A little background: My DD had an OT eval and was diagnosed with SPD a couple of months ago. The OT told us her fine motor skills were significantly delayed (1st %tile). She also can't pedal a tricycle. She has some echolalia and outbursts in the classroom, as well.
Even though the county's evaluators felt she was in the normal range for everything they tested for, they did open up a case file for her and are going to observe her at school in a couple of weeks. They are also going to look over the final report from the OT (if they ever freaking get it to me), and ask her preschool teacher for feedback.
Bottom line: It's doubtful we'll get services at this time, but we're on their radar. They know about her severe allergies and the SPD. I was impressed with the amount of time they spent with DD. Initially, they told me the evaluation would take about 30 minutes, but they spent over an hour with her.
I have an appointment to talk with the pediatrician about my concerns later this week. I'm right there with all of you all who are playing the waiting game hoping for some answers
Edited: for clarity
Re: Had DD's eval through the school system
This is your four, no? Hi Auntie, yes, this is my four year old.
Most school districts don't get excited about SPD in a mainstream setting. It's not an official classification under IDEA and unless the child has some other issue that is being addressed it's dealt with informally if at all. In my district, sensory needs are only addressed in self contained classrooms. I know that, where the school system is concerned, no one thinks SPD is that big of a deal, but I'm hoping that once they see the report from the OT that maybe the vestibular issues will classify her as having a "higher risk of injury." They told me that the school district only provides OT services as part of a "special needs profile" which sounds to me like I need to get a real diagnosis in order to push for more.
The 1% for fine motor is worrisome. Yes, I agree. They only assessed her fine motor around writing, drawing, and stringing beads. Her drawings are better and more detailed than most four year olds, and she writes letters correctly. The thing that the private OT pointed out to me is that she doesn't use her hands correctly. Because of her tactile issues her hands are super sensitive so she tends to hold things differently than she should--we're working on this at home and with the private OT. That should qualify for services aroung writing, drawing, scissors, etc. Did she attend preschool? Was this noted then? Yes, she's been in preschool for the past 2 years. Again because she writes and draws so well, her teacher last year noted zero fine motor issues. Sometimes schools will take a wait and see or a RTI approach for a young child if they feel she hasn't been given ample opportunities to learn these skills. For example, if she was in an in-home day care with younger kids, she may not have gotten to use age appropriate art materials because of the risk to younger kids. I have a friend who teaches ELL, she has boys in certain cultures who do not get to use things like eating utensils, markers, scissors, etc and who arrive in her class very delayed in this area. Most catch up with exposure.
Did the county test her for gross motor or speech? The testing was done by an SLP and a Special Education Teacher. She breezed through the SLP portion with flying colors and demonstrated absolutely no echolalic responses according to the SLP. She also tested fine in the cognitive portion. Her hand-eye coordination is good, and her gross motor skills are good (she walked at 10 months and has always been early in gross motor). Is there a report from a PT, SLP and school psychologist? Peddling is a zero order skill at 4; mine couldn't peddle until he was five-ish. We didn't realize it at the time, but it was related to DS's autism as a function of hypotonia and poor prescioperative skills/motor planning. This did go away on its own, but it was a red flag we missed. I agree that the peddling is a red flag--it's definitely on my radar.
How much ecolalia does she have? Is her speech delayed significantly. Her speech is not delayed at all. Her vocabulary and pronounciation are better than average. A certain amount of echolalia is normal in a child as they learn language, but if it persists past 36 months it could be a red flag for autism. There are all kinds of echolalia- reciting dialog from DVDs over and over as a stim, repeating the ends of what they've been told (sometimes this is an auditory processing flag), repeating themselves (pallalia), delayed and even functional (where they borrow scripts of words but use them in situations where they make sense). Most of her echolalia is either reciting books/dvds or functional.
I think you're wise to talk to your PCP about these behaviors and the tantrumming. It might be useful to have her evaluated by a medical team of private psychologist. Having a dx or second opinion may help you advocate better to get her services she needs.
The special education teacher that we met yesterday is going to do a classroom observation in mid-September to assess the social piece in a group setting. DD's pre-K teacher is in the loop on all of this--she's awesome. We are supposed to reconvene with the school system team in October to see where we are, so hopefully I'll have something more concrete for them by then.
I finished the Coplan book, btw. Thanks for recommending it. It was very interesting--I learned a lot.
Yeah, the fine motor stuff and the balance issues both need to be addressed. I'm definitely keeping all of your advice in mind. I don't think we're going to get any quick answers, but at least I feel like I'm helping her work on some of these things now.