Wednesday, October 31, 2012

To OT or not to OT

So - a bit has been going on in our world.  Anjali has started preschool - and she seems to really like it I'm told by her teachers....and other staff that stop me in the hall with all these cute stories about her.  She still cries a bit when I leave her - but I recall Joshua doing that as well, and I'm told that's all normal.  She stops crying before I even leave the area :)  - and last week she hugged her teacher when we left.

Our biggest challenge has been the busy schedule.  She goes to preschool on Monday, Thursdays, and Fridays, and we have been having PT and OT on Tuesdays and Wednesdays.  But now I'm wondering about the OT.  When we go to our provider of these services, she LOVES the PT activities and seems to hate the OT time.  I totally get the need for her to have PT -- I can see why, and I am fully bought into the idea of PT, this girl needs to build a strong core -- she falls alot and needs muscle building.  But OT, I'm not so sure -- so this is where all of you come in -- please post ANY advice you may have.

They say she is a sensory seeker -- at times I question whether or not she's just a child, three years old, exploring her new world....which let's face it.... is DRASTICALLY different than where she lived before for the first three years of her life.  She has transitioned so well.... and we've really asked a lot from her when you think about it:
  • Long trip home across the ocean
  • She attends church service (plays either in the nursery or the 3 year old room - depends on her mood - and everyone is fine with that :) ....LOVE our church
  • She goes to small group on Wednesday nights with Joshua at church
  • She has stayed with her Nanna while Brad and I have went out for dinner a few times
  • She goes to preschool
  • She's met a bunch of people
  • She shops with me
  • She plays inside and out
  • She plays with other neighborhood children and families
  • She loves to help with cleaning dishes
  • She is trying tons of new foods
  • She has a different bedtime routine than most of her life
  • She has a new brother -- who at times picks on her a bit - in a loving brotherly way -- but is someone she adores
  • She's still warming up to her daddy -- honestly she LOVES when he comes home because he does this special swinging activity with her
  • She met two new grandparents when Brad's parents came to visit .....
and I'm sure this list goes on and on..... so I have to this girl adaptable???  Yep, I think so.  Can she be rigid - like her LOVE for "shock-o-lot" (Chocolate) - her opinion that rice and rice and more rice is her preferred food... that SHE likes to peal a banana -- please let her do it her self -- and even more recently her desire to use the toilet -- and actually want to pull the step stool to the toilet HERSELF so she can get up on the toilet -- keep in mind this kiddo is somewhere around 25 or 26 lbs. She is tough, she is strong... she is smart... she is determined....she is eager to please.

I'm told, she needs OT - because of her sensory seeking behavior that she will have trouble learning, writing and fine motor skills (don't really believe that, given she can easily hold a pen or pencil the correct way), and she will struggle focusing on a single task that her teachers will want her to do that she may not prefer....... sound familiar about ANY child age 3-23??   So I struggle to what extend do we keep pushing her??  I'm not saying I don't see the sensory seeking things she does, I do -- but I feel now that we know what it is, we can better respond -- and when we give her inputs, she does very well.  Will the life skills come with overall daily activities?  How important is OT at this very moment??  (The care providers seems to put on the guilt by saying things like, "if you don't get OT now, you will be back later for it" and "it's so much better to do this now than when she's in school and grades matter", etc, etc..... ).   So I continue to struggle with this decision.  And of course she's verbal and jabber, jabber, jabbers alot -- problem is, it's in Marathi - so I have no idea what she's saying.  Here is what I do know, she's happiest at these times:
  1. When she sees Joshua first thing in the morning
  2. When we pick Joshua up from school
  3. When she's having pretend sword fights in my kitchen with Joshua, having horsey rides with him, playing on her scooter, or playing with almost any of his toys
  4. And I'm told she's happy around the other children at her preschool. 
  5. And she's happy when all of her family is together

I'm trying not to be one of these "blinded - biased" parents -- but at some point don't we just let kids be kids?  Help me here if I'm off my rocker -- and from any of your experiences OT was the best route early on..... what do you think the criteria should be before sending a child to OT?.... help me with this abstract service - because at times it just seems like they are just playing with children -- and isn't that what we as parents are supposed to be doing?  So can this sensory stuff go away through the normal course of growing up - and playing - being in a family???   What about the brushing - what would you say is the criteria for a child to begin brushing? We give lotion massages at night - and she seems to really enjoy it -- plus her skin NEEDS it so badly this often. So does anyone know of any good website discussing this, have experience on this topic, etc?? I want to be able to cancel OT for a few months, maybe even until spring - but don't want to make a mistake that we regret down the road...any thoughts??       


  1. I am not an OT expert, but I think I would probably ask a few more questions. Such as:

    1. Does your OT specialize in working with adopted children, or have a good amount of experience working with children who've been in a orphanage setting? If so, I'd take what they say pretty seriously -- because they do see the results down the road with kids who do/do not receive OT. If not, I'd probably do a little research and call an OT who has experience with our kind of kids. They might have more insight.

    2. I would ask to stay during OT and ask a bunch of questions about what the different tasks/play are designed to accomplish. First, because I just don't know :o), and second, because I do know that some normal play behaviors accomplish particular kinds of brain development (such as crawling, which is important for kids' reading skills later, etc.).

    3. I'd also consider what her orphanage was like, if you have any details about the care there and the adult-to-child ratio. Some kids really have never left one room for most of their lives, were never held, were not held while being fed, were in a crib most of the time, never heard music, were never read to, etc. That info may help the OT (and you!) with assessing her needs. Of course, most of us don't know anything but what we observe the day we meet our children . . . so there may never be much info about that.

    So, no advice, really -- just a few thoughts I had while reading your post! I know that an institutional setting is very different from a home regarding physical activities, mostly for one-on-one stuff and sitting still kinds of activities (being read to, doing craft activities), as well as time exploring outside. So that's my two cents! Let us readers know what you decide -- we're all learning from you. (But no pressure!!!)
    Hugs to you,

    1. Nancy -
      These are great points! I think that they see a fair number of adopted kiddos - but I also think the owner is business growing mode - based on a few exchanges with her - so I find myself skeptical. I do go back with her during the sessions - but do need to probably ask more questions - we are ususally so wrapped up in getting her to participate - once she does - we are very quiet not to disrupt it -- but I do need to ask more, for sure. The orphanage is hard - because I do think that she did likely spend quite a bit of time in a crib - but I think was also held a lot - did get PT while in the orphanage - but I also know that she had many care givers, but I think was well taken care of, well fed, etc -- so not sure about that one - I think she has some sensory issues for sure - just not sure how much need addressed at OT - and what we can work on at home?? School seems to be doing wonders for her too.

  2. What kind of sensory seeking behaviors are you/they seeing? I have a 5 year old, home from India at 3.5, no one ever suggested OT, and I think she may need it, but my daughter has clear sensory related behaviors that give her trouble in relating to others - when she meets someone, she may slap or punch them instead of saying hi. She runs around and crashes into things when she is happy/silly, her emotions are always very up or down, she can't self regulate when she's mad, and on and on...
    I would think if her behaviors are not interfering with daily life, I might take a wait and see approach.


    1. Carole - her issues are mainly that she rarely sits to play for any extended length of time - she is constantly on the move and has very little attention span. She does many things, some being... try to play on the computer, turn off and on light switches, washes hands and brushes teeth many times during the day, hitting the stapler on the desk multiple times (I don't like this one), she also does some rocking and headbanging to self-sooth (which I think is fine). When we bounce her or swing her upside down -- she will ask for more of it a hundred times over. These may sound like all normal things - it's the constant desire for these things - it's like she needs something to calm her insides and she is going out looking for that "something". I'm told this could lead to troubles in reading, learning, etc. later on - especially if she doesn't learn how to process things - because otherwise going through school will be a real struggle. This article was about the best one I could find that explained the types of sensory issues. It seems to me a child either needs more input -- or need considerable less and likes things quiet, can't handle certain clothes, etc. I'm with you - I think if these things aren't interfering - we wait and see until her core gets stronger through PT - and see what she needs then. She seems to be able to engage in preschool very well. This article, I thought was good:

  3. I think that the questions that Nancy has suggested are great! Jadon really should have had OT at a young age. The OT evaluated him in some areas, and since his gross and fine motor skills were excellent, they said that he didn't need it. But, he has severe tactile defensiveness. We had an OT evaluation last year, but I felt like I knew more than the therapist since I had done a LOT of reading and workshops. So we didn't actually do OT.

    I don't think that it would hurt at all to wait a few months, but I would read a LOT about sensory issues, since, other than general fear, I think that this is the biggest issue that we've dealt with with two (Jadon and Yana) of our adopted children.

  4. My youngest came home from India at 2.5. He has spastic quadriplegia, so many therapies are absolutely necessary. That being said, we minimized his services for a while, because he was changing so quickly, and we really felt that establishing home was more important. Especially with busy families (we have 4 kiddos 9 and under), I always keep in mind that there has to be time for him to just be a kiddo. I love the questions that Nancy posed. It's a balancing act sometimes.