About this blog.

My son was diagnosed with PDD-NOS at 24 months. I created this blog to bring meaning to the often-confusing label. Sometimes I have answers. Other times, just more questions.

Thursday, October 22, 2009

The best things in life are free.

Recently, I asked Brad's occupational therapist for her thoughts on treatment, short-term and long-term. Our ration of insurance-approved visits will be up in February 2010.

Short term, she's going to continue strength building, grasping exercises, fine motor exercises and the play therapy (Floortime-ish).

For the long-term, when our insurance benefit is up, her sage advice: "Play outside a lot, and have him go on a lot of playdates."

"No, really," I said.

"Really," she said.

"What about occupational therapy? Or physical therapy? Services???" I stammered. "He must need something. Look at him. He still has terrible postural stability."

"Waste of time and money," she replied. "You're buckling him up, and confining him in a car, to drive him somewhere so that he can exercise. Plus, a one-on-one service hour deprives him of play with his peers."

At this stage, I can't say whether Brad's OT is right or wrong, but her common sense advice does resonate with me. Compare and contrast to the advice of Brad's private speech language pathologist (who happens to be quite thorough). Brad's SLP told me Brad's IEP is wholly inadequate and that he needs more service hours at school. Turns out, many children in my school district with a diagnosis do get more service hours in an ABA based program - even the borderline are-they-or-aren't-they PDD kids. Brad's SLP relayed this recommendation to me over the summer, and I have ignored her advice for the very reason Brad's OT cited: more one on one service time at school deprives of playdates and freeplay with Jeremy, which I think is valuable, socially - more valuable than being holed up in a classroom.

So for the time being, I'm inclined to place more stock in the common sense approach of Brad's OT than his SLP. Am I right or wrong? Only time will tell.


Kris said...

There is truth and sense in the OT's advice. Have you read the book "Overcoming Autism"? That book's approach is pretty much teaching real life experiences, having play dates, etc.

The reason I pulled Alec out of social skills classes last spring was as the weather got warmer, he was outside playing with his siblings and neighborhood kids. I was taking him away (and having to fight him to do it)from valuable real-life social situations where he was having a great time to "contrived" social situations with kids he didn't like. I felt like playing with typical kids who were treating him well was more therapeutic than working on "anger management" (not one of Alec's issues anyway) with some kids who were mean to him and from whom he was NOT learning appropriate social skills. Seemed kind of ass-backward to me.

I think some interventions are helpful (for us OT has been great) but real life experiences with peers and family is invaluable.

Anonymous said...

You might look around for a tumbling kind of class. Charlotte has done that consistently for the last 3 years and it's been great. There's other kids, it's a lot of physical activity.

It's not free, but it's consistent and great for the winter when getting outside to play is hard.

The place where we do tumbling also has swimming and dance which are the classes my 2 are doing now, but after each class, we spend a half hour or more in the indoor playground (which is free -woot!) just so Charlotte can get in some physical work.

I do believe they reach a certain age where one-on-one therapy has served its purpose and group stuff is better.

Follow your gut!

K said...

there is a LOT of sense in what the OT said
OUr Floortime therapist said this - surround his day with the 3 S
Sing + Swing + Swim ( including bathtub)

Nyx said...

well we're doing the minimalist thing. we saw one ot once and were supposed to back in for a checkup, but we never got the report we paid for from her (she had to have surgery for cancer), so ... now we're cued up for an eval from the county ot ... but he's made enormous progress on all the areas that she pointed out and we don't really DO anything. all the stuff she said he needed to do, he really just started doing all by himself! she suggested a bar to hang off of, but one day he just pushed a stool up to a window and grabbed it and hung off of it, also started doing it at the playground. she said he needed a little spinning to stimulate the vestibular, but shortly thereafter he started spinning around all by himself. other stuff too. we do a lot of physical roughhousing type stuff, which he LOVES. Also learned that he will run forever and ever if we give him a clear wide straight path -- empty hallway/sidewalk/boardwalk, and we get a lot more running from now due to that, and that has been great for him. We do a LOT of playgrounding too and he just seems to be developing on his own. But it's true that he still ... kind of lurches when he runs ... that one toe is always a little curled in ... I don't know. Have you taken Brad to see a neurologist, actually? I've been thinking about doing that lately. I wonder if I would get any better or different information?

father of four said...

"Play dates" are definitely over-rated im my experience and always leave me wondering whether it is worth it! Spending time outdoors with him doing something physical that he enjoys seems to be a much better choice. Positive social interaction with his peers? There's school, neighbourhood kids, his siblings, ... we are still working on this.

Brenda said...

You know your child best, Laura, so keep that in mind. And since it's something you can do fairly easily, it will be something you can always adjust. But I am always curious about conflicting advice: is your OT advising play IRL as the best course to follow period? In other words, not because insurance is running out, but because it is the best advice for Brad right now? Big hugs. Decisions like these are always so hard.

Laura said...

Kris, Goodfountain and K, thanks for the encouraging words, and good to know. Father of Four, Brad is only 3.5 so his playdates are mostly parallel play at this point. Nyx, no, haven't taken Brad to neuro, and Brenda, I told my OT I would have at least considered paying for OT out of pocket if she recommended it.

A little boy just 3 years old said...

The other point of view I come from.... is that my son really seems to pay better attention and allow the outpatient OT to do new things that at home he just fights. It's that old problem where kids act great for someone else, and horrible for their own parents.

But it is what keeps me knowing SLP and OT are the way to go for us. If we can just get him to do it with them ONE TIME he'll at least entertain the idea of doing it at home for me, 'Just like Jen did'.