What type of Dr to see (NJ)- Sensory/Explosive

studying_torah

Sun, Sep 03 2017, 7:21 pm

Ds (aged 9) is a very sensory, low tone child with zero emotional tolorence. He blows up at the tiniest thing, loses it at the smallest frustration, can't calm himself once upset, etc.

We have tried the OT route in a very popular, albeit expensive center here. The therapist collaborated with him for ideas of how to calm himself . He refuses to implement any suggestions. We tried another OT who does a more behavioral approach, but I wasn't pleased with her qualifications or methods.

In school he controls himself somewhat, though there have been some explosive episodes, but at home he doesn't even bother to try. Anyone who dares do anything that he dislikes, gets exploded at. No one wants to play with him, be near him at all.

Does anyone have ideas of whom to take him to to figure out what makes him tick, and how to modify his behavior?

I have United healthcare in NJ.

Thanks!

amother

Magenta

Sun, Sep 03 2017, 8:15 pm

The mainstream route would probably be to see a neuro-psychologist or a developmental pediatrician (sorry, no recommendations in NJ), but I'd strongly recommend also seeing an integrative MD who can help you look for biomedical root causes. Good luck!

amother

Babypink

Sun, Sep 03 2017, 8:27 pm

studying_torah wrote:

If you're in northern nj Hackensack and valley have good child study centers with associated neurodevelopmental peds.

studying_torah

Sun, Sep 03 2017, 8:59 pm

Do you know if they take insurance, and have long wait times? I know most developmental peds in the hospitals have months and months of waiting time.

amother

Babypink

Sun, Sep 03 2017, 9:24 pm

studying_torah wrote:

Do you know if they take insurance, and have long wait times? I know most developmental peds in the hospitals have months and months of waiting time.

They do take insurance afaik, and the wait times are very long. Call tomorrow or Tuesday to get on the list. There's also a good center at st Joseph's in Patterson I heard.

animeme

Sun, Sep 03 2017, 9:27 pm

Book an appointment whenever they have it. And then put yourself on the cancellation list.

studying_torah

Mon, Sep 04 2017, 12:34 am

Good idea, animeme! Does anyone have vontact info for hackensack or valley place please?

animeme

Mon, Sep 04 2017, 9:07 am

Also, while you wait, there may be more help in the world of OT. As opposed to how you help him when he is agitated, you can work on things that reduce the overall agitation level and increase body awareness and control. And you don't necessarily need an OT to do it.

For example: This is a nice age to put him in a martial arts class. It moves his body, promotes body (and also emotional!) control, and works fine for kids with low tone- just talk to the instructor. It's great fitness for kids who have need help with spatial awareness.

Also, will he let you touch him? He's still young enough to get massage from you. You can consult with the OT you like about the best way to so it, but in general, you want firm touches starting from the middle of the body and moving out. To get him used to it, start slow, and possibly while he's doing something else. Done regularly, it can really help.

Hatzlachah!

studying_torah

Mon, Sep 04 2017, 9:15 am

We tried martial arts (private class for just our family), it was not good. He disrupted the class, and refuses to practice. In general he is very reluctant to move.

amother

Sapphire

Mon, Sep 04 2017, 9:50 pm

studying_torah wrote:

Hi, sorry I can't help with specifics, not being from/in NJ, but I am an OT, and while I would say I've had clients like your son who benefited greatly, there were many others for whom OT was not the (primary) answer. There is a very fine line, sometimes, between what's being caused by a behavioral or sensory concern, and while I initially started practicing with a very sensory-focused lens, I've been straying from that the more I've worked in a behavioral setting. Are there any practices with ABA around? One that would do intense training both with your DS and family. I've found that the assessments and tools available to OTs are typically sensory-based, so they indicate a sensory-deficit if there are any atypical behaviors. The tools the ABA (behavior) specialists use look more at the cause of the behaviors, including what they call "automatically reinforcing" (which is essentially "sensory" to my understanding), and then help devise a plan of how to best attack that behavior. For example, if they felt the behaviors were sensory based, they'd likely recommend Sensory Integration therapy (with an OT). But if it's to avoid work, seek attention, etc., there's a very different response. These assessments are typically completed in a few sessions to get the best picture of the child in their environment(s).

A couple quick examples: If a child yells every time his sister sings, and throws a tantrum, is it because the singing is actually bothering him and he can't tolerate it (perhaps a sensory concern)? Is it because momentarily, she's getting attention, and he's craving it?

A kid is bouncing off the walls instead of sitting down to do his homework. Is it because he's trying to avoid the work? Is it because he has a lot of energy and needs a proper outlet?

Each of these scenarios would require a different response, and with proper training, parents can implement the strategies they've been taught to help address the situation, whether it is using noise-cancelling headphones or running an obstacle course (some typical sensory strategies), ignoring the behavior (in the moment, while flooding with positive attention in the absence of negative behaviors), or identifying why homework is so difficult (tutoring?) etc.

I hope I haven't overstepped, but I do think with a good provider, you could get some really good insight as to what is going on and be"H have the tools to help your family function better!

Hatzlacha!

studying_torah

Mon, Sep 04 2017, 10:16 pm

Thank you sapphire, your post was very wise, and truthfully I do not know. Even as a baby he was always having a hard time, and his tantrums continued way past usual age, so we took him to a child psychologist. He was the one who suggested sensory issues, bec he really did not know what was wrong.
It's possible that the sensory turned behavioral.
How do we determine what this is, and if we need a behavioral/aba approach instead of sensory/ot?

amother

Coral

Mon, Sep 04 2017, 10:44 pm

If u live in lkwd, contact brain builders. They are amazing!

studying_torah

Mon, Sep 04 2017, 11:19 pm

Thanks, I'm not in lakewood.

amother

Babypink

Tue, Sep 05 2017, 12:28 am

studying_torah wrote:

Neurodevelopmental ped is your first step. Sounds like related services could still help and he could benefit from pt as well.

animeme

Tue, Sep 05 2017, 9:29 am

amother wrote:

Neurodevelopmental ped is your first step. Sounds like related services could still help and he could benefit from pt as well.

Agreed. If ABA/behavioral therapy is indicated, a relevant diagnosis (which you would get from the dr) can get it covered by insurance. Also, some people I know have benefited from seeing a child psychologist, either with their child or on their own, to get help with managing and shaping their child.

Final note- for a very sensory child, particularly one with motor issues, age nine is late enough to have internalized the ideas that 1) movement is hard and frustrating and therefore not worth it, especially since it may affect his social life as a boy, and 2) that the world is threatening. The average knocks of a ball game or even walking down the hall are experienced as if someone punched him, yet everyone tells him it's nothing. Walking outside on a sunny day may raise his stress level but nobody notices or cares. Same with a crowded classroom or a seat near a kid who taps his pencil. It's often easier to say "I can't " than to try, and being reactive may be ingrained (plus, physically sensitive people are often more emotionally sensitive too.) So there can be a lot of psychological/behavioral work associated with sensory issues. Doing it can lead to more acceptance of any other help that may come. So, if possible, is a male OT. Or a good pediatric PT who knows OT.

Oh, and make sure to cover physical issues. Underlying conditions like eczema or stomach irritation can increase overall irritability and equilibrium.

amother

Sapphire

Tue, Sep 05 2017, 11:04 am

animeme wrote:

Agreed, and to OP as well, what may have started as sensory differences could very well have evolved into behavioral. And more than "I can't" DS might be thinking/saying "I won't/I don't like to/ it's stupid or boring" etc. I do hope you find a good Dr who can help you find the resources that will be beneficial, and I think it will be important to find out whether the doctor recommends tackling sensory and behavior components Hug

simultaneously or if one should precede the other. (I could argue either way.)

Hugs! Hug

studying_torah

Tue, Sep 05 2017, 11:42 am

Thank you all so much! So now I need to find a neurodevelopmental pediatrician- is that diffetent from a "regular" developmental pediatrician or "regular pediatric neurologist"?
I wonder what types of drs the hackensack child study team has, and if that is the way to go instead of trying to find a single specialized dr.