Talk to me about OT for young children w ASD

[Anonymous]

My toddler was recently diagnosed with level 2 ASD. I understand how speech and ABA fit into his treatment plan (understanding and using more language are definitely the big needs), but I’d love to understand better about OT. Other than not yet using a spoon, he’s pretty on track with fine motor and seems to have minimal sensory issues. Have those of you who had kids with a similar profile seen benefits from OT?

It’s overwhelming figuring out how to schedule so many hours of therapy each week for a child who still naps 3 hours in the afternoon. ABA wants 20 hours and then we were also told to do speech 3x a week and OT twice a week. We are doing our best to coordinate it all but it’s a lot.

[Anonymous]

While I can’t speak to ASD specifically, my toddler has had adjacent emotional regulation and sensory challenges. He has ADHD.

Has your son had an OT evaluation? OT evaluations- privately and through our school district- picked up on more needs than I observed at home. His under vigilance due to his adhd caused issues with proprioception (being aware of his body), so he would be stepping all over himself and objects. He has trouble sitting still at circle time or when he’s expected to focus on non preferred more academic tasks. He gets overstimulated in really noisy and chaotic settings. OT helps with the sensory integration piece, along with daily living activities and the underlying skills needed for the motor planning required. It also helps learn coping mechanisms for emotional dysregulation which is a component of adhd.

All of that said- when you first receive any diagnosis, there are so many treatment options. It is overwhelming. My schedule really can’t handle more than two different therapies in any semester, so that’s what I’m prioritizing right now- two different things. If OT isn’t at the top of your list, I would get an evaluation and see what DCs needs are, but don’t add a burden to yourself if it isnt the most important thing at this moment.

Your other option is to get evaluated through your school district. If your son qualifies for OT, he can receive in school or possibly at home if he’s not in preschool (this will depend on your district).

The main factors to consider are what’s most important at this time to prioritize in a way that balances your sons well being with that of yours and your family’s. Good luck OP. Early in this journey other families with older kids with SN reassured me that things stabilize and every day won’t feel like you’re drowning.

[Anonymous]

15:34 hit the nail on the head with things you didn’t realize were challenges/needs. I also have a 4 year old with level 2 autism. His OT picked up on some needs with lack of grip strength, and areas of regulation in terms of being able to attend and follow directions. My kid struggled (still struggles!) in both preferred and non preferred activities. Preferred activities he’d want to go off on his own and explore and not wait for directions. Non preferred activities he wouldn’t want to do at all. Some of that can be learned gradually as he he gets older with more patience and experience, but it’s a lot harder for ASD/ADHD/otherwise ND kids of all ages to learn it. And level 2 kids can be mainstreamed at school with supports and pull-outs, so I don’t want my kid to be disruptive when it’s time for whatever activity and he either goes nuts because he loves it, or elopes/refuses to participate because he doesn’t like it.

[Anonymous]

I found it a huge waste of time. The OT basically played with my child. I wanted help with the fine motor stuff like scissors/handwriting, etc. but they barely focused on that and did things like board games, and other play stuff. Others really like OT though.

Be careful about doing too many therapies for too many hours. Many warn about it here but it's very easy to get burnt out and your child get burnt out.

Maybe start with 10-12 hours of ABA a week vs. 20.

[Anonymous]

Anonymous wrote:While I can’t speak to ASD specifically, my toddler has had adjacent emotional regulation and sensory challenges. He has ADHD.

Has your son had an OT evaluation? OT evaluations- privately and through our school district- picked up on more needs than I observed at home. His under vigilance due to his adhd caused issues with proprioception (being aware of his body), so he would be stepping all over himself and objects. He has trouble sitting still at circle time or when he’s expected to focus on non preferred more academic tasks. He gets overstimulated in really noisy and chaotic settings. OT helps with the sensory integration piece, along with daily living activities and the underlying skills needed for the motor planning required. It also helps learn coping mechanisms for emotional dysregulation which is a component of adhd.

All of that said- when you first receive any diagnosis, there are so many treatment options. It is overwhelming. My schedule really can’t handle more than two different therapies in any semester, so that’s what I’m prioritizing right now- two different things. If OT isn’t at the top of your list, I would get an evaluation and see what DCs needs are, but don’t add a burden to yourself if it isnt the most important thing at this moment.

Your other option is to get evaluated through your school district. If your son qualifies for OT, he can receive in school or possibly at home if he’s not in preschool (this will depend on your district).

The main factors to consider are what’s most important at this time to prioritize in a way that balances your sons well being with that of yours and your family’s. Good luck OP. Early in this journey other families with older kids with SN reassured me that things stabilize and every day won’t feel like you’re drowning.

NP. How long did it take for OT to help with the issues you outlined? The goals our OT made for us are similar and they sound great, but it feels like we're moving at glacial speed.

[Anonymous]

PP here. He started private OT about two months ago. I have seen some some subtle changes. I’d say it takes a few months. That said my son is also starting adhd medication in conjunction which is a huge enabling factor so hard to say for sure.

[Anonymous]

My dc was in OT at age 3-did not get the ASD dx until 4.5 yrs old. OT was GREAT for my child! She had gross and fine motor skills delays.

By the time she finished OT, she was able to jump (previously would not lift both feet off the ground), swing, climb, and learned to use scissors.

That being said, I was only able to do once a week OT, due to my work schedule (she also did private and group ST). But I spoke to the therapist each time and they helped me implement stuff at home-things like, got her a foam balance beam, scooter board, ect for use at home (amazon is great for this stuff). She actually hit all her goals right around her 5th birthday, and we stopped, restarted briefly around 6.5 due to aversion to hair/teeth brushing. That was improved in a few months and we stopped then.

I would probably not cut back on ABA for OT though. I would revisit that in maybe a year or so and cut back then if need be. I would prioritize ST and ABA.

[Anonymous]

Agree with PP that OT should be the first thing to cut. We didn’t see much help from it despite going for a year (for emotional regulation type stuff). Maturity helped the most.

[Anonymous]

I went to Pediatric Development Center in Rockville and they have speech and OT. The OT is a big gym with some climbing equipment. It took a little bit of time to get in the appointment schedule but I was able to do speech and OT back to back. I think it helped my DD but then the pandemic hit and we stopped.

[Anonymous]

I did not find it to be super helpful in and of itself. My DS also does not have sensory issues but has a super high activity level and is very impulsive.

We did do an OT/Speech cotreat that I think was very productive. He ended up with an ADHD diagnosis as well and I do think the gross motor OT activities allow him to absorb more of the speech. It was also nice to be able to pick the brains of two therapists at once on what we were seeing.

[Anonymous]

You don’t need to do everything they tell you to do all at once. You don’t want your child to get overwhelmed and burn out.
At age 2.5 we did 15 hours of weekly ABA, 9-12 Monday to Friday. I found a speech therapist that did Saturday appointments and we did that once a week. OT was also once a week. I would sit in on the sessions and the therapists would also give us tips so we could practice at home.

[Anonymous]

NP. This thread has been helpful to read! Does anyone have OT recs they liked in Montgomery County or NoVA?

I noticed one PP mention Pediatric Development Center in Rockville

[Anonymous]

We liked skills on the hill! They have an Arlington location.

[Anonymous]

Lots of bad OTs and OT practices that don't really accomplish anything- beware!

[Anonymous]

Anonymous wrote:Lots of bad OTs and OT practices that don't really accomplish anything- beware!

Can you provide more detail on what to look out for? We’re strained for time and money so really don’t want to waste on bad therapy.