OT stressing DD out

[WindyCityMom]

Hey everyone!  My DD is almost 5yo.  She's in Occupational Therapy for sensory issues and gross motor planning delays.  She hasn't been formally diagnosed with Aspergers but it has come up as a posibillity, though I go back and forth on it.  She has selective mutism and is uneasy in social situations.  She used to completely shut down in all social situations.  Now, if she knows what to expect, she approaches the situation cautiously and doesn't do the whole shutting down and going mute thing.  I mean, she still does, but not in all situations if that makes sense.

Her motor skills have improved SO much in OT.  She has come so far.  That was her therapist's priority.  Now they have moved on from that focus and shifted to dealing with her social issues.  DD hates going to OT now.  We are playing hooky today for the second time in two months because DD is begging me not to go.  She doesn't like interacting with other kids (last week she had to play connect four with another child, the week before that it was another game).  She's fine talking to adults- her therapist has her do art projects and then walk around and show off to other therapists- DD can deal with that.  She just is an emotional wreck after the sessions where she has to interact with other kids.

I understand the importance of trying to get DD to come out of her shell but I'm not sure it's helping for her to be terrified and an emotional wreck each week.  The therapist says that that is the outcome she wants to see so she can help DD figure out a way to deal.. and that makes sense, but when DD is a complete mess for hours after the session, it's really, really hard to see the benefit.

I don't want to pull her out of OT- I'm scared if they do that she won't get into the behavioral and speech therapy she needs.  She's also on a waiting list for a playgroup for kids with social issues, but she has been on that for at least two years...

Advice?  

[Piglet68]

I'm not sure how it works where you live. Our OT comes to our home and works one-on-one with our kids (they are homeschooled). She models social skills with her interactions with them (they play a lot of games, specifically chosen for such things as the need to take turns, for example). So I think it is possible to start working on that without having to be in a group (I know if kids are in schools they often don't get a chance for one-on-one therapy so it depends on your situation). I consider this a necessary step for my DD particularly, who struggles with being around other kids in group settings and she is just not ready yet for what you've described. She loves her OT sessions but I know if she were doing what your DD is she would also be a wreck afterwards.

My feeling is this: it's good to push these kids just a little bit beyond their comfort zone and a good OT knows where that line is. If my kids get pushed too far they are a wreck as you described. But when they get pushed just enough they are emotionally tired afterwards, but in a good way, like post-exercise. I notice they will take some quiet, alone time for themselves to rest their bodies and minds. So I use that as a gauge. If they were having real troubles coping I would consider that going too far, too fast. HTH.

[KCMichigan]

Originally Posted by Piglet68 

My feeling is this: it's good to push these kids just a little bit beyond their comfort zone and a good OT knows where that line is. If my kids get pushed too far they are a wreck as you described. But when they get pushed just enough they are emotionally tired afterwards, but in a good way, like post-exercise. I notice they will take some quiet, alone time for themselves to rest their bodies and minds. So I use that as a gauge. If they were having real troubles coping I would consider that going too far, too fast. HTH.

Totally agree.

I would ask the OT to step a bit back , but CONTINUE to do activities that help your DD experience structured social settings with peers. Maybe if she was playing games for 15 min then ask for it to be shortened to 8 min. Etc.

I would not give in to begging to not go. Just be matter of fact. I see OT/PT etc as medicinal. My DD did not like PT, it was uncomfortable-- but to stretch weak muscles it is the best way to get range of motion. No she did not like it, but it was needed. Try to pair up the sessions with something your DD LOVES afterward (as long as it is not too overwhelming) to help build a positive association. Or maybe do a positive activity before hand.

On OT days, we always had a sensory 'cool-down' at home afterward-- weighted blanket, quiet, low activity, etc. Also make sure the time is good--- DD always did better in the AM  versus PM. She just could not handle the extra nudge toward things she found difficult in the afternoon, but mornings she was much more willing to try it out or go a bit further sensory-wise.

It is possible the OT is trying to prep her for group social class. That will be more kids and more structure and she likely will find it challenging. But one on one may be a good transition to a small group for social skills.

Maybe also ask for some social stories to read before and after OT to help her emotionally. I know some kids react positively to 'knowing' what will happen ahead of time and being able to process it a bit.

Also possibly try older (teen) or younger (toddler) kids--- the age difference was a  bit less threatening to my DD, if that makes sense. Teens were 'almost adults' and toddlers were 'babies' and really did not talk back to DD. 

Talk to  your OT and find a good solution. It is not good for constant meltdown and hours of anxiety, but also I would not pull her out of OT.

I am sure that they are used to this situation (in fact, our OT warned us that we would see an increase in behaviors at first with brushing therapy-- but to keep going and it would improve and then go on to get even better. She was right!! The first week  of brushing was hard, but it got so much better and DD was better regulated afterward for months.).