Recently, Dr. Lucy Miller, Ph.D. OTR, who is known in international circles as the top researcher in Sensory Processing Disorder (SPD) agreed to speak to Can Mom Be Calm about how parents can find good Occupational Therapists (OTs) for their children. Dr. Miller is also the author of Sensational Kids: Hope and Help for Children with Sensory Processing Disorder and trained under A. Jean Ayres whose pioneering work brought SPD into the spotlight.
Choosing The Right Therapist
When I asked Dr. Miller to help us figure out how to choose a therapist, she first pointed to a page in the SPD Foundation website that discusses this issue but I was able to get a more specific response. “Before you even start an evaluation, ask them for their resume.” Ohmigosh, I had never done THAT before. However, it’s a great idea, why not? While I don’t have my pediatrician’s resume, I know where she went to medical school, where she did her residency, and at which hospital she can admit patients.
“You have to know where they went to school, how long have they been mentored and where they completed their mentorship. Experience is important, too. You should ask how many years they have been treating children with SPD and how many of these children do they see a year.” Dr. Miller says that this will help you figure out how much experience they have in treating SPD. She also feels it is helpful to ask how many continuing education courses they have taken. If a majority of the courses deal with sensory processing disorder, then that is good news. Hint: On the SPD foundation website, there is a treatment directory that shows examples of resumes reflecting good experience in SPD therapy.
Asking the therapist about their philosophy of treatment is critical. Dr. Miller says, “You want to hear about family-centered care, parents' priorities, and they should have an eclectic approach.” This means they could implement DIR®/Floortime™ (Dr. Greenspan’s approach) or they might implement an NDT (neurodevelopmental therapy) approach. I honestly don’t even know if any of my kids’ therapists do this or not and now feel very much in-the-dark. Seriously, I felt well-read on SPD. Wrong!
There actually is a certificate for SPD. However, the certificate just means is that the therapist is certified to provide the sensory integration and practice test. Unfortunately, it does not automatically mean they are completely capable of treating a child with SPD but it also doesn’t mean they can not. Nothing is easy for us, is it?
How Can You Tell If the Therapy is Working?
Four Steps to Remember
This question is huge to me because I see things in black and white. But OT doesn’t work overnight so how does a parent know that the therapy is helping their child?
- Dr. Miller believes that there should be clear goals from the beginning and that short term goals are best. The OT should be able to provide that to you so you know if it’s working or not working. You have to see changes in function, if not, find another therapist. They should also start their first session speaking with you to clearly understand what you need to see from your child. I can remember very few OTs doing that with me. However, in my experience, the ones that do that initial talk with me, really makes me feel like we are working toward specific functional goals.
- Dr. Miller then said something which really surprised me. Take a vacation from therapy. What? Hello? I worked SOOOOO hard to get my children the amount of therapy sessions they receive from the government but that is what she said. She believes that children should have intensive therapy but then take a vacation from it. “This is how you know what is working and what is progress as a result of just growing up.” You have to admire doctors who tell the truth like that.
- Don’t let the therapist take your child and go into a room while you wait for them in the waiting room. Go in, see what they’re doing and talk to your therapist, she told me. They should be good with communicating with you and you should be comfortable with them. This made so much sense to me because Spencer’s therapist does this almost every time I see him. I get a least one comment from him about his progress and he informs me on the tactics he uses to get Spencer to overcome his tactile defensiveness. We have a great advantage because Spencer gets therapy at home and
is not home to interrupt it. Logan
- I was about to wrap up the topic but Dr. Miller threw this in because she felt it was very important. That is, parents must get their therapist to do standardized testing and not just give clinical observations. Of course, testing is done in the beginning and at the end of therapy but simpler forms of testing performed during the period of therapy can help parents measure progress.
My conversation with Dr. Miller really sent me spinning. I called both of Logan's occupational therapists (school and clinic) to talk with them right away about
There is more to come from Dr. Miller. We talked so long that she was able to tell me some very important things that parents can do to help their child succeed. This conversation really floored me. She actually said that when it comes to sensory issues, parents should use the F-word. It’s too much to explain here but don't be alarmed, it's a lot more tame than you think. I’ll be posting that story hopefully by next week.
In the meantime, please visit www.spdfoundation.net. I'm so grateful to Dr. Miller and the foundation for giving us this advice and I know Logan and Spencer will definitely benefit from it. I am also going to see how I can support them. I used to support children's organizations but I haven't done a lick of volunteer work in years! I heard there is a bumper sticker coming out and I think I'd like to start with that since I love to spread the news and it also might help cover some scratches from my miserable parallel parking attempts.