Accessing Services for Child With Challenging BehaviorsQ: We are in the midst of desperately trying to address our daughter’s sensory issues. She is very bright, but we have wrestled with a very active, non-sleeping, sensory seeker since our days in Vietnam. Early Intervention clinicians found her ineligible for Early Intervention services but recommended an Occupational Therapy Evaluation because of sensory issues. We now will have to fight with our health insurance provider who approved the OT evaluation, but will not authorize the recommended treatment (OT). ?How do we access services for our daughter? We cannot afford to pay out of pocket for OT as one of us has already had to give up income to stay home.

A: We did a Creating a Family show on Sensory Processing Disorders with Carol Kranowitz, author of The Out-of-Sync Child: Recognizing and Coping with Sensory Processing.  Both the show and the book are a great first step for getting more information about SPD.

Convincing insurance companies to pay for OT can be difficult and frustrating. First, I would take the information from the OT evaluation back to your county/state Early Intervention program and ask for a reconsideration of getting services. Second, I would fight your insurance company arguing that SPD is a neurological problem, not a developmental problem, assuming neurological problems are covered by your insurance policy.

If you lose on both of these, can you afford one visit to an Occupational Therapist to get help in setting up a program that you can implement at home? The suggested therapies, especially for preschoolers, can relatively easily be incorporated into play, but it helps to be more intentional with time and specific activities. Also, read some of the books I list to add additional activities that you can incorporate easily into your day. If possible, go back to the OT every few months to see how you are doing.

Image credit: @rtimage – Debora Bogaerts