Does my child need an occupational therapist?

occupational-therapy-therapist-young-boy-playing-womanDear GHF,

Recently, my child was evaluated for kindergarten readiness. Despite his ability to read Magic Treehouse books on his own and his fascination with the relationship among mathematical functions, we were told he was not yet ready and that we should have him evaluated by an Occupational Therapist. I don’t understand what an occupational therapist has to do with my child’s readiness for kindergarten, and why, since he’s clearly academically ready for kindergarten, he should wait a year.

Confused in Campbell

Dear Confused,

That’s where the asynchrony thing comes in. Your child does appear to be gifted, but gifted isn’t simply an academic construct—it’s how the brain is wired]. Regardless of his accomplishments, there may be areas in which he has some trouble. Presumably, that’s what the evaluation determined and the reason for seeing an occupational therapist (OT) is to identify and mitigate these issues.

An OT will evaluate your son’s neurological development in areas of gross and fine motor skills, as well as areas of sensory processing. We don’t know the specifics for your child, but it’s not unusual for a gifted child to develop unevenly in different areas, for example, having advanced (compared to age peers) academic skills but not having some of the basic gross motor development, such as kicking a ball, riding a bicycle, or standing for long periods without tiring. Sometimes, it’s not gross but fine motor issues, which can significantly impact a child’s ability to show what they know, since pencil grip, writing, and drawing are all impacted by delays in fine motor development. Here’s some information on what you can expect from your meeting with the OT.

If your son does need occupational therapy, the good news is that frequently children really love going to OT and see it as play time rather than work time. Additionally, a child who is unable to keep up with their age peers in some activities will likely feel badly about themselves, nevermind that they are way ahead of their age peers in other ways. They may be subjected to teasing and bullying, as well. OT provides these kids with extra support to help improve brain development, increase confidence, and build sufficient skills to better keep up with their age peers. There are lots of things you can do at home to enhance the effectiveness of this therapy. There are many terrific resources that can help you understand more about what your child might need.

The larger question of why he should wait a year is indeed a difficult one, and why we frequently find ourselves recommending homeschooling as a good option for such children. If kindergarten is not required by law where you live, it might make more sense to let him range where he will academically on his own, while paying special attention to motor skills and sensory processing, without actually enrolling in a formal school-based program. The question of when (or if) you should enroll him in school will be one of balancing the many factors and options. Some families go ahead and enroll their children in an academically appropriate environment and then provide scaffolding to support the placement. Other families choose to wait and see. We would suggest that, before you make your decision, you cultivate a deep understanding of who your gifted child is, and what your gifted child needs. Many characteristics which are of concern in neurotypical children may be perfectly normal in gifted children, and vice versa. Be careful with which yardstick you choose to measure him.

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