My four year old son was just diagnosed with sensory integration disorder and qualifies for OT services. The OT who evaluated him suggested we see her every other week for 45 min. to 1 hour sessions. He doesn't have a severe case, but does struggle with it. He's made a lot of progress in the past 6 months. I just received a call from the OT and our insurance denied covering the therapy. Evidently it is an issue with our contract so the likelihood of it being reversed is slim if we fight them. The Children's Hospital out of pocket fee is $60 for 1/2 hour or $120 per hour. Do any of you have any suggestions on what I should do? I'm a SAHM so we don't have a ton of money...but if this is important for his health we'll obviously find the money. I'm wondering if maybe we do one session every three weeks with a lot of homework in between. Or...maybe I can go back to the school (they tested him before and said that he didn't qualify). We live in Va. Having never been to an OT session I’m at a loss on what’s best for him. Any suggestions or experiences with anything like this?

By Pamt on Friday, February 2, 2007 - 04:06 pm:

I'd go once every 3-4 weeks and also have the OT develop an extensive home program for you. Sit in on every session and take notes, so you'll remember what to work on and how to do it at home. I have a lot of kids denied for speech tx and I am always happy to do a home program and just see the kid as often as the parents can afford it. FWIW, our rates are much more expensive, so that's a pretty good deal. If the issues aren't significantly affecting "education" (and it's a narrow-minded definition), then the schools won't treat him.

By Pamt on Friday, February 2, 2007 - 04:09 pm:

Oh! Also, IMO, more often for 30 minutes is better than occasioanlly for an hour. If it is a choice between once a month for an hour or every other week for 30 minutes, I'd suggest the every other week route.

By Kaye on Friday, February 2, 2007 - 04:44 pm:

Pam has great advice. My child shares this diagnosis. Ask the OT for a sensory diet. We always make a game of it. There is a book called "the out of sync child" that is a great read. But just doing some internet research will give ideas.

What I think is most important for you to know is this...at age 4 you can really make big improvements. Yes he will likely have funny issues for ever, but he will more than likely learn to cope and people won't notice. My son has an issue with how his clothes fit, well now I know, we don't buy cargo jeans, just slim fit jeans. Instead of a regular swimsuit, he wears "jammers" (think bike shorts). He is almost 9, we started therapy at 4 at that time he couldn't hardly sleep with out shoes, he had to have footed jammies or socks at least. Now I occasionally catch him barefoot outside (but not on grass..lol).

A couple of things we did in the beginning. We made sure his chair fit him well at the table, supported him at the right height and feet supported, so when we did activities he was sitting up and more comfy. He had a trunk strength issue too. But we found things he liked, um like bob the builder and found a bob the builder playdoh set.

If you list some of the things you notice, we might be able to give some suggestions for games to play.

By Mommmie on Friday, February 2, 2007 - 05:56 pm:

You can do a lot of stuff at home although most kids love, love, love going to OT sessions.

By Bellajoe on Friday, February 2, 2007 - 08:32 pm:

my nephew has those same issues, he started going to the OT when he was 3, i think. I can tell you that they made a WORLD of difference! He is now 5 and doing very well. He's not a typical child by any means, but he does much better than he used to.

I don't understand why, but my nephew sometimes wears a special weighted vest. My sister's friend made it for her and i believe she now makes some for other kids like this too. Somehow the vest makes him feel better at certain times. He likes to be "squished" we lay on him and tickle him and stuff, and he loves that 'pressure'. Once in a while he likes for my sister to "squish" his hands...she just puts his hand between her two hands and puts pressure on it.

He does go to OT and speech. I know he really enjoys the OT

By Jjb on Monday, February 5, 2007 - 02:06 pm:

Thank you for the advice. This is all new to me so I'm learning as we go along. His biggest issues are tactile and he has some difficulty with noise. Both have improved a lot in the past 6 months, especially the noise. We went through a car wash yesterday and he did fine which is a first. He still needs help, especially with tactile things. I've been getting him messy more often instead of avoiding it. We made pudding the other day and I gave him a tiny spoon to stir it so he was covered in pudding, we made and played with play dough, and we played car wash with shaving cream. Each of these he didn't enjoy in the beginning, but with his brother's encouragement he ended up having fun and getting messy at the same time. We've also tried deep pressure exercises which help. He is always moving and has a very hard time sitting still. He is the worst in the afternoons (it seems that he tries to hold it in all day and then just can't do it any longer). We have a lot of trouble at his older brother's bus stop- it's so stressful. We do have a good youth chair he eats in with sides and a place to put his feet. It works okay for him, but he still has trouble sitting still. It drives DH nuts. He can't sit in a regular chair-- it just doesn't work. Any advice would be great! Thank you so much!!

By Zoie on Monday, February 5, 2007 - 07:14 pm:

I'd also recommend the half hour sessions, and depending on how much you can afford, I'd ask for a half hour session every 2-3 weeks to start out, and then you can decrease that and eventually end it as you become more and more knowledgeable about how to provide him with appropriate treatment strategies. Do as Pam said, stay and observe treatment the entire time, ask questions, beg for homework!! :o)

As for daily activities that are difficult, the key is to look for compensatory techniques to make the situation manageable immediately and as treatment begins to take effect, you can gradually start removing compensatory strategies and give him opportunities to try the activities more and more as you would do them for a typical child.

Take the bus stop for example. What is the situation? How long is he there, what kind of environment is it (i.e., a sidewalk, a yard, etc.), are there other people there, and what exactly is it that he does that is stressful. You can then analyze that situation to see what exactly is triggering his negative behaviors and then come up with a solution for how to manage that with compensatory techniques. Email me if you want -- we'll figure it out. :o)

By Elizabeth704 on Tuesday, February 13, 2007 - 02:02 pm:

My son had the same diagnosis at age 3. We went to OT once a week and it was very helpful, but they send you home with a home program or "sensory diet" to follow. The "Out-of-Sync Child" book can also help with some sensory diet ideas. Maybe your OT can do that home plan early in the process. The only things you may miss out on is all the great equipment they have.

One more idea, check with your local school system. In NC they have to provide these services (OT/PT/Speech) for 3 yr and up. I learned this after almost a year of insurance co-pays and by then my son did not qualify for their services. In our county, it was through the "special education" dept. It requires alot of testing and an IEP, but I found the people were very knowledge about sensory integration.

Regardless of how you do it - it made a TREMENDOUS amount of difference in my son. His case was fairly mild also, it mostly appeared behavioral in preschool when he was surrounded by lights, sounds, colors, textures, etc. He is now a very successful first grader. Most of symptoms were over by age 4.

Quick idea for the sitting still issue - our OT used a weighted fishing vest (bought at a sports/fishing store). It somehow centers them and helps them to sit still and focus. Also , she sometimes would put a sand bag across his lap when he was coloring, etc (always out of sight under a desk). This would sometimes drive him crazy, so it could only be done in short durations.

Good luck!

By Jjb on Tuesday, February 13, 2007 - 09:15 pm:

Thank you for the advice! We're now trying to get services through the school district. Originally they denied services based on the Denver test which didn't include anything related to sensory problems. I'm really hoping that they'll provide some kind of OT for him...but if not we'll handle it on our own. It's nice to hear that your son is doing well. I'm frustrated with how long this process is taking- we began getting him tested in August and we still don't have therapy for him. Hopefully things will come together soon. In the mean time I'm trying to do things from home. I'll try the weighted vest. He normally likes to dress up and loves fishing so hopefully he'll tolerate it (you never know).

By Kaye on Wednesday, February 14, 2007 - 08:14 am:

With the weighted vest, they only wear it for 15 minutes every couple of hours tops.

So for me what I would do, bus stop is tough, then I would have him wear his vest to the bus stop, or have him wear it the time right before going.

My son loves those compresion shirts (underarmour) he wears those most days.

By Saveymom on Sunday, March 4, 2007 - 11:26 am:

There is also something for sensory issues that you place on the chair for them to sit on. Don't know what it's called now but it's like a air-filled wedge with bumps on it. My son loved this. He would sit on it and wiggle a little but did not try to get up from his chair so much.

Good Luck