Confused/upset about OT eval report

[Anonymous]

Just got the OT evaluation for my three year old and its pretty doom and gloom. Very poor fine motor, gross motor, poor balance, possible midline issues, attention issues, motor planning, and some sensory stuff. But when I asked the evaluator at the end of the session if she thought I should see a dev ped (we are, soon), she said "Oh no, its not anything global or anything." I am confused - it sounds like my child has some pretty major issues, and we will of course be seeing the dev ped. I am just confused now and upset. I know more information is good but I think I just feel overwhelmed and sad.

Also, has your child had issues like these and "overcome"/been able to thrive with them? what supports did you need? I know that is vague but I am not sure how else to ask.

[Anonymous]

"global delay" usually refers to intellectual functioning

I would consider seeing a developmental pediatrician

my kid has DCD and basically we do lots of OT

[Anonymous]

We are seeing one soon. How was DCD diagnosed? And what is a lot of OT, like twice a week? Thanks so much.

[Anonymous]

If there are concerns about your child's development, and it sounds like there are, it's a good idea to see a developmental pediatrician. OT's diagnose a certain set of things, and certainly can't say what a developmental pediatrician might see or not see. It seems really irresponsible to advise against seeing one. In particular, attention issues need to be evaluated by someone other than an OT.

It's really impossible to say where things will go from here. I know kids who've done OT for a few years and stopped when everyone agreed they were doing great and didn't seem to need it anymore. I know kids who have continued OT for many more years than that, but who manage OK. Good luck to you and your child!

[Anonymous]

DS was 'diagnosed' with DCD - motor planning - a year ago (at age 4) & I still don't really understand it - even after an entire year of OT. Have found there's a HUGE range in what it can mean & how different professionals recommend dealing with it. We didn't ever go see a developmental pediatrician (also were told it wasn't really necessary) - but did find that functionally seeing him in OT and the progress he made in it helped me get some sense of things where he could use help (one category of issues -- things not instinctually knowing how to climb out of something vs. having to learn the body memory for it, which is neurological & people who don't have therapy for it usually learn ways to adapt but early intervention can help; second category were delays like crossing the midline/bilateral movement which he very likely would've just 'grown out of' but therapy helped gain experience faster, and category 3 seems to be fine motor); They have the kid do basic coordination activities, build strength and it helped our DS gain confidence to try more things. At our 5 year old wellcare exam, when i talked to our regular ped - I was talking about his therapy - and asked "this is mostly like what they called 'klutzy' in the 70s, right?" and she nodded and smiled. Overall, tho, like I said, I think I've learned in the past year that it means such a broad range of things that it is somewhat hard to generalize from anyone else's experience too much. If you start OT with a good therapist, at least what that did for us was to translate what these scary sounding things translated to in helping him in daily life. If he has behavior and attention issues, seems like no reason not to see a developmental pediatrician.

[Anonymous]

Anonymous wrote:"global delay" usually refers to intellectual functioning

I would consider seeing a developmental pediatrician

my kid has DCD and basically we do lots of OT

Global means delays in all areas such as gross motor, fine motor, speech, etc. It is not a code word for ID or something else.

[Anonymous]

My kid started OT at age 1 and continued it all the way through HS. His handwriting is still incredibly lousy, and he is no good at sports- but he types, drives a car, and gets along ok. Some OTs with MCPS were better than others- the best one was actually a certified occupational therapy assistant who really helped him a lot in 4/5 grade.

[Anonymous]

Thanks, everyone. It sounds like finding a good OT is key. I am not sure about this one yet.

[Anonymous]

Everyone I know who has been sent to an OT (for a variety of reasons- sometimes as simple as because the kid was premature so it is standard to go to an OT) has had an eval of doom and gloom. We had one, but no particular diagnosis, told that there were no global issues etc. some of the stuff "disappeared" between the eval and the first therapy session. Like, in his eval at age 34 months, they indicated he had fine motor skills of an 18 months old because he used the fist grip in the five seconds he held a pencil during the eval. Two weeks later when they say him in a classroom, that had miraculously gone away and he was using a developmentally appropriate grip.

I fee like most functioning adults would have weirdo issues that could be flagged on an OT eval. Like yeah my writing grip is lousy. And I'm not good at creativity but I see things very geometrically. Just to pick dumb examples. It doesn't mean I ned therapy. Not to say OT won't help some people, or that they don't need it.

Go see the dev ped to confirm nothing is up, but my impression of the OT eval is that for most kids, these are issues that would go away enough that they'll be fine in kindergarten -- a cutoff that I had a child developmental psychiatrist told me was not chosen arbitrarily 200 years ago, but was chosen because lots of kids are all over the place prior to that, but by 5, they're mostly all at the same place.

[Anonymous]

Anonymous wrote:

Anonymous wrote:"global delay" usually refers to intellectual functioning

I would consider seeing a developmental pediatrician

my kid has DCD and basically we do lots of OT

Global means delays in all areas such as gross motor, fine motor, speech, etc. It is not a code word for ID or something else.

From the DSM V:
"315.8 Global developmental delay
Pertains to those under 5 years old whose intellectual functioning can not be systematically assessed."

[Anonymous]

Anonymous wrote:Everyone I know who has been sent to an OT (for a variety of reasons- sometimes as simple as because the kid was premature so it is standard to go to an OT) has had an eval of doom and gloom. We had one, but no particular diagnosis, told that there were no global issues etc. some of the stuff "disappeared" between the eval and the first therapy session. Like, in his eval at age 34 months, they indicated he had fine motor skills of an 18 months old because he used the fist grip in the five seconds he held a pencil during the eval. Two weeks later when they say him in a classroom, that had miraculously gone away and he was using a developmentally appropriate grip.

I fee like most functioning adults would have weirdo issues that could be flagged on an OT eval. Like yeah my writing grip is lousy. And I'm not good at creativity but I see things very geometrically. Just to pick dumb examples. It doesn't mean I ned therapy. Not to say OT won't help some people, or that they don't need it.

Go see the dev ped to confirm nothing is up, but my impression of the OT eval is that for most kids, these are issues that would go away enough that they'll be fine in kindergarten -- a cutoff that I had a child developmental psychiatrist told me was not chosen arbitrarily 200 years ago, but was chosen because lots of kids are all over the place prior to that, but by 5, they're mostly all at the same place.

yeah, some of the stuff I have to think about and be like whoa. I can't eat with chopsticks, at all, and I was a terrible, and I mean terrible athlete and a generally clumsy kid, so some of it could just be inherited. And my child was indeed premature, so there is of course that. We also got the hold the pencil with the fist thing. I have never heard of anyone going to an OT and them being like "No issues here! Move along!" so there is also that! I am waiting for the dev ped apt to really get a sense of what is going on and what our plan should be.

[Anonymous]

Anonymous wrote:My kid started OT at age 1 and continued it all the way through HS. His handwriting is still incredibly lousy, and he is no good at sports- but he types, drives a car, and gets along ok. Some OTs with MCPS were better than others- the best one was actually a certified occupational therapy assistant who really helped him a lot in 4/5 grade.

What type of ot did your child get in hs? Our county is trying to get us to drop ot support for hs.

[Anonymous]

It sounds like there are a lot of issues across different motor skills--and the OT did a good job testing different aspects of motor development--but that doesn't necessarily mean that any of them are severe. As one PP said, kids develop at all different rates in different areas in the early years, so it may just be that this is where he or she is lagging at the moment. It's good to have an idea of where your child is lagging so you can provide assistance to get them caught up, but don't stress too much. If something were really seriously wrong, you'd probably know it without an OT telling you.

My kid had most of those things. 3 years later, we're still struggling with fine motor (but it's not terrible -- he can dress himself and write messily), and we're now on medication for the attention issues. The sensory stuff we continue to struggle with, although some of it has improved a lot.

[Anonymous]

Anonymous wrote:It sounds like there are a lot of issues across different motor skills--and the OT did a good job testing different aspects of motor development--but that doesn't necessarily mean that any of them are severe. As one PP said, kids develop at all different rates in different areas in the early years, so it may just be that this is where he or she is lagging at the moment. It's good to have an idea of where your child is lagging so you can provide assistance to get them caught up, but don't stress too much. If something were really seriously wrong, you'd probably know it without an OT telling you.

My kid had most of those things. 3 years later, we're still struggling with fine motor (but it's not terrible -- he can dress himself and write messily), and we're now on medication for the attention issues. The sensory stuff we continue to struggle with, although some of it has improved a lot.

I disagree. An OT can't diagnose things. A developmental pediatrician can.

[Anonymous]

Anonymous wrote:

Anonymous wrote:My kid started OT at age 1 and continued it all the way through HS. His handwriting is still incredibly lousy, and he is no good at sports- but he types, drives a car, and gets along ok. Some OTs with MCPS were better than others- the best one was actually a certified occupational therapy assistant who really helped him a lot in 4/5 grade.

What type of ot did your child get in hs? Our county is trying to get us to drop ot support for hs.

In high school: they still kept working on handwriting. Worked on seating and positioning at desks (he was pretty low tone and sometimes needed a footstool under his desk to put feet on). Worked on organizational skills- setting up and using binder etc. worked on keyboarding. Worked on adapting math assignments so that he could use the compass and protractor. He did not need "sensory" activities. His issues were more with "tool" usage.

As an adult now he still has bad handwriting. Took him forever to learn to drive. The whole visual motor thing was problematic.