Square Peg, Round Hole

Dear Single Point of Access Team Integrated Children’s Services

Thank you for your letter regarding the referral from the Community Pediatrician. In the letter you state that the referral requested an assessment by an Occupational Therapist. I assume that this is regarding my son’s sensory issues, as that in our recent meeting with the Community Pediatrician she said that she would refer him for that, as it will apparently not be covered by his assessment with the Autism Spectrum Condition team. I have to assume, as no mention of sensory issues is made in your letter and, not being a healthcare professional, I had no idea that Occupational Therapists dealt with sensory issues. If I am wrong in this assumption and  this is not to do with his sensory issues then please could you let me know the actual reason that you are writing to me about.

With the letter you sent a Additional Supporting Information – Occupational Therapy form for me to fill in. I must admit that I am struggling to work out how to best fill this in. For a start it seems to make no reference to sensory issues at all (making me doubt my assumption and wonder why I’m filling it in). Then there is simply the fact that many of my answers to these questions simply do not fit in the tick box answers provided.

Take for example the first question about whether he can dress and undress himself. If you mean is he physically capable of dressing and undressing himself, then the answer is a definite yes, in fact he could do this when he was 2 years old. However, our life is not that simple, and there are many occasions when he has been incapable of dressing himself for reasons other than physical ones. For instance, because he woke up one morning and all his school trousers felt “wrong” and he couldn’t bear to wear them (despite having previously worn them many times without complaint). Or when his favourite uncle was staying and he wanted very much to get dressed so he could go out with him, but instead had a meltdown because he was so upset that all of his trousers were the wrong colour and therefore couldn’t be worn. Or because he unexpectedly wanted to change out of his uniform after school and the only pair of non school trousers that he would countenance wearing at that time (which I had sewn myself as I couldn’t buy any that met his specifications) were in the wash in order to be ready for next weekend. Or not because of any of those reasons, but because he is now feeling cold (when the other 3 people in the house find it perfectly warm) and therefore will not move, at all, but will only lie in bed rigidly, refusing to move. So, yes, we do have problems with him getting dressed, despite him being physically able to do so, but even then if I assume that this sort of answer is included in your question, my answer still doesn’t fit into the boxes, as the frequency of these problems are less than 25% (the last of  your 4 options), however when they occur (which is not at all predictable) they could not in any way be described as “mild and tolerated by the child”, rather they are very disrupting not just to the child’s life, but to our entire family life (so would fit into the first option).

As for the last three questions about environment, I am not actually sure what you mean by “access to lounge/bedroom/bathing facilities” and I can only assume this would be relevant to a child with mobility issues, which he doesn’t have.

Also, I can’t see any space for letting you know things like the fact he was unable to be in a class photo because he was asked to wear someone else’s jumper and had a meltdown, is that a lack of ability to follow instructions perhaps, or an example of not tolerating changes in his routine?

So, I find myself at a loss on how to proceed. Not because I don’t want to give you additional information, because I very much want to do anything that will help my child and I have no aversion to filling in forms if that is what it takes. But rather because most of the questions you ask seem to be about completely different things than the issues we’re having, my answers to several of the questions don’t remotely fit in any of the provided answers and to be honest, I’m not sure that I’ve been sent the right form, or if I have, that this is the right service.

I do hope that you understand my problem with this form. I also hope that I’m not coming across as negative, like I said before, I do very much want to help my child who so very obviously finds many things in life quite tricky that his peers do not seem to struggle with.

I look forward to your reply confirming why you have sent me this form and giving me advice on how to proceed.

Many thanks

The Boy’s Mum

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