Special Needs

Intro and some questions re: SPD

Hi!

I've thought for a while that my older DD (4 years old) has sensory issues, but whenever I brought it up with my pedi, she didn't seem too concerned--the pedi has very good rapport with my DD, so I think it's less apparent at her office than in other environments.  Around January I called several therapy centers and got on the wait list for an OT evaluation based on my concerns.  Her preschool teachers thought it was a good idea as well.

We had the evaluation yesterday and the therapist said that she believes that DD has SPD and that she has fine motor deficits (which I knew) and problems with her vestibular motor system.  She's also sensory-seeking with movement and sensory-avoiding with tactile things.  The therapist recommended weekly OT, and after watching the evaluation, I absolutely think DD needs therapy.  As it stands, we don't have an official diagnosis and our insurance is rather crappy, so we'd be paying out-of-pocket.

I'm wondering if we should have her evaluated through Child Find to see if she would qualify for services and if I should have her evaluated by a developmental pediatrician, as well.  Her language skills are very good, so both her teacher and the pediatrician were skeptical that she would qualify through Child Find.  Some of her fine motor deficits seemed pretty glaring to me during the evaluation, though.  She can't figure out scissors, sewing cards are a huge struggle, she can't operate buttons or snaps.  On the other hand, she can write her name and draws very detailed figures.  She's very outgoing and social, and she is able to follow the routine at school, but she tends to avoid certain activities because of her sensory issues.

For those of you with more experience with this, how would you proceed?  Should I start therapy while pursuing additional evaluations that might possibly result in some of it being covered?  Doing that might mean that we'd have to switch therapists at some point.

Thanks in advance for any advice!  I've been lurking on this board a bit and have found it to be a great resource.

 

Re: Intro and some questions re: SPD

  • Sorry that was so long!  I guess I forgot about the intro part, too :)  I'm a SAHM with two girls.  We used to live in the Boston area and moved to Northern Virginia two years ago.  I'm still a New Englander at heart, though!
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  • image-auntie-:

    When you say "Child Find" do you mean, Early intervetion or do you mean School District services? EI turfs kids to the school district on their 3rd birthday.

    This may be something for which you have to pay out of pocket. Many insurance policies are written around OT services from a disease/accident perspective- they're set up to help someone who had a stroke or accident regain skills. They can do this because school districts are mandated to identify and serve child with disabilities around their educational needs. The downside is, the educational needs of someone in preschool are pretty lame and she might not qualify at this time.

    If your policy ecludes developmental therapies, having an official dx from a dev epdi won't make a difference in terms of making them pay. Some states have mandatory autism coverage for certain policies, but with her social skills, she won't get that dx.

    In your situation, asking for a district eval, asap, would be prudent. The time line on this is that you would write the letter requesting a MFE, stating your concerns, and wait until school starts. Then the clock starts running- 60 school days in which to evaluate- you might have some answers by Thanksgiving or Christmas break. She might not qualify- scissors are generally a kindie/1st skill, dressing is not an educational skill. It sounds like she's drawing, rather than writing letters, so that may be flagged if she has a good kindie teacher. But otherwise, you might not qualify at this time. Schools often downplay the impact of sensory issues, For now, SPD is not a classification in the DSM or under which services are entered into an IEP.

    Thanks so much for your reply.  Yes, "Child Find" is what they call evaluation centers for school-based services around here.  That's pretty much what I suspected, and since they only have 1/2 day kindergarten around here, I feel like her areas of difficulty wouldn't really start to present a problem in school until first grade.

    She still has another year of pre-school, but I feel like we need to work on this stuff.  She's getting better at finding ways to avoid activities that are difficult or uncomfortable for her, and I feel like that's limiting her experiences.  I'm pretty certain that my DH has an undiagnosed LD.  He's developed good coping mechanisms and work-arounds, but he really struggled in school despite getting good grades for the most part.

  • imageCnAmom:
    Just want to add that the response you get might depend on your state, school district, and even the child in question. Bot of mine have SPD but the school district seems to think that DS2's sensory issues are more worrisome than DS1's. While DS1's sensory issues have been noted on his records, DS2's are physically on his IEP as a reason why he was accepted into the school. While our school district has been very receptive to acknowledging their SPD, they seem to be a little picky and choosy about what qualifies for services. I agree with Auntie about getting the ball rolling on this ASAP, but that might be something to consider going forward.

    Thank you!  That's very interesting.  I felt kind of sheepish about requesting an evaluation through the school because when I looked through their lists of developmental guidelines there were only a couple of things that stood out to me, but after seeing the evaluation yesterday I realized that those few things are just symptoms of what's really going on.  The good thing is, even if they don't approve her for services now, they will re-screen at a later time if things change.

  • My DD will be entering Kinder this fall, and she has some similar issues.  She's got gravitational insecurity (vestibular sensory issues) which has translated into gross motor and fine motor deficits.  She cannot ride a bike, has trouble with some heights and stairs, etc.

     We did private therapy from 2.5-3 years old because EI was only willing to provide 30 minutes of PT (she needs/gets OT) once a MONTH and I wanted more for her.  Our insurance covered a limited number of sessions, and then we had to pay out of pocket, and we have excellent insurance.  At age 3.5 I had her evaluated by the school system, and she did qualify for services.  She did not attend the local SN preschool, but I took her there for 3 service sessions a week.

    I wouldn't assume your DD won't qualify.  DD's issues are fairly subtle at this point, but she did. They work with her on being comfortable on the playground, crossing midline for table top tasks, scissors, etc.  She can also write quite well (though, like Auntie said, some letters she "draws") and draws incredibly detailed pictures.

    She's made great strides in 2 years of school-based OT, and her IEP will carry over to kinder.  I already had her transition meeting with the new team at her new school, so she'll start up day one.

     Anyway, I agree that asking for the evaluation would be a good first step.  GL! 

  • imagewellfleet04:

    My DD will be entering Kinder this fall, and she has some similar issues.  She's got gravitational insecurity (vestibular sensory issues) which has translated into gross motor and fine motor deficits.  She cannot ride a bike, has trouble with some heights and stairs, etc.

     We did private therapy from 2.5-3 years old because EI was only willing to provide 30 minutes of PT (she needs/gets OT) once a MONTH and I wanted more for her.  Our insurance covered a limited number of sessions, and then we had to pay out of pocket, and we have excellent insurance.  At age 3.5 I had her evaluated by the school system, and she did qualify for services.  She did not attend the local SN preschool, but I took her there for 3 service sessions a week.

    I wouldn't assume your DD won't qualify.  DD's issues are fairly subtle at this point, but she did. They work with her on being comfortable on the playground, crossing midline for table top tasks, scissors, etc.  She can also write quite well (though, like Auntie said, some letters she "draws") and draws incredibly detailed pictures.

    She's made great strides in 2 years of school-based OT, and her IEP will carry over to kinder.  I already had her transition meeting with the new team at her new school, so she'll start up day one.

     Anyway, I agree that asking for the evaluation would be a good first step.  GL! 

    That's so helpful--thank you!  The vestibular issues are completely new to me, but after reading more about it, some of DD's struggles make so much sense in that context.  I think we are going to start private therapy now and seek an evaluation through the school simultaneously.

    Thanks so much for the advice, everyone.  I'm sure I'll be participating more on the board :)

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