View Full Version : Should I make an appointment with an OT for Jack?


Aim
07-08-2007, 01:27 PM
Thanks to the time I spend here LEARNING about GERD and other related and non-related issues and disorders, I'm becoming more and more convinced that my almost-3-year-old (7/31/04), Jack, has a minor-to-moderate case of Sensory Integration Disorder. As he gets older, it is impacting his behavior and his relationships with me and DH enough that I think we should get a professional evaluation for him. ESPECIALLY before we enroll him in Preschool this fall as we were hoping to do.

He's worked with a Developmental Therapist and a Speech Therapist (through Early Intervention) due to a minor speech delay, but Occupational Therapy was never recommended.

However, I'm also confused/concerned because his symptoms seem to be conflicting with any one form of SID. He is both hypo- and hyper-sensitive. Here’s a rundown of my observations:

1) He hates tags and seams on clothing, but is otherwise EXTREMELY physical (and physically affectionate), often to the point of being unintentionally (but seemingly uncontrollably) rough and aggressive. He hits/bangs things (and people) repeatedly to elicit a response…despite the fact that it is usually not a positive response. (Thankfully, he’s never been a biter, though.)
2) Despite usually being physically affectionate with people, he has just finally started to exhibit some “stranger/acquaintance anxiety” in the last month or so.
3) He LOVES to swing and spin and run around and crash into things…then fall down laughing like crazy.
4) He is NOT clumsy at all...in fact he is a daredevil and is seemingly fearless when it comes to playground equipment, jumping on furniture, etc. People are amazed to observe his climbing/balance skills (from a VERY young age…he was walking at 9 months and climbing rock walls at the local park before he was a year old).
5) He often has HUGE (embarrassing) tantrums when it’s time to transition from one activity to another. (Especially stopping something “fun” or leaving somewhere “fun”.) And it’s hard to know when a tantrum will happen and when it won’t, so it’s not a fun guessing game. But I’ve been finding that SOMETIMES, just taking him into a big bear hug (which is not easy with him kicking, flailing and screaming) will “shut him down”.
6) He seems to get overstimulated and hyper very easily, but can also become fixated on one activity (often a repetitious activity) for an inordinate amount of time. (His Speech Therapist has commented positively on his attention span for his age.) For example, he drives his father and me nuts with pretending to mow the lawn and use a weed “whipper” (as he calls it). It’s not the activity so much that annoys us, as it is the incessant, droning “WAHHHHHHHH” sound effect that he INSISTS must take place during that pretend play.
7) He is a thumb-sucker (when tired or overstimulated) and is very attached to his blue blanket that we have named “Blue”.
8) He is NOT a good eater, wanting to eat/drink only dairy products and sweets/carbs (bread, crackers, pasta). It is a fight every day to get him to eat a “balanced” meal.
9) He is always “on the go” and we find ourselves frequently telling him to “slow down” or “calm down”.
10) He will NOT allow water to be poured over his head during a bath, so it's always a fight to wash and rinse his hair. It's not even that he doesn't want water in his eyes, he just doesn't like the "feel" of water on his head.
10) He is VERY stubborn and rarely takes the path of least resistance. We don’t want a child who is totally “passive’, and we know he has to “test his boundaries”, but we would love it if we could get him to “go with the flow” sometimes and realize that cooperating even when he doesn’t want to do something will make things a lot EASIER and more pleasant for everyone.

Of course, other parents I talk to or who observe him (and have no knowledge of SID), say he’s just a *NORMAL* (albeit hyper, aggressive and unpredictable) MALE toddler. But as DH and I grow more and more frustrated/exasperated by his behavior and our lack of knowledge on how to “rein it in”, we feel like we need to do something to make life happier for all of us.

We’re also worried about what he’ll be like in Preschool if we don’t get some of these “habits” under control before then. But we’ve also observed that this behavior seems worse around us than it is around “outsiders”. So sometimes we think the fact that we are his sole caretakers (and very rarely have had babysitters for him…we have minimal babysitting support so we only use it for “emergencies” or VERY special occasions) is also causing problems. Like on some level, he’s sick of seeing just the 2 of us (and his baby brother) all the time. So he “acts out” out of frustration, etc. because he doesn’t know how else to express his feelings. But we try to get him outside and to do things (and play with other kids) to burn off some of that energy as much as possible. And he’s definitely more pleasant to live with when he gets some time outside. Unfortunately, the temp has been regularly in the 90s here for the last few weeks, so being outside really isn’t an option and we’ve ALL been going stir crazy!

So anyway….all that being said, does it sounds like he might have some degree of SID, or IS he *NORMAL*, or could there be something else going on? He is super smart, so that also aggravates us, when we know HE knows what he *should* and shouldn’t be doing, but does what he shouldn’t be doing anyway. But I DO also recognize that to be a normal part of raising a toddler. He can also be extremely sweet and thoughtful (he seems to be getting a good handle on “empathy” for the most part), so those characteristics also perplex us as they seem to be “contradictory” to this other behavior that he’s exhibiting.

Sorry this was so long, but it’s the first time I’ve gotten all my thoughts about this situation together in one place. Any insight/suggestions you can provide would be greatly appreciated. I know you can’t officially “diagnose” him, but I’d like to hear your interpretation based on the details I gave. I actually found some local Occupational Therapists that are covered by DH’s insurance, so that makes me even more inclined to make an appointment, if for no other reason than to be told that he is a “normal, rambunctious, inquisitive child” and that we should embrace and nurture it.

Thanks for your time...

pedi-ot
07-10-2007, 11:19 PM
Wow, I am very impressed with your observational skills! Your thread read like an OT describing a patient with SI symptoms.

Yes 3 year-olds can present with many behaviors that can be described as "age appropriate" or typical for a child that age. However, Jack does present with some very classic "SI" symptoms. Some of these you can attribute to his speech delays, but others I feel could possibly be signs that Jack could benefit from SI therapy, but definitely a SI evaluation as soon as possible. Especially if you are about to enroll him into a preschool program in the fall. These behaviors, if not addressed early, can impact his ability to learn and interact with his peers appropriately.

A majority of kiddos who have SI dysfunction are very bright, so do not read anything into the diagnosis. They do not have to be clumsy at all. Each kid with SID is different, and that is why a formal SI assessment will help an OT form a treatment plan that is appropriate for Jack. Jack appears hypersensitive to light touch (clothing and water can be noxious input) yet he is seeking out deep input (rough and tumble play). Jack also appears to need proprioceptive and vestibular input (jumping, going around in a circle) in addition to auditory input (the humming noise). He also seems to be very rigid with his routine, which can be typical of kids with SI.

I recommend The Out of Sync Child by Carol Cranowitz to all of my mommies who think they have a child with SI issues. It is a quick read with good guidance. You have done a super job, Mom, with reading your child's needs. I think Jack would benefit from a SI evaluation. Your OT will come up with a treatment plan to help you address all of these behaviors you are observing. You, in turn, will help Jack be a happier child :)

Robynne

Aim
07-16-2007, 05:14 PM
Thank you so much, Robynne! I didn't see your response until today. :oops:

Part of the reason I can document such detailed observations is because of everything I have learned HERE about SID! But I also am the kind of parent who errs on the side of "What if there's a problem?" vs. "Oh, he's FINE!" and just blowing things off or being in denial.

There is NO DOUBT that Jack is verrrrrrrry intelligent (too smart for his own good! ;-)), so I'm not at all concerned about that. I just want him (and us) to be able to "deal" better in social situations, and in general. I know things could be so much more pleasant OVERALL if we could all learn how to interact with each other more effectively.

So thank you for confirming my theory that he should at least have an evaluation with an OT. DH hasn't really been on board with the idea, but he also hasn't absorbed what SID is all about. So I'll talk to DH about it tonight and keep you posted on what we end up doing.