Dyspraxia, SPD and Discontinuing Occupational Therapy

Jam is 5 years old!

A while back, I wrote here about our dilemma of whether to continue with occupational therapy after Jam's therapist closes her home practice and retires at the end of July. Well, the end of July is fast approaching. And we don't have a replacement therapist lined up. In fact, I've decided it's a good time to end OT. At least for now. Maybe forever. Who knows? I'm a little nervous. But also a whole lot excited.

We've been attending occupational therapy for 2.5 years- that's half of Jam's life! And I mean attending religiously. At minimum once a week, regardless of holidays and vacations. And there's been more than a few long stretches of going twice a week. We initially started doing that because Jam, when younger, was so SPD avoidant and dyspraxic slow and so little was getting accomplished, he needed two appointments a week just to cover one appointment's goals for any hope of progress. Then later, due to preschool anxiety issues, we'd attend semiweekly appointments the month before school started through the month after just to keep him manageably regulated. And now, since our therapist announced her plans to move on, well, we're getting in all the appointments our insurance will let us cram in!

Jam doesn't remember a time before Miss S and visiting her home for work and play. OT has been a huge component of Jam's life. And of mine these past years. So why do I feel now is a natural time to stop?

OT is time-consuming

It's not just the OT sessions themselves that are time-consuming, but the whole routine before and after the sessions. Traditionally, Jam had been very resistant to transitions so we developed a ton of routines around these transitions to lessen his anxiety and increase his comfort level so that he could actually learn things and do things and progress on things. And while Jam doesn't need as many now that he's older, weaning him from some of these routines has been a very gradual process. And he's kept a few of them, like playing in the therapist's outdoor sensory playground for upwards of 40 minutes after each session. By the time we actually get home, it's time for lunch already. Except that Jam usually requires time to transition peacefully from the car to the house and so ends up playing in the car or outside in the yard for another 20 minutes before finally coming in. OT has never been a 'get in, get it done, get out' sort of thing.

We need more unstructured time

I'm always looking for ways to balance Jam's structured activities with his (and my) need for downtime. We have a lot of structured activities/appointments. And this kid is only 5 years old! Breaking from OT now would free up some time. Especially morning time which is Jam's best time of the day. Unfortunately, his 'best time' is also the best time for him to actually be in therapies learning and practicing new skills. Right now, he has four 10am appointments a week. Soon, we'll be down to one.

OT is expensive

Need I say more? And that's with great insurance coverage. Co-pays add up.

I want a turn

I've been attending those OT sessions right along with Jam. I'm in the room. I'm paying attention. I'm doing my research. And Miss S has taught me so much about how to observe Jam and figure out what he's needing and why. She knows we will not be continuing with OT at this point and has spent a lot of time these past months in helping me put together a game plan on how to work with him. I've always had so many ideas of things he and I would love to do to practice his skills if we just had the time. But he's always so tired and with what little uninterrupted free time he actually has, he just wants to play. Because, well, he's 5! And I haven't wanted to take that away from him. I'm really looking forward to getting to spend even more one-on-one time with him.

Priorities shift

Now that Jam has made solid gains in his motor skills and SPD coping strategies, it's a good time to evaluate priorities. One being 'social skills building'. Whereas Jam was initially terrified of kids as a group, now he wants to be around them in social settings and to make friends. A great measure of the progress Jam's made, I now need to make sure those opportunities are available. A bit challenging given our current schedule balanced against his need for downtime.

So discontinuing occupational therapy is not to say that Jam's been 'cured' or that he's 'graduated' out of the need for OT. In fact, I feel that the therapy has gotten Jam on the upward spiral he's been on for awhile now. And it's that upward spiral that is actually enabling us to end formal OT at this time. If that even makes sense.

And it's not like he's dropping hippotherapy or integrated movement therapy or swimming. He's still got a lot of therapy happening. Plus, if I've made some huge mistake and he plateaus or plummets downward, it's not like we can't start OT up again elsewhere. I've got the referral info.

And, above all, I'm realistic. We might be seeking OT again later. Jam's dysgraphia is an issue he and I very well may need assistance with down the line when he's ready to tackle handwriting. Which is not now.

Right now, he's five. And I want him to have some time to do as many five-year-old things as he can.