Friday, November 27, 2015

OT evaluation

On Wednesday P had an evaluation to see if he needed occupational therapy. I had been somewhat afraid that I would be told that his problems were nothing, and that we should never have requested a referral. Instead, when I told the OT that P had been assessed for occupational therapy through his school system, she said, "He didn't qualify, did he? Yeah, he'll qualify with me." Which on one hand, was nice because he'll get help, but on the other hand I thought, Jeez, he must really be lacking in skills if she's so confident that he needs this.

Yeah, he was lacking.

His core muscles are weak. His joints are weak and floppy. He can't coordinate moving his limbs together, like doing jumping jacks or using both hands to put pennies in a bowl. He has a primitive neck reflex that keeps him from moving his head without turning his body (I've noticed before that he sometimes gives me a certain look out of the corner of his eye when he asks a question - I thought it was a cute mannerism, but it turns out that he just can't move his head). His vestibular system is jacked up, which is maybe why he gets so carsick. His pencil grip is wrong. He seeks sensory input. The whole time I kept thinking, How did I not notice this? How did I not realize he was so far behind?

The nice thing, though, is that she seems to feel confident about his prognosis. She has a plan of attack and she'll give us things to do at home. I feel like we'll see results.

The other interesting thing was that she either picked up very quickly that he was gifted, or she read his chart. Either way, about ten minutes into the evaluation she started talking about very bright kids and the frustration they can experience when motor delays affect their ability to write or do projects. She talked about how bright he was, asked if we were considering enrolling in the local gifted magnet school, and discussed the more academically-centered high schools. When I mentioned that the school seemed to have some difficulty understanding the difference between his physical difficulty with writing and a lack of cognitive ability to write, she rolled her eyes and said that one absolutely did not equate with the other. At the end of the evaluation she said that it would be fun to work with him, and that he was a "great kid."

One one hand it's great that he has an OT that gets him. On the other hand, the people that think that he's gifted but quirky include the team that evaluated him last spring (a psychologist, a special ed teacher, an occupational therapist, a speech therapist, a special ed supervisor, and a social worker), two gifted & talented teachers, a psychologist who reviewed P's records when we were considering a 504 earlier this fall, and now a clinical OT. They all see his strengths and weaknesses as pieces of a larger pattern, a profile of gifted asynchrony that includes both skills to work on and talents to nurture. The deficits don't erase the gifts, and the gifts are awesome.

And yet, his teacher just sees a kid who's basically behind but managed to ace an IQ test. His principal just sees an undiagnosed autistic kid with a mom in denial. I don't know how they can be so entrenched in their opinion in the face of so many dissenting opinions.

Maybe after OT beings to help with the deficits they'll see more of his abilities. I doubt it, but one can hope.

Saturday, November 14, 2015

New books

P's school has started a program where kids get a prize if they read 20 minutes a day. P usually reads like he breathes, which is constantly, so I was really surprised when I had to remind him to do his daily 20 minute readings. Last night I asked him why he wasn't reading as much, and he sighed heavily and said, "I haven't been happy with my reading lately. I've read all of my books and I'm tired of them."

Usually book fairs, book order forms, and trips to the library ensure that we have a steady stream of fresh reading material in our house. It didn't even occur to me that might be a problem...but in thinking on it, we hadn't gotten a book order form until just recently, and things have been too hectic for library visits lately. Sure enough, he was out of books.

I offered to let him read a book online, and I signed into a website that allows teachers to print out leveled reading books. I found an entire section of science books and we sat reading about deep-sea creatures, how different animals have different eyes, and how diamonds are formed. P curled his long, lanky seven-year-old self into my lap and stopped me after every passage to comment or connect it to something he had seen or read elsewhere. Every once in a while he stopped me to say, "That's amazing," or "That's fascinating. Isn't that fascinating?"

What really struck me was that he seemed to unwind and relax before my eyes. It was like he'd had an itch all week and was finally able to scratch it. He loves learning, the voracious consumption of facts. I underestimate that sometimes.

Soon his book order will come. He'll get a book about minerals and another one about how to grow sugar crystals. He'll be so happy.

Sunday, November 8, 2015


On Friday afternoon one of the occupational therapists came to talk to one of my colleagues. I overheard that she sends her kids to one of the schools we're considering for my son, so we got talking about that school, and then about gifted kids, since her two kids are.

I got on a roll about my son's school, and how they think he's a bad writer because of his bad penmanship, and how he should just use an AlphaSmart for typing, and see, this is what they're complaining about, this is his handwriting, as I showed her a photo of his writing my phone. She took it and flinched and said, "Oooh, that's bad."

Now, there's a difference between bad handwriting, and bad enough to make an occupational therapist flinch handwriting. Apparently my son has the latter. She offered me a couple templates of special handwriting paper and a list of community resources for occupational therapists. She also asked some he clumsy? Does he seem to have trouble with awareness of space? She said gifted kids live inside their heads a lot, and that doesn't lend itself to learning spatial and body awareness. It all makes sense, but it's still weird to hear, "Your child could use occupational therapy," from an actual OT. It makes it seem like something is really wrong.

Part of me is furious because it means that, to an extent, his school was right. Something is wrong. I know I come into school meetings and err on the side of, "He's extremely bright and misunderstood," because I feel like I have to in order to counteract their attitude of, "He's probably autistic and he should go to a different school." Considering occupational therapy is like conceding to their viewpoint. I'm also afraid that if they find out they'll say, "Well, look, he needs extra help. He's obviously special ed. We need to refer him again and make sure he's labeled this time."

Part of me is frightened. I know my son is outside of average, but this is a concrete sign of that. Most kids don't need OT to learn how to write, or put on a coat, or walk without banging into things. If he needs that help it means his brain is not doing something it should be doing. What else won't he be able to learn?

Part of me is embarrassed, because I have friends who have kids with real, diagnosed disabilities who get occupational therapy and physical therapy for an actual, physical reason. Because he has a motor disease. And I just keep thinking, What am I even complaining about? So he can't write clearly or tie his shoes, so what? Seeking out a prescription for OT seems to be akin to saying that I think my son's issues are just as tough as their kids', which isn't true of course. Now, as a speech pathologist I know that's not how therapy is...I see a spectrum of kids ranging from kids who can't speak at all to kids who have a mild stutter. But still, I feel like I'll be laughed out of the OT/PT clinic and my son's troubles will be traced back to my own inadequate parenting.

In the end, regardless of how I feel or what the school thinks I have to do what's best for my son. And that means talking to my husband and our son's pediatrician about whether this is something we need to pursue.