Why developmental evaluations are not all created equally!

Sally Fryer

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Who likes the idea of having their child evaluated for an “attention problem?” I certainly didn’t when my son’s teacher first told me that he was having trouble focusing in school, and suggested that I might consider having him evaluated. In fact, I initially resented the implication! After all, this was my son she was talking about! A smart, active little guy who perhaps liked to day dream a bit…and maybe said “no” a little too often, but who doesn’t? My observation of his behavior and attention at home seemed to be the exact opposite of what she had to say, or was it, I began to wonder? The physical therapist in me was forced to start looking at things a little more objectively, a hard thing to do when it’s your own child. He seemed to have super attention when focusing on something he liked (his favorite movies, Legos and toy army guys), but now that she mentioned it, transitioning him away from those things to participate in our daily routine tasks, was actually pretty frustrating for us all. Now I started to pay more attention to some of the other signs that I had initially ignored as well. It wasn’t too long before I had to admit to myself, as well as agree with her, that maybe he did need some kind of an evaluation after all.

Having a career specializing in sensory integration (SI), it wasn’t a stretch for me to come quickly to the realization that he needed a good sensory motor evaluation (SI eval). Of course, this was after one more kick in the right direction from his pediatrician who suggested we try medication as our first option. I began to accept the fact that he was no different from many of the other children I was used to seeing, and accepted that he could in fact, use a little help. The reality is, we all tend to make excuses for our kids and its easy to gloss over the very behaviors that may actually be red flags, just like I did at first. Things like behavioral issues, inattention and learning difficulties are more often than not, caused by little sensory glitches affecting how a child is able to make sense of the world. But how do you know who to go to in order to really find out what is going on?

There are so many options out there…we have pediatricians, developmental pediatricians, neurologists, educational testers, physical therapists, occupational therapists, counselors, psychologists, psychiatrists, and behavior specialists. Even schools will often provide their own brand of evaluation to see if your child is a good match for their school. All of these specialties certainly have something to offer, however the one common factor that is at the bottom of just about every developmental issue, is your child’s sensory motor foundation. The professionals who are trained to look at this specifically are your pediatric Occupational and Physical therapists who have additional training in sensory integration. The key here is “trained in sensory integration.” Finding the right OT or PT trained in SI is critical. If you treat a child’s foundation first, many of the problems you are seeing can be addressed before they get to be bigger problems and require more services.  It is so important to know what it is that is causing these challenges in the first place. You want someone who is going to focus on the underlying issues, not on the symptoms alone. Programs that focus solely on specific skills like eating, dressing, talking, behaving or even walking stand a good chance of missing the boat if they are not looking at your child’s sensory motor foundation. You want someone who is looking at her balance and coordination and how she moves in her environment. How is he positioning himself in his chair or on the floor when he sits and uses his eyes and his hands together. What happens when you kick or throw a ball, roll down a hill or climb up a rock wall.

Finding that “just right PT or OT” who is trained in sensory integration, is really worth the effort. Go visit the clinics in your area, talk to the therapists, ask about their training, see if the office staff are helpful and friendly and most of all see if you get a good feeling about them. Don’t underestimate your intuition in this process. You want a therapist who you can talk to and learn from as well as have them be able to relate to and motivate your child. I can guarantee that once you find the right program and therapist, your child will be able to meet new challenges you might never have dreamed of. With this comes success and with success come greater self esteem. What greater gift is there besides having your child believe in him or herself and having plenty of options ahead to choose from. It certainly worked for my son!

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For more information on sensory motor evaluations watch:Integrative Pediatric Therapy – “Filling in Development Gaps”

https://www.youtube.com/watch?v=__ARAtAyUxI