2 yr old cries through OT/Speech

[Anonymous]

My daughter has some developmental delays (jury is out as to whether or not it is autism). We currently take her to a private speech/OT practice once a week. When we started in April with OT sessions, she would cry at the beginning of the session and then calm down about 5-10 minutes into it. By June, the crying was very minimal. In July, we were able to add speech via a co-treatment session - speech and OT at the same time. The idea behind this is that the OT will be able to get her calmed and focused through some sensory exercises so that the speech therapist can work on communication. We've only had 5 co-treatments so far, and during the first 3 the crying was very minimal - she cried for 5 minutes and then warmed up (although she did frequently walk to the door to indicate that she was done). During the last 2 sessions, though, she cried through the visit. She was still working hard - making good eye contact, signing very deliberately, participating in activities - but she was really very upset for the entire 50 minute visit. Our concern is that she is overwhelmed by having 2 therapists in the room with her, and so the normal calming techniques (massage, brushing, songs. swing) aren't gong to work and so the sessions won't be as productive. Do any other parents out there have advice for dealing with this? Should we stick with the co-treatments, should we try to have 2 separate sessions (although we will have to go back on a waiting list)? Any other ideas?

[Anonymous]

I feel your pain. My son, who is 7, has been having a variety of therapy (ST, PT, OT) since he was an infant, and he always protests and dislikes it and gets upset. When it becomes routine enough (and he knows what to expect and what's expected of him), the transition gets easier (though he has been known to remain upset throughout the session, even now after years of therapies), but I have to tell you that the thing that works best is having someone other than me (the mom) take him. A lot of the upset is for my benefit, and always has been. Even when he was a baby and the therapists came to the house, if I wasn't home, he was less upset about the transition from doing what he wanted to do to doing what they wanted him to do. (They always kindly described him as "very self-directed".) Have you tried having a babysitter or your spouse take your daughter instead?

[Anonymous]

Hi - OP here. Thanks for letting me know that I'm not the only mom going through this. We see mixed results. Last week, I was the one to take her and she cried throughout. This week, her grandmother and grandfather took her and it was the same response. I will say that we also work with an Infant Educator through FFX County (a GREAT teacher) and after the 4th visit, we both mutually decided that it was not productive for me to be around for the sessions. It's taken about 6 months, but our daugther FINALLY had her first non-crying visit with her Educator. It is probably much harder on me when my daughter cries than it is on my daughter, but it's still so distressing.

[Anonymous]

This is the 15:50 poster again -- Breathe deeply and know that you are being a good parent and making sure that she gets the therapy she needs, even if she doesn't like it. She knows you feel bad about making her go, and she's playing to that emotion.

For my son, it helps if he's well rested, not hungry, and has time to play in the waiting room before the session starts. I let him know when it's five minutes before the hour, two minutes before the therapist comes out to get him, and so on. And then the therapist has a board with velcro-backed pictures of the activities they are going to do. He likes it best if she lets him decide what order the activities will be done. He's very funny, because sometimes he takes the ones he doesn't like and throws them in the trash can, or he puts the all-done picture first! The more control you can give your daughter over the activity, the less overwhelmed by it all she'll feel. Maybe you can work with your therapist to help her have more control and feel less like everyone is trying to get her to do what they want her to do. I'd hate that, too!

I tell my son that if he cooperates, we'll do something he wants to do afterwards, like go rent a video he wants, or go to the toy store or book store. But he knows he only gets to do that if he cooperates. So I help him be able to cooperate by making it as easy for him as possible to do that. It's a little harder with a younger child, but perhaps you could use new small toys as rewards when she has a good session.

Maybe let her grandmother and grandfather take her a few more times and see if it gets better with them there instead of you?

[Anonymous]

I'm a former nanny who has previously taken children to sessions and was told that worked better then the mother b/c the emotional attachment was lessened and I could bring the a more objective eye to the child's progress at home, etc. The biggest things I have always found are to make sure the child is well rested, well fed, has gone to the bathroom or been changed. Also that transition time in the waiting room can be key, as well as warnings of what you are about to do.

Something great is to make a chart on posterboard of things you do each day to show your daughter in the AM, on days of her sessions you can include a picture to indicate them so she begins to know what to expect, it once again gives the child a feeling of control.

[Anonymous]

For my son, who is Autistic, I have OT and speech therapy at home. This makes a HUGE difference. At the clinic, he cries and does not engage. At home, he does great even when I am not in the same room. It took me a while to find a provider to come to the house. Ask around because I have found that therapists will come to your house if they live close by for about $20 more/hour.

[Anonymous]

OT is supposed to fun for kids. Most kids absolutely LOVE it because it's all play. IF the OT is compassionate and fun, the child will love it. I would look for a new OT. We see DIR Support SErvices in Bethesda, MD. They are a little out of the way, but excellent.