Last week I found myself in a unique situation. A very unique situation. I — a pediatric occupational therapist who enters families’ homes on a daily basis to conduct developmental evaluations and provide therapy for their little ones — found myself sitting in my apartment waiting for an occupational therapist to come evaluate my own little one.
Without going into too much detail, we have had feeding and sensory issues which have caused quite the ruckus in our household over the past 10 months or so. With my husband’s blessing, I contacted our local Regional Center and asked them to come out and take a look at our non-bottle-drinking, non-sleeping, non-self-soothing, head-butting bundle of joy to see if they could give us any pointers.
I couldn’t believe how nervous I was in the minutes before the therapists’ arrival (yes, they sent TWO therapists to check in on us…talk about feeling like you’re under a microscope!). If I — a therapist who does this for a living — was feeling this way (and I even knew exactly how the entire process would go), I can’t imagine how it must feel for parents who don’t know anything about the system or the process and simply want to know what’s going on with their child.
As we await the results of the evaluation, I wanted to share with you some tips from the perspective of a pediatric therapist for how to prepare for and participate in an in-home developmental evaluation, should you ever find yourself in such a position.
Here are five things to avoid:
1. Don’t go out of your way to clean your house. If you’ve been meaning to clean your house anyway and the fact that strangers are coming over provides some incentive for you to finally get it done, then by all means, clean away. But if you’re having your child evaluated, chances are your day is already stressful enough. Don’t complicate it by rushing around to put away toys, wash the dishes, or mop the floor. We’re coming to evaluate your child, not your homemaking skills.
2. Don’t worry about what your bathroom looks like. The person coming to evaluate your child more than likely won’t ask to use it. I know I don’t. And if they do, they will do it as quickly as possible and will certainly not be snooping through your medicine cabinet. Just make sure there’s some soap and a towel in there so we can come back out with clean hands.
3. Don’t worry about making a place for us to sit. Unless other arrangements have been made, we will spend the majority of the evaluation playing with your child, and that means we’ll be down on the floor with them. We’re used to it. It’s what we do.
4. Don’t change your parenting behavior just because a therapist is in your house. Talk and interact with your child in the same way you would if we weren’t there. We want to get a good look at how things usually go in your child’s life, not how you wish they would go. If you normally use baby signs while talking to them, then use baby signs. If you usually speak to them in more than one language, then speak to them in those languages. If you typically give them a time out when they misbehave, then enforce the time out if they end up earning one during the evaluation. Don’t get nervous about your parenting style just because there are strangers in your house. Again, we are here to evaluate your child, not your parenting skills.
5. Don’t get defensive. It is our job to scrutinize every little thing we see your child do and be hyper-analytical about it. It’s what we’re trained to do. And it’s also what the assessment calls for. We are required to obtain developmental levels for all major areas of development: cognitive, language comprehension, language expression, gross motor, fine motor, social emotional, self-help, and maybe sensory processing (depending on your concerns). So even if you are only concerned about your child’s language skills, we are still required to complete a full developmental evaluation. It’s the law. It also gives us a better sense of why they may be struggling in the way they do so we can create the best possible plan and recommendations for them. Additionally, we will not only test skills at your child’s level, but also above their level so we can get a feel for where they’re at and what would be appropriately challenging goals to set for them. So please don’t get defensive or upset about the questions we ask or the difficult tasks we ask your child to complete. We’re here to help.
And here are five things to be sure to do:
1. Write down bullet points of your main concerns before the evaluation. Include how long you’ve been concerned, some examples of how these concerns have manifested in every day life, and any questions you have related to these concerns. Unless I’m a total weirdo, I’m pretty sure you will feel frazzled and maybe even overwhelmed during your child’s evaluation (I sure did). It’s your baby — your precious baby who means the world to you — that they’re scrutinizing, and you’ll find yourself stumbling over your words as you look over at your child and try to explain what the problem is. So know your main concerns and be able to clearly state what they are.
2. Try to schedule around your child’s naptime to the best of your ability. I know firsthand how inconsistent naps can be but, please, do your best to schedule around them. We are coming specifically to interact with your child and it’s hard to get an accurate assessment if they are asleep the whole time. Do your best to gauge when they’ll be napping on the day of the evaluation and if it looks like there may be a collision of schedules, try to call the evaluator just to give them a heads up. That will give them a chance to prepare themselves accordingly and maybe switch around some things in their evaluation or even in their schedule for the day.
3. Start a folder so you can keep track of all the paperwork and handouts you will receive as part of the evaluation (and possibly intervention) process. This will make life so much easier for you and it will keep your brain organized as you meet with an assortment of people whose names and titles will escape you as soon as they exit your front door. You can get a basic folder from the grocery store for less than a quarter, so there’s really no excuse. On the day of my first meeting with our therapy service coordinator, I had absolutely no idea where I had put the paperwork she had mailed to me and specifically asked me to make sure I had filled out for her when she arrived. Sleep-deprived mommy brain to the max. I felt so stupid! I searched and searched and panicked and rushed around the apartment and then, 15 minutes before her arrival, I found it sitting neatly in a very logical spot over by the mail. Doh! Don’t make the same mistake I did. Get a folder. Label it. Put it somewhere you’ll remember. You’ll be glad you did.
4. Ask the therapist what activities you can do with your child in the time between the evaluation and when therapy services begin. It often takes several weeks (or more) between having an evaluation completed and actually beginning therapy. In addition to their full day of treating clients, the therapist has to score your child’s assessment, write the report, submit it to the appropriate parties, and then await authorization for services. As a parent, you’ve probably waited long enough before seeking out services, so the last thing you want to do is wait even longer to get started in helping your child. So ask the evaluating therapist if they have any suggestions for what you can do with your child while you wait for therapy to begin. They will be happy to provide some simple suggestions that will get you rolling and, hopefully, relieve some of your anxiety about your child’s progress.
Learn more about activities to support infant development milestones, best toys for baby’s first year, and best toys for toddlers.
5. Remember that the therapists are on your side. We are here to help. We went through many years of formal education and training and have likely submerged ourselves in an unimaginable amount of debt in order to help people just like yourself and your child. It is our pleasure to work with you, and we want nothing more than to see your child succeed. We are on your side.
I hope this list is helpful and, hey, if you know of someone who could use this info, please pass it along!