To OT or not to OT

Ya gotta appreciate the beauty of a palindrome like "To OT" flanking the title of a blog post. Toot toot!

Yesterday, we had an early Thanksgiving with my husband's parents. One of the guests, whose son has a variety of "issues" (none of them autism related), commented that her pediatrician and his colleagues think OT is B.S. As in, occupational therapy is bullshit. And her further comment was that she agreed.

I sat there, eating the premature dinner of turkey and dressing (No nuts! No fruit! No SAUSAGE! This was real cornbread TEXAS dressing, thank God), and pondered it. I didn't get testy about it because in one sense, I agreed with her. When TH first entered into therapy, we tried a couple of things, including an OT who was named after a bird, and a psychotherapist. The OT almost gave all OTs a bad name because on our second visit to her (the first had lasted 45 minutes), as TH literally bounced off of the walls, she kept saying, "Oh, he's soooo much better! Wow! He's really doing sooooo much better!" The psychotherapist was a whole 'nother country, one we moved out of pretty quickly.

I couldn't tell if the OT Bird had just gotten TH confused with someone else, if she'd forgotten her meds that day, or if what she was doing was so flaky that one could experience it for 45 minutes, take a weeklong break, and then show up already doing soooooo much better. What made things even worse was that Mr. DMFP, not quite the knee-jerk skeptic I am, actually took her at her word. "He's so much better?" he asked, hopefully. "Yes!" she squeaked. I just rolled my eyes, and we did not take our son back to that OT Bird again.

And so, yes, I could see where a team of pediatricians might think that OT is bunk. Why they'd think that OT is worthless. I could see where this guest at the table felt the same way. Her son had experienced the negative, worthless side of occupational therapy, receiving treatment for the one thing he probably didn't require help with.

But I can also see where OT has changed my youngest son's life. He has real professionals, not twittery, gushing, flaky birds, professionals who work with him three hours a week. It's partly the professionalism of the OT and SLP team, partly the density of time, and partly our own greater experience on the home front, a therapeutic trifecta that has shifted Little Da from the path of shutdown-and-shutout to the only child we've ever had who knows how to give a hug. In our book, OT is not BS or bunk, at least not when used right, used judiciously.

Why the different impressions? Well, as anyone can guess, there are good OTs and bad OTs. The ones who know what they're doing, who know how to sift the good and sensible approaches from the nonsense (brushing anyone? I mean...I like it because it feels quite nice, but I'm not buying the "brushing = dopamine" and "joint compression = serotonin" and both Must Be Done or Else stuff...and onward).

Just as that is the case with OTs, so it goes with MDs. As it happens, the very MD who said this to the table guest happens to have been TH's first pediatrician. We liked him. He didn't give us any crap when we delayed vaccines. He took a laid-back attitude about most things. But...when I took TH in at his one-year and asked about his obsession with spinning, this pediatrician said, without batting an eyelid, "He's on target with language. He's fine." When I asked again at 18 months and at 2 years, now concerned about much more than spinning, again, the response was, "My opinion is, he's on target with language, he's fine." And the MD was wrong, at least in one sense. TH is fine, but he's also autistic, and those signs were there from very early on, for anyone to find, if they only knew how to see. Or where to look.

So, that particular MD--and the table guest--may be of the opinion that OT is a waste of time, that it's BS, that it's bunk. But, as the pediatrician in question so ably demonstrated in our case, sometimes, opinions can be wrong.