Speech therapy, feeding therapy, OT for toddler--feeling overwhelmed

[Anonymous]

My toddler son (22 months) is currently in speech therapy because at his 18 month appointment he had zero words. Now at 22 months he has 5 words (but some are sign language and some he has only said once and never again). He is making progress in speech therapy though. Feeding has always been a huge issue, for awhile he only ate beige food, and he has an extremely limited number of foods he is willing to eat (less than 10 foods). He has lost 2 pounds since his 15 month appt. because of the picky eating, but pediatrician is not concerned yet because he has always been 90% for weight and height (at least until 18 months when he dropped down to 75%). Lately he seems to be in a food regression, where he is eating less volume, throwing most of his food on the floor, and being even more picky. We are going to start feeding therapy soon and hope he will make progress there.

As background, my son was born right on his due date, and was 8 pounds at birth. I had an uneventful pregnancy, though I did have severe nausea for most of the pregnancy and had difficulty gaining enough weight. He has always made great eye contact, doesn't have any of the red flags for autism other than what I'm describing here, and ped and speech therapist are not concerned about autism.

However, it was also recommended that he start OT for sensory processing disorder. He has a lot of sensory issues and always has--dislikes getting hands dirty, sensitive to loud sounds, doesn't like being around large groups of kids, etc. but now that he is in a morning preschool class, I am seeing that he is not interacting with other kids much, and he is the only child in a classroom of 10 who is doing his own thing most of the time (like climbing on chairs and tables), and refusing to participate in all group activities like singing or music. He has always done this, but it's becoming more apparent to me now that I see him in a more formal classroom setting with other kids. This is a mommy and me class, so I am there with him.

I am starting to feel really overwhelmed and feeling like there are a lot of issues going on. We live in Reston. Can anyone help me make sense of all of these issues? Can anyone suggest any resources/therapists (especially feeding and OT) within a 25 minute drive of Reston?

Thanks!

[Anonymous]

Meh... some of that stuff is normal and can be outgrown. My son went through some. We supplemented with toddler formula for a few years due to picky eating. My kid would have starved. Supplement.

[Anonymous]

OP,

Have you ever gotten an endoscopic examination for his swallowing?
http://www.asha.org/public/speech/swallowing/Feeding-and-Swallowing-Disorders-in-Children/

Also, please see a developmental pediatrician for a full evaluation. Your kid may or may not be on the spectrum, but there are major red flags here and a probably a little denial on your part. "It has been recommended..." We use the passive voice when we don't want to own up to responsibility.

So give yourself a big hug and make an appointment with a developmental pediatrician near where you live.

[Anonymous]

Anonymous wrote:Meh... some of that stuff is normal and can be outgrown. My son went through some. We supplemented with toddler formula for a few years due to picky eating. My kid would have starved. Supplement.

It's not "normal" to supplement formula for food, especially for years.

OP, what did your pediatrician suggest in terms of weight loss. Did you ask about your kid's growth curve? That's more important than percentiles and pounds.

Just so you know, "SPD" isn't a diagnosis. It doesn't mean sensory issues don't exist, but you need to get a global evaluation.

[Anonymous]

Your DS sounds similar to mine at that age. He was later diagnosed with apraxia of speech in additional to general developmental delays. At 6 he got an ADHD diagnosis. I agree with the PP that you would be well served to get an evaluation by a developmental pediatrician. You need someone to take a global view and it will be also good to start getting what I call 'baselines'. It will help you better see how quickly he makes progress. One of the best things we did at that age was participate in some NIH research studies. If you look for studies on ASD or developmental delays, you should get a number of hits. They were amazing! We learned so much about DS and had excellent documentation/records for later evaluations and school. Hugs!

[Anonymous]

This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Meh... some of that stuff is normal and can be outgrown. My son went through some. We supplemented with toddler formula for a few years due to picky eating. My kid would have starved. Supplement.

It's not "normal" to supplement formula for food, especially for years.

OP, what did your pediatrician suggest in terms of weight loss. Did you ask about your kid's growth curve? That's more important than percentiles and pounds.

Just so you know, "SPD" isn't a diagnosis. It doesn't mean sensory issues don't exist, but you need to get a global evaluation.

May not be "normal" but it worked. If OP child is losing weight, supplementing is an option. We went through a feeding strike between 2-3 where my child wouldn't eat for days even with what were his favorite foods. Formula was our only option (beyond pedicure which isn't meant for multiple meals for very young kids). What is your better option. Eventually around 4 my kid slowly started eating a few things and its slowly gotten better.

At 22 months, they are going to throw tons of services. We were in 4 day a week speech (I was exhausted and needed a break from 5), OT and more. Its very hard as OP said. OT was useless. Eventually as the speech came, everything else slowly came (or is coming). Some things its just time, some its therapy.

[Anonymous]

Anonymous wrote:This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

Talking by 24 months is nota true speech delay. We were set up for feeding therapy when my kid started to eat a few things and the doc said if we were managing at home, don't do the therapy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

Talking by 24 months is nota true speech delay. We were set up for feeding therapy when my kid started to eat a few things and the doc said if we were managing at home, don't do the therapy.

WTH?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Meh... some of that stuff is normal and can be outgrown. My son went through some. We supplemented with toddler formula for a few years due to picky eating. My kid would have starved. Supplement.

It's not "normal" to supplement formula for food, especially for years.

OP, what did your pediatrician suggest in terms of weight loss. Did you ask about your kid's growth curve? That's more important than percentiles and pounds.

Just so you know, "SPD" isn't a diagnosis. It doesn't mean sensory issues don't exist, but you need to get a global evaluation.

May not be "normal" but it worked. If OP child is losing weight, supplementing is an option. We went through a feeding strike between 2-3 where my child wouldn't eat for days even with what were his favorite foods. Formula was our only option (beyond pedicure which isn't meant for multiple meals for very young kids). What is your better option. Eventually around 4 my kid slowly started eating a few things and its slowly gotten better.

At 22 months, they are going to throw tons of services. We were in 4 day a week speech (I was exhausted and needed a break from 5), OT and more. Its very hard as OP said. OT was useless. Eventually as the speech came, everything else slowly came (or is coming). Some things its just time, some its therapy.

OP, generally, the only way to get four-fives days of a week of speech covered by insurance is if you have an autism diagnosis. In the long-run, seeing a developmental pediatrician will be helpful b/c you'll get more services covered regardless.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Meh... some of that stuff is normal and can be outgrown. My son went through some. We supplemented with toddler formula for a few years due to picky eating. My kid would have starved. Supplement.

It's not "normal" to supplement formula for food, especially for years.

OP, what did your pediatrician suggest in terms of weight loss. Did you ask about your kid's growth curve? That's more important than percentiles and pounds.

Just so you know, "SPD" isn't a diagnosis. It doesn't mean sensory issues don't exist, but you need to get a global evaluation.

May not be "normal" but it worked. If OP child is losing weight, supplementing is an option. We went through a feeding strike between 2-3 where my child wouldn't eat for days even with what were his favorite foods. Formula was our only option (beyond pedicure which isn't meant for multiple meals for very young kids). What is your better option. Eventually around 4 my kid slowly started eating a few things and its slowly gotten better.

At 22 months, they are going to throw tons of services. We were in 4 day a week speech (I was exhausted and needed a break from 5), OT and more. Its very hard as OP said. OT was useless. Eventually as the speech came, everything else slowly came (or is coming). Some things its just time, some its therapy.

OP, generally, the only way to get four-fives days of a week of speech covered by insurance is if you have an autism diagnosis. In the long-run, seeing a developmental pediatrician will be helpful b/c you'll get more services covered regardless.

Sad, but true. Most insurances will not cover a developmental delay but they will autism. We did three days at a preschool and 1-2 days privately (when preschool was out of session 2-3 days a week) so part of it was covered for the 4 days a week and some was private pay. Ours claimed to cover developmental delays but kept denying speech and we were private
paying for a year till a developmental ped (not impressed by his diagnostic skills but that's another issue) was able to do it under autism. Then, they were overly generous - speech, OT, ABA (dropped it after a few months as speech was better) and feeding clinic (we were scheduled but ended up not doing it). OP, my child has outgrown a lot of the quirks you described - some kids can outgrow it with age and some kids are going to have life long issues. Its impossible to know but 2-5 is the most important time to do intensive services and its exhausting. We are finally on the tail end of it but it sucks when others are going to all kinds of fun things and you are going to therapy.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

Talking by 24 months is nota true speech delay. We were set up for feeding therapy when my kid started to eat a few things and the doc said if we were managing at home, don't do the therapy.

WTH?

If your kid is talking sentences by 24 months, that is not a big deal. We were told to worry at 24 months with no to a few words. Kids who are not talking by 3-4-5, that is a delay.

[Anonymous]

I've seen an SLP work wonders with a toddler 15 mos to 26 months around food issues. Toddler couldn't swallow correctly and had sensory oral issues. SLP would use sensory sticks, et, in her mouth before eating to "wake up" her mouth before eating and other things and the child was dismissed at 21/2 eating normally. And at 15 months she only ate bananas and drank formula. That's it. She'd suck the taste out of food but didn't swallow. Lost so much weight she reset her weight, went from a robust baby to a skinny older baby. But that SLP caused an amazing turnaround. Do feeding therapy. See the OT about sensory things, that will help. He's young so getting therapy now will make a difference.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

Talking by 24 months is nota true speech delay. We were set up for feeding therapy when my kid started to eat a few things and the doc said if we were managing at home, don't do the therapy.

WTH?

If your kid is talking sentences by 24 months, that is not a big deal. We were told to worry at 24 months with no to a few words. Kids who are not talking by 3-4-5, that is a delay.

I think you are old fashioned and unwise.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:This sounds very similar to my child. He never lost weight, so we didn't pursue feeding therapy, and he made rapid progress in speech therapy (no words at 18 months, sentences at 24 months). He also didn't engage with the other kids at preschool and we did a year of OT. At that time, no one seemed concerned about autism and we didn't pursue a more global evaluation. At 5, he was having more difficulty with groups and still wasn't engaging with other kids; we finally got a global evaluation and an autism diagnosis.

OT was a waste of time because the sensory issues weren't what was preventing him from engaging with other kids. If you feel like you're already overwhelmed, I would skip OT.

Talking by 24 months is nota true speech delay. We were set up for feeding therapy when my kid started to eat a few things and the doc said if we were managing at home, don't do the therapy.

WTH?

If your kid is talking sentences by 24 months, that is not a big deal. We were told to worry at 24 months with no to a few words. Kids who are not talking by 3-4-5, that is a delay.

I'm the first PP. Clearly, in retrospect, my child's speech delay was not a big deal. But at 18 months when we started therapy, we had no way of knowing what was going to happen. Similarly, the OP doesn't know what trajectory her child is on. I was merely pointing out that my child and OP's child looked very similar at 18-20 months, we ended up with an ASD diagnosis, and OT was the least useful thing that we did.