Questions about upcoming appointments

[olivegoose]

DD sees a new OT tomorrow and I'm planning on stopping by the old OT and getting a copy of her evaluation and stuff from them to take with me. We also see the child psychologist next week. Should I plan on bringing a copy with me there? Anything else? I have a questionnaire from my paperwork for the DP for her teacher, would it be helpful to ask them to fill it out before we see the psychologist? I could make a copy so I can get a more current one closer to her DP appointment. They didn't request anything but I was just wondering if anyone knew what would be helpful. 

[Life is interesting]

As one who feels I have had biased appointments in the same hc setting I don't bring records until after a visit. I want each provider to come up with an independent assessment based on their training.

Remember too, an OT is a support person/ theraoist, not a diagnostician. They can treat typically based on medical provider orders.

For the psychologist is it a neuropsychologist or psychologist? Either way they should perform their own testing and evaluation. Records csn sometimes be helpful.

Just try to make sure you are ready with snacks or familiar toys if needed as you talk and be sure to let the provider know if your child is responding as he typically does or not.

Best wishes for a great eval and plan!

[olivegoose]

It's a psychologist @life is interesting. Mostly just to help us come up with ideas to help her manage issues while we await DP. Thanks for the advice!

[mrsbuttinski]

Mar 16, 2015 21:45:15 GMT -5 Life is interesting said:

As one who feels I have had biased appointments in the same hc setting I don't bring records until after a visit. I want each provider to come up with an independent assessment based on their training.

Depending on tests done, you might want to at least have a list handy of what scales were done previously and when. A number of instruments used have strict time guidelines which could render a test invalid if repeated too soon. If you're relying on insurance, they will exclude payment and you'll be stuck paying for something that has no value.

Remember too, an OT is a support person/ theraoist, not a diagnostician. They can treat typically based on medical provider orders.

OT is the generally the professional who dxs SPD. Many dev pedis shy away from it since it isn't recognized as a "medical condition". Of course this sets up a situation where the person benefiting financially from the therapy is the one suggesting it which isn't ideal.

[olivegoose]

mrsbuttinski Your last point is actually why we are seeing a new OT. We felt like the old one just did anything to say she needed services but never explained why she did, never did a sensory diet for home, and didn't work with her on the goals we set. For example, our biggest issue at the time was transitioning. If DD didn't want to stop her task they just let her keep going. One time she colored for 45 minutes.

[mrsbuttinski]

Mar 17, 2015 9:35:00 GMT -5 olivegoose said:

mrsbuttinski Your last point is actually why we are seeing a new OT. We felt like the old one just did anything to say she needed services but never explained why she did, never did a sensory diet for home, and didn't work with her on the goals we set. For example, our biggest issue at the time was transitioning. If DD didn't want to stop her task they just let her keep going. One time she colored for 45 minutes.

It would never occur to me to have an OT address this.

It's a behavior. Behavior, IMHO, should be addressed behaviorally. 

I think a lot of people with kids who eventually get pegged on spectrum rely heavily on their first therapists. This can lead to seeing behavior exclusively through the lens of SPD or speech delay. 

[olivegoose]

mrsbuttinski, they asked me what my goals were for her and that's what I said was my biggest concern at the moment. It was never suggested to me that it would need to be addressed in a different manner or that it could be related to something other than SPD. They agreed to it as a goal. I didn't know anything about any of this then, I barely do now.

I like the new OT. She said that she has some auditory processing issues, specifically if she isn't looking at you when you are talking to her. I did a new sensory profile for her and signed paperwork so the old OT can send over their records.

[mrsbuttinski]

Mar 17, 2015 21:50:23 GMT -5 olivegoose said:

mrsbuttinski, they asked me what my goals were for her and that's what I said was my biggest concern at the moment. It was never suggested to me that it would need to be addressed in a different manner or that it could be related to something other than SPD. They agreed to it as a goal. I didn't know anything about any of this then, I barely do now.

I think this is an example of the old saying when you only have a hammer, everything look like a nail. This is the risk of a 10 Blind Men and the Elephant approach- everyone who has a part is trying to understand it in the context of their own limited area of expertise. This is why a dev pedi or psychologist can be useful as a kind of general contractor; they can identify needs and prioritize them instead freeballing it. Does the psychologist you'll be seeing have a primarily ASD client base or is this another generalist?

I like the new OT. She said that she has some auditory processing issues, specifically if she isn't looking at you when you are talking to her. I did a new sensory profile for her and signed paperwork so the old OT can send over their records.

What? All four year olds have immature auditory processing. It's part of being four. AP is an emerging skill well into puberty, even for well developing kids. Audiologists, who are the professionals who dx this condition (not OTs), generally don't give the dx until around 7 or  8. 

When you say "not looking at you" do you mean she tunes you out if she interested in or doing something else? Like if she's focus on playing with something or watching a DVD? Or do you mean if you haven't established eye contact? A lot of people on spectrum have difficulty with eye contact; it can be very anxiety provoking. It can feel like an assault. If people are pushing eye contact, she may be shutting down to avoid you. 

What does it look like? Is she unable to remember multistep directions? Does she take an inordinate amount of time to come up with an answer? Does she just blow you off with "I don't know" or a nonsense answer?

[olivegoose]

She oftens blows me off with a nonsense answer or an "I don't know." She has a hard time with multi-step directions. She will complete the first task and then need to ask me what she's supposed to do next.

She has a hard time with eye contact if you request eye contact, like to look for a picture or if you ask her to look at you when you're giving instructions. She makes good eye contact otherwise. I don't ask her to look at me when I talk to her, I ask her to show me she's paying attention (we've talked about what that looks like). The OT said that when she was working with her she noticed that if she didn't first get her attention it was like she didn't hear her.

Concerns over how she processes sound is the reason we started this whole journey in the first place. I feel like she hears way more than the average person does. She used to cry over things like the vacuum cleaner, loudspeaker at the grocery store, car alarms, lawnmowers... but as she's gotten older and can understand what those noises are they don't bother her as much, but she has to know what every thing she hears is. Sometimes I have to stop and listen to figure out what she is talking about. We have noise reducing ear muffs that we take with us if we are going somewhere that will be especially noisy (Fourth of July, the movies, the fair, children's concert at the zoo). She can still hear through them but she doesn't get upset.

[olivegoose]

She's a child psychologist her specialties are listed as: "Abuse: Physical, Abuse: Sexual, ADD/ADHD, Anger Management, Anxiety/Fears/Phobia, Depression/Mood Disorders, Divorce Issues, Family Issues/Therapy, Foster Care, Grief/Death, Women's Issues" on the practices website.