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Sensory Integration Issues: Getting Help

Help for children under age 3

Sensory Integration Issues: Getting Help Assuming you haven't already done so, the first step is to get your child properly evaluated by professionals who can help you sort out the problems and develop a therapeutic action plan. If you've been working with an OT and perhaps other therapists on your child's sensory issues for a while, it may be helpful to quickly review this chapter before moving on to another.

Evaluation and Therapy for Children Age Birth to Three
If your child is under age three, you can get a free evaluation through your state's early intervention (EI) program. These programs are federally funded and go by many different names, such as "Birth to Three" or "Child Find." You'll find a full listing of contact numbers for EI programs by state on our Web site at www.sensorysmarts.com.

One of the greatest benefits of getting your child evaluated through early intervention is that the evaluation may be multidisciplinary. An occupational therapist (OT) is usually the primary professional for treating SI dysfunction. However, even if you're concerned only about sensory issues, your child may also be evaluated by a speech-language pathologist, special educator, and often, a physical therapist, in addition to an OT. This is because it is very common for children to have developmental delays in addition to sensory issues.

If your child qualifies for services, EI will provide them for free or for low cost, depending on your state's program. Usually, the therapy sessions will take place in your home, or less often, in an early intervention center-based program. While she is in EI, your child's therapy will focus on everyday life activities, such as playing, doing puzzles, running and jumping, holding a crayon and coloring, dressing, and eating. The document outlining therapy goals and services (which you will be a part of creating) is called an IFSP, or Individualized Family Service Plan. When your child "ages out" of EI around her third birthday, your service coordinator will help you transition to services supplied by your local school system or in your community. Sometimes these transitions are virtually seamless, particularly if the child has been getting services at a preschool that is not only an EI provider but has a contract with the school system to serve children aged three to five.

Help for children older than 3Evaluation and Therapy for Children Over Age Three
Once your child reaches age three, he is no longer eligible for EI, but can get an OT evaluation through the school system. Whether your child is three years old and still not in preschool or age thirteen and attending junior high, your local school district is required to evaluate your child for developmental delays. You can call the special education director at your local school district and ask to set up an evaluation (follow up with a written request). If your child is found to be eligible for services, he will get an IEP, or individualized education plan.

Because schools sometimes don't recognize the importance of sensory problems, it will help to notify them of any diagnoses your child has (such as ADHD) or developmental delays you are concerned about (such as if he seems uncoordinated or has difficulties with physical activities such as buttoning, writing and drawing, and catching a ball, or if he has trouble following verbal instructions). Should "related services" such as OT be recommended after evaluation, the school district is mandated by law to provide therapy.

While there are many wonderful OTs with strong SI backgrounds working in the schools, there are many others who are more expert at evaluating and treating difficulties with fine motor, gross motor, and visual-perceptual skills. Therefore, you will have to politely insist that the OT evaluator (and the treating therapist, should OT be recommended) be very knowledgeable about SI dysfunction.

Who does the evaluation?Typical Members of the Evaluating Team
In addition to playing the lead role in working with sensory issues, an occupational therapist also addresses fine motor skills, gross motor skills, visual-perceptual skills, self-help skills, and other important skill areas. In a nutshell, though, occupational therapy addresses all the skills needed for the "job of living" – all those tasks that occupy one's time such as playing, going to school, eating meals, and so on.

A physical therapist (PT) looks at difficulty with neurological, musculoskeletal, sensory, or other issues that impair mobility, balance, coordination, strength, range of motion, and endurance. A PT works on developing a child's gross motor skills – to crawl, sit, stand, walk, hop, jump, and run. In treatment, a PT addresses postural control, stability, joint alignment, muscle tone, and motor planning skills. In the EI evaluation, the OT may assume the role of both OT and PT in assessing motor skills.

A speech-language pathologist (SLP) looks at both receptive and expressive language problems, auditory processing, and oral-motor difficulties such as low tone and feeding problems. SLPs often work closely with OTs on oral-motor issues and with audiologists on receptive language problems.

A special education teacher considers cognitive development and learning issues as well as behavioral issues and social skills.

A case coordinator will also be present during the EI evaluation, taking the lead in learning about your family's history and your child's developmental background, and coordinating the entire process.