OT Developmental Question

manhattanmom

Fri, Feb 12 2010, 1:18 pm

I have a 14 month old who (at least to me) is showing some delays in his fine motor skills.
He does not have a pincer grasp (still whole hand palmer grasp), had difficulty playing with toys that have buttons and activities that require fine motor skills and does not isolate any fingers (to point, etc.) Everything is still whole-hand.

I have no concerns regarding the rest of his overall development. He walks (almost runs), climbs on everything, and even has 3 words, and definitely understands instructions.

My question basically is: Is this (his fine motor issues) a valid concern at this age? Is an evaluation worth it now--or is it better to wait. I doubt he'd be eligible for services at this point if this is his ONLY area of concern.

amother

Fri, Feb 12 2010, 2:20 pm

Just got my degree in OT. according to one of my textbooks, a pincer grasp should develop at 10 months and a fine pincer (more accurate grasp) should develop at 12 months. If your child really has no isloated finger movement at fifteen months, then I think you should get an evaluation, just because this is the only problem does not mean you wont be eligible for services because the Board Of Ed gives services to develop skills needed to excel in school, and for a child many of those skills are fine motor (writing, cutting etc) s oyou may be eligible- but either way you wont know unless you get an evaluation.

manhattanmom

Sat, Feb 13 2010, 7:40 pm

Thanks.

I wanted to bring up a few points with your suggestion--
First, where I live Early Intervention is the Dep. Of Health.

From what I know of the system (as a parent of another child and as a professional) it is usually hard to get services for a child in ONE area unless there is a 33% delay or 25% delay in 2 different areas.
Right now, this is the ONLY area of concern. In other ways, his development is great (even advanced--walking really well--super gross motor skills! and he even has a couple of real recognizable words!)
So my question now is--
Are you familiar with the system in New York City and do you think he'd qualify for OT without having to "look around or make-up issues" in another area of development?

bnm

Sat, Feb 13 2010, 8:11 pm

manhattanmom wrote:

my daughter has a 40% delay in one area and we didn't get approved thanks to the incompetent therapist who did the eval.... make sure you use a good agency and therapist.

pina colada

Sat, Feb 13 2010, 8:21 pm

bnm, if your child was not eligible for a 40% delay in one area it must have been sensory, nutrition or feeding as Early Intervention does not approve services for children with a delay only in one of the three mentioned areas.

Op, I am not an OT so I do not know if your child's delay will be large enough to qualify for services but a large enough delay in fine motor skills only should be enough to qualify him for services.

You do not have to worry about 'wasting' an eval, your child is eligible for a 'core' eval (a developmental eval and social history;parent interview) and 4 supplemental evaluations per year. So if you have him evaluated at this time and he is not eligible you can reevaluate him in 4-6 months if recommended by the evaluator.

bnm

Sat, Feb 13 2010, 8:28 pm

pina colada wrote:

I got a letter saying that since she falls within the guidelines of needing therapy but the therapist didn't write in the report that she needs therapy then I can go to a different agency to get her reevaluated without waiting. However the best therapist for her issues is at that agency.....

Otrox

Sun, May 08 2016, 9:04 am

bnm wrote:

I know that this is an old thread, but I would like to clarify the issue with agencies in ei. As a parent in NYC, you would be entitled to choose your service coordination agency (the agency that arranges services and meetings), your evaluating agency, and your service agency for each service approved. So you can approach agency a for service coordination, and tell your service coordinator that you would like agency b to evaluate. Once approved you can choose to switch service coordinator if you would like. You can also request specific therapists, or agencies to provide therapists, to work with your child.

Many parents are not aware of this.
There are also free seminars provided by the state to educate parents an providers of the early intervention process. See eilearningnetwork.com for more details.

bnm

Sun, May 08 2016, 11:28 am

Old thread and all but I wanted to update- child was evaluated a few months later by a different therapist and agency who told me she IS eligible, then at the meeting I was told someone did the math wrong and she isn't eligible but she does need therapy and I should go through insurance. Before that no one had mentioned insurance might pay... so thats what we ended up doing. Once we finally got a therapist to evaluate her through insurance she was horrified the child wasn't approved for EI services since- chewing is developmental and covered under EI and swallowing is medical so they wouldn't approve her but the therapist said she couldn't even move her tongue properly. She got a good few months of therapy and showed major improvement. She is 7 now and when I tell people she used to be failure to thrive they don't' believe me. moral of the story is if you feel your child needs the services pursue it in any way possible.

bnm

Sun, May 08 2016, 11:32 am

Otrox wrote:

my next child needed a lot of services and thats what we did- one agency for service coordination and evals, another agency provided the ot and a third agency where he attended their EI special ed program.