EI re: how to request a new therapist

MrsT0514

I brought this up here not long ago, but I'm feeling like it may be time to act on it...but honestly, I feel awkward talking to our service coordinator about it.

Im not crazy about our current PT. She's a nice lady and all, and its easy to sit and chat with her, but I'm just not fully on board with her technique/approach. DS cries through pretty much every session with her and I'm just not comfortable with it. I get that therapy isn't all fun and games, but idk. I cant quite put my finger on it, but something in me isnt quite clicking with her.

Plus I had a private PT Eval done by a PT/OT that we have personal history with. I highly trust her professional opinion and even she said that he shouldn't be crying that much during sessions..and to question exactly how much benefit he's getting from sessions if all he's doing is crying. Especially bc he's not like that with anyone else. She mentioned that she does not observe any physical issues (like strength/range of motion, etc) worthy of needing PT per se, but it seems like there definitely could be a sensory component, so she referred us to the OT clinic through our local children's hospital, (since her clinic is small and mainly geared toward PT, not OT/sensory) which his eval is this Thursday. He also has an OT Eval thru EI tomorrow morning that was already set.

So I guess my questions is this. Obviously I will see tomorrow if he qualifies for OT services. If he does, I'm somewhat inclined to either request a new PT or just cancel PT services altogether and proceed with OT thru EI as well as privately through the children's hospital clinic (pending eval on Thursday). Especially bc the PT sessions just dont seem to be benefiting him all that much. How in the hell do I bring this up to the service coordinator without being "that obnoxious parent"?

EmAre

We switched OT's just because my daughter didn't seem to mesh well with her first therapist. She seemed to just set fine manipulatives down and "check out" for the most part. Requesting a change was the best thing we ever did. My daughter responded so much better with the second OT and got much more out of her sessions. I just called our service coordinator and requested the change and it took less than a week.

I would suggest switching over canceling PT altogether because your child could still gain so much by focusing on gross motor in addition to fine motor. EI is only for such a short amount of time. I tried to maximize on what my daughter was eligible for while we still could.

MrsT0514

@ChickenOnSunday‌ thanks for sharing. The last time I brought up a concern regarding the PT's approach, our service coordinator seemed to backpedal a little and say "well thats why we all say PTs have the hard job, bc some crying is to be expected".

Not only that, but she just seems to be sort of an alarmist too. We've seen an ENT, our pedi, and a Neuro re: his balance/coordination and none of them have been concerned enough to recommend further testing right now. But the Pt will say stuff like "oh well I'd probably go ahead and do an MRI just to make sure there's nothing else going on". Or the one day DS zoned out for a second bc he was absolutely exhausted (he napped for like 2 1/2 hrs as soon as she left), she said to keep an eye on it bc if it happened again, we should have an EEG done bc it COULD be an absence seizure..well it hasnt happened since (he's always able to turn and look at us if we call his attention and the neurologist did not mention any concern). Idk, I'm not trying to be ignorant, but I'm also not going to rush to sedate my 20 month old for a test he likely doesnt need. Furthermore, if there is a concern that should warrant testing I'm sure our dr would mention it.

I mean, like I said, I'm sure she's a good Pt, there's just something about her I'm not meshing with. But how do I say that to the service coordinator without coming off bitchy or flaky?

MrsT0514

Sorry that got long, I guess my main point is that I just need our therapist to do just that...provide focused therapy for what they are here for...not try to be our doctor. Bc that's what we see our doctors for, am I right?

I keep wavering back and forth on trying to give it more time and bringing it up to the service coordinator. But idk. I think maybe I just need to bite the bullet and risk looking that "that obnoxious mom" and just make the call to request a new therapist.

kcisthebombdotcom

I would not worry about being that parent at all. Sometimes a therapist and a child just don't click. It's not going to be the first time it will happen and it won't be the last. I would discuss with your service coordinator and do both ot and pt.

MrsT0514

@ClaryPax‌ yes, its encouraging that both the EI PT and private PT agree that most of the coordination stuff is probably sensory (also what the Neuro touched on...the possibility of it being developmental coordination disorder, but she's not otherwise concerned enough to do any imaging at this time).

Although the private PT does not think he needs PT. he thinks he'll benefit more from outpatient ot in a clinic with a sensory integration approach. so idk.

I dont want to decline free services that he's already getting, but I find myself dreading our current PT sessions lately, bc I hate seeing him get so upset, and I really question how much benefit he gets from it.

MrsT0514

Also re: the balance issues, at our most recent ENT appt, the dr said, although the balance issue is not an ear fluid issue, it could be something with inner ear like a benign paroxsymal vertigo or something like that that he'll likely grow out of, but he felt that the balance testing was too rigorous at this age and wouldn't be beneficial right now. So we should just continue with therapy and this could very well be a non issue in a few months.

MrsT0514

ClaryPax said:

MrsT0514 said:

@ClaryPax‌ yes, its encouraging that both the EI PT and private PT agree that most of the coordination stuff is probably sensory (also what the Neuro touched on...the possibility of it being developmental coordination disorder, but she's not otherwise concerned enough to do any imaging at this time).

Although the private PT does not think he needs PT. he thinks he'll benefit more from outpatient ot in a clinic with a sensory integration approach. so idk.

I dont want to decline free services that he's already getting, but I find myself dreading our current PT sessions lately, bc I hate seeing him get so upset, and I really question how much benefit he gets from it.

Maybe wait to hear on the OT, then attend the first OT session through EI and ask them if they think he needs to continue PT or maybe even ask the OT in the evaluation.  Do they go over the results with you right away/ same appointment?  Cause when OT is going over the results, you can ask oh do you think he needs any PT then?  Or ask your pedi. 


Yeah, thats what I was thinking too. I'll see what they say at the eval tomorrow, bc they usually go over results immediately.

PipSqueak0313

I'm a little confused about the crying during PT. How is it normal/acceptable? Ds gets private PT through medical insurance 2x per week and EI PT through local school district 1-2x per month. Except when he is not feeling good, he doesn't cry for more than the last few minutes of therapy (PT & OT are back to back at same location) if he cries at all. I'm right there with you on dreading making the call to change out EI person.....I put off calling ours to replace the teacher due to me being sick the past few days.

MrsT0514

@PipSqueak0313‌ @Usm123‌ Thats where I'm at. I get the whole "asserting their will" stage that most kids go through at this age, but honestly, their is a difference between my kid fussing/whine-crying for a minute bc he's not getting his way and the full on tears and screaming/crying that come with the current PT visits. Its awful to have to sit through as a parent, and I'm just not up for it anymore.

So yeah, I guess you ladies are right. Screw it, I need to just make the call (or I'll just mention it after the OT eval today since our service coordinator will be here). I'd rather look like the bitch mom to make my kid happier in the long run, than have to sit through another awful PT session.

MrsT0514

Ugh. Well, we just had the OT eval and it went well. We start once a week OT next week. I asked if they thought he still need PT and they said it'd be good to keep on, although both PT and OT would be work in toward the same goals (Better balance/coordination/increase body awareness).

I brought up my concerns to the service coordinator about trying out a new PT and the service coordinator once again said "well, its also his personality too...He's strong willed so it could just be him protesting the work the PT is giving him". Then she asked if i wanted to cancel PT. When I asked if there was a different therapist available, her response was "I'm hesitant to put a new PT on bc I'm sure she'll just do the same type of things". Idk. Whatever. For now, we decreased PT to just 2x a month instead of once a week. I guess we'll see where it goes from here. It frustrating to feel like my concerns are invalid though.

MrsT0514

@KatyBriggs‌ Yes, our service coordinator has been providing our twice monthly family training/counseling thus far, and will be providing our OT services once/week starting next week.

I get that he is strong willed, but usually that involves him fussing/whining for a few minutes abd then moving on. Not crying with full on tears like he does in PT.

So whatever. If the next few weeks prove to be non beneficial and lots of crying remains, I'll probably just cancel the PT altogether for a while, since we're also persuing a private ot eval/outpatient OT services through the local children's hospital specialty clinic.

kcisthebombdotcom

MrsT0514 said:

Ugh. Well, we just had the OT eval and it went well. We start once a week OT next week. I asked if they thought he still need PT and they said it'd be good to keep on, although both PT and OT would be work in toward the same goals (Better balance/coordination/increase body awareness). I brought up my concerns to the service coordinator about trying out a new PT and the service coordinator once again said "well, its also his personality too...He's strong willed so it could just be him protesting the work the PT is giving him". Then she asked if i wanted to cancel PT. When I asked if there was a different therapist available, her response was "I'm hesitant to put a new PT on bc I'm sure she'll just do the same type of things". Idk. Whatever. For now, we decreased PT to just 2x a month instead of once a week. I guess we'll see where it goes from here. It frustrating to feel like my concerns are invalid though.

I would speak to her supervisor. That's bs. Toddler age kids by rule are strong willed. It is absolutely not normal for a child to cry during the whole session. My kiddo was so people avoidant at her initial ei Eval that she put her head in my lap and cried anytime they tried to get her attention and even she didn't cry nonstop during therapy sessions.

MrsT0514

Yeah, I mean its just confusing to me. When she first gets here, he'll smile and be social with her lile he does with anyone else, but its like as soon as she starts (usually with wheelbarrow holds or some other restraint type exercise), he loses it. She gives him breaks to regroup, and he'll calm right down after a few minutes, but then she'll start back up and he cries again. usually at the end of the session he's fine and will engage her again, but its the fact that she pushes him to get way too upset for ny comfort during the session.

I just feel like he's not getting much out of it right now. I get her reasoning, in that she wants to instill the confidence in him that he can do this stuff, and he cant quit just bc its hard work, but the whole process is difficult for me to watch as a parent.

MrsT0514

Ok well, the service coordinator just called and asked if she can come out next week for the PT to do a cotreat video (pt/ot) . This way we can all get on the same page with the action plan/goals. A step in the right direction I guess!

funchicken

MrsT0514 said:

Ok well, the service coordinator just called and asked if she can come out next week for the PT to do a cotreat video (pt/ot) . This way we can all get on the same page with the action plan/goals. A step in the right direction I guess!

That's promising :)If they think his balance/coordination issues are sensory related, then the OT should definitely be taking the lead on the treatment plan. Let us know how it goes.

MrsT0514

Damn autocorrect. I meany cotreat visit! Not video!!

meldoo2002

I will say… maybe not the best reassurance you want, but I work in EI (and have preemies with epilepsy and probably ADHD)… it does happen that we have children that cry throughout their PT sessions.  It doesn't happen with every child, but there are some that are very strong willed that really don't like the way PT feels or makes them work .. even if it doesn't technically hurt it could be uncomfortable for them to move that way.  I sorta joke that Kathy makes all the kids cry…. she's our PT.  It really unfortunately can be very normal at this age.  

MrsT0514

@meldoo2002‌ thank you for your insight. I think that's what the Service coordinator was trying to explain to me. Although it doesnt make it any easier for me to deal with when my kid is crying during sessions. But I guess we'll see how the next one goes.

Assembly_Reqd

Do they have a bunch of robots doing PT? We've had four now. All worked on the same things. All hade very different approaches to working on the same things. it was a benefit to Nate to switch up. tell your coordinator to assign someone different. Period. IFSP stands for family. the plan is not working for yours.

lvisser

Kinda different, but I've had to request a few different speech therapists for both boys and I just suck it up and do it.. Like ripping off a bandaid.... I'll have to do it shortly, probably, since I am considering a switch in Ezra's ABA therapist... That one will be harder, but I just have to remember it's not about ME it's about Ezra.

MrsT0514

See, I'm just feeling kind of stuck right now. I'm not thrilled with the fact that my service coordinator seems to be blowing off my PT concerns, but she is coming out next week for a cotreat visit with the PT so "we can all get on the same page", which I guess is a step in the right direction. Although it really feels like they're working together with each other more so, than with us as a family, which is a shitty feeling.

Also, it seems like every time she (service coordinator/OT) comes out lately, she's commenting on how concerning his balance issues are and how we really need to push on the doctors for an answer. Umm, not for nothing, but no shit, its concerning...thats why we are in contact with you people anyway. i dont need you to reiterate it to me over and over and instill more fear and anxiety in us as parents.

But on the flip side, I have my son seeing some of the best doctors in the state (neurologist is through our local children's hospital and highly recommended, ENT is also the highest recommended in the state). Neither of them were overly concerned nor suggesting a million dollar work up at this time. If they are not overly concerned and recommending a battery of tests yet, I'm surely not going to put my 20 month old through it if its not absolutely necessary.

I guess I'm just not sure how to handle this situation, and I'm frustrated all around. I feel like as therapists, they need to focus on therapy to help my kid with what he's struggling with, but instead they are becoming a source of anxiety and frustration for me. I'm certainly not an ignorant parent, and if our dr suggests more testing, I'm willing to oblige, but I feel like its not the therapists' place to be pushy on that...its up to myself, MH, and our doctors. So, idk. Its really leaving a sour taste in my mouth.

funchicken

MrsT0514 said:

See, I'm just feeling kind of stuck right now. I'm not thrilled with the fact that my service coordinator seems to be blowing off my PT concerns, but she is coming out next week for a cotreat visit with the PT so "we can all get on the same page", which I guess is a step in the right direction. Although it really feels like they're working together with each other more so, than with us as a family, which is a shitty feeling. Also, it seems like every time she (service coordinator/OT) comes out lately, she's commenting on how concerning his balance issues are and how we really need to push on the doctors for an answer. Umm, not for nothing, but no shit, its concerning...thats why we are in contact with you people anyway. i dont need you to reiterate it to me over and over and instill more fear and anxiety in us as parents. But on the flip side, I have my son seeing some of the best doctors in the state (neurologist is through our local children's hospital and highly recommended, ENT is also the highest recommended in the state). Neither of them were overly concerned nor suggesting a million dollar work up at this time. If they are not overly concerned and recommending a battery of tests yet, I'm surely not going to put my 20 month old through it if its not absolutely necessary. I guess I'm just not sure how to handle this situation, and I'm frustrated all around. I feel like as therapists, they need to focus on therapy to help my kid with what he's struggling with, but instead they are becoming a source of anxiety and frustration for me. I'm certainly not an ignorant parent, and if our dr suggests more testing, I'm willing to oblige, but I feel like its not the therapists' place to be pushy on that...its up to myself, MH, and our doctors. So, idk. Its really leaving a sour taste in my mouth.

I hear you--that's really annoying. Our OT was always asking about DD's vision and talking about her having trouble with tracking objects. She really made a big deal about it. DD failed her vision screening at her six year appt, so I took her to a pediatric ophthalmologist who said her vision was great, no issues. He spent almost an hour doing various tests. He told us he thinks allergies and attention issues are probably why she failed the screening. The OT still thinks there's something wrong. Whatever, lady.

MrsT0514

@funchicken‌ Thanks for the commisseration. Its comforting to know thag I'm not completely off base for feeling this way.

I get that EI is there to help advocate for ny my child and all, but lately I just feel annoyed, crowded, and frustrated each time they visit. Like we've said a million time around here, no one knows my kid better than I do. So for me, seeing day to day inklings a small progress here and there and feeling really good about it, only to have EI come in and reiterate "how concerning his balance is" and that "we should push for answers by moving forward with test x, y, or z" just feels like a kick to the gut.

Its like, oh ok, thanks lady. And where did you obtain your medical degree?