Lisa's current behavior is very erratic. Her everyday speech is laced with profanity. She is claiming that she was pregnant and just had a baby, but this isn't true. She is physically aggressive, sexually precocious and inappropriate, and has attempted suicide twice.
Lisa was referred for occupational therapy in her residential program because the previous foster family took her for a sensory-based occupational therapy evaluation that they pursued privately. The outside evaluation indicated that she had severe sensory processing difficulties and recommended the following:
- Wilbarger Brushing Protocol
- Listening to music, such as Mozart
- Diaphragmatic breathing exercises
- Early release from school so she isn't overwhelmed
- Increased intake of water
- OT Consultation to the entire residential program where she lives
I am calling this evaluation to people's attention because it represents such a horrific example of how we are not addressing needs. I would not be surprised to find out that this child does have some difficulties with emotional and behavioral regulation based on some sensory processing issues, but I do not expect that her gigantic problems will be fixed with a brushing program and a lot of water.
In fact, these kinds of recommendations are irresponsible and inappropriate. I am thinking of having the evaluator provide this intervention herself and see how much improvement is made.
Wouldn't it be interesting to listen in on that intervention session: "Gee, Lisa, it says here that you have been in 6 different foster homes, you were sexually abused when you were a toddler, and your biological parents abandoned you and were both addicted to drugs. Why don't you let me brush you and you can take a few deep breaths while we listen to Mozart. That should make it all better."
I am hopeful that some educators and practitioners and students will all read this and think twice the next time they talk about what would constitute an appropriate evaluation, what our scope of practice should include, and how we should be conducting ourselves as professionals.
Please keep Lisa's Christmas List in mind next time you think about how to identify a child's needs. The OT evaluator thinks that Lisa needs a brushing program, lots of water, and early dismissal from school to address her sensory needs. Lisa thinks she needs a car, a Christmas tree, a home, a dad, and a mom.
Which one is closer to being correct?