing", but rather how certain sensory issues may be getting in the way of things they could be (and are likely capable of) doing, and how you help them remove those barriers. And the fact that you are acting early also means there's a lot you can do to potentially have a big impact on their development.

@Scratchybaby Thank you so much for your helpful response. Have just ordered the books 🙏🏻

I know, I was quite upset that she just handed me the report and waved me off. Having to figure it all out on Google only upset me further.

Has been really helpful to come on here and hear other people’s advice/perspective. I have learnt a lot already and feel much more positive than I did previously 💛