Has anyone had success with Occupational Therapy and ADHD?

Question

Occupational therapy has been suggested for our 6 year old with ADHD. Has anyone had success with this mode of treatment?

Answer 1

I think most parents do amateur/informal occupational therapy for their children with ADHD without realizing it. To me, occupational therapy feels like formalized common sense. It entails adapting a child's environment to better fit his needs, and teaching him coping skills to help him adapt when his environment can't.

For a child with ADHD, examples of adaptations to environment are:

• eliminating distractions
• providing lots of breaks for physical activity
• providing interesting tasks that can help the child achieve flow.

Examples of adaptive behaviors are:

• Organizational skills like writing things down.
• Use a fidget toy to maintain focus.
• Learn social skills like when to ask for help and when to work on your own.
• Learning meditation techniques for getting on track.

Occupational therapists learn tons of these techniques, and know how to objectively assess their effectiveness for individual children. They are powerful advocates when trying to get accommodations from a school. They are good at making therapy fun, and most children really enjoy their OT time. They can recognize other subtle sensory or learning issues that are often overshadowed by ADHD or mistaken for it. They use natural techniques that can help your child avoid drugs. There is very little downside to trying OT.

Answer 2

An occupational therapist is is not a doctor. ADHD is a actual medical condition and should be treated as such. Medical conditions require doctors.

A diagnosis and treatment of ADHD requires a doctor. Depending on your local, it quiet likely requires a Psychiatrist or a Pediatrician. Potentially a GP, who has a lot of experience in the area might work, though I would be cautious.

A specialist doctor can give proper medical advice, this medical advice may include a referral to a psychologist, to a OT, or even a dietitian. A doctor knows the expertise of the specific people they are referring the patient to, and how it fits in to a overall plan of treatment. Far better than strangers on the internet.

If you were advised to see a OT by a specialist doctor, then of course you should (a a general guideline) follow their advise. If you have doubts about their advice, you are best asking them to clear up any question you have. They know why they advised it better than we could.

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There is a lot of misinformation around about ADHD, perhaps in part because of incorrect diagnoses, and perhaps because of selective reporting (eg Current affairs shows about "problem children" or "ADHD psycos".). Many people think they know about ADHD (I had a pysio once who thought loose muscles was a little known symptom of ADHD. Everyone is a expert in their own mind.)

If you just go to a random OT who claims to be good at treating ADHD, you have no guarantee of their training. How reliable their knowledge source was etc. There is not any specific requirement in for a OT to have training in this area.

Where as if you go to a Psychiatrist or a Pediatrician, they have formal qualifications from a medical school. They will have specific knowledge about this.

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Why you need to be cautious (my personal experience)

A as a child I was diagnosed with ADHD, by a pediatrician. This has continued into adulthood. I was appropriately medicated, which worked very very well for me. I recently had to show a new psychiatrist my school reports so he could confirm the diagnosis. The change is absolutely marked. Obvious improvements in grades. Comments from teachers teaching multi-year studies (ie who knew me before and after the medication) about the sudden decrease in fidgeting and more paying attention. Medication was for me a very good answer. But I am no doctor (and nor is an OT) and can't make recommendations for you.

I also have dysgraphia, which may be related. Dysgraphia is the inability to handwrite.I was referred to an OT for my disgraphia. Well first my school provided me with one, and then she referred me on to her mentor, a more experienced OT.

The OT did somethings that helped, and somethings that did not. The OT wanted to address problems holistically, so took the ADHD as part of the picture that incorporated the disgraphia.

Things the OT did that helped

• Sent me to a behavioral optometrist. Who found I had a tracking disorder, and with the OT worked to solve it. And also spotted early signs of my deteriorating vision (I now have 6/20 vision)
• Sent me to an Osteopath. Who realigned my spine and "cranial plates". This took many months of weekly sessions. This did help with my headaches. I suspect going to a physio may have been more effect in the short and long term. The Osteopath thought she cure my ADHD this way, but told me and my parents not to tell the pediatrician. The osteopathy did seem to make me calmer, but I now attribute that more to the regular meditative/relaxing experience ritual.
• Sent me to a podiatrist, who found I needed orthodontics. This helped with a pile of minor pains.
• Many year later, I had to visited as different OT to get approval to have a computer in my university entrance exams. She looked at the facts, and wrote a recommendation in the the language the school authorities would accept, which got me special considerations.

Things the OT did which did not

• talk about crystals, energyflows, and laylines. She also taught me to dowse with a pendant. (Complete garbage and not the kind of thing you want a impressionable child to here from a supposed expert)
• diagnose me (incorrectly) with dislexia (rather than disgraphia). OT's have no diagnostic training
• do a whole slew of learning style tests, most of which I had seen at school before. And which are now coming under increasing fire as not proven effective in real learning.
• Encourage me to keep on practicing writing. Which someone with suitable training would know can not help (most) people with disgraphia. A better selected OT may have been the answer. I would hope that a pediatrician could recommend a OT with experience in that area. And the same is true for ADHD.
• Rather expensive, and not covered by the national medical scheme or by my families medical cover.

Summary

So my overall impression of OTs is that the can look at the whole problems and look at all the issues and make some recommendations. I don't doubt that getting all the other things (like my tracking disorder) sorted reduced many of the symptoms which are associate with the ADHD. They also can speak the language the school system wants. But they have no real diagnostic/medical experience, and can be absolute nutters. It would have been a utter disaster to have one as the primary person managing my condition.

I think, on the other hand, had the OT being recommended by the pediatrician, I would have ended up with someone who was less of a nut, and who worked with my doctor to come to some really good solutions. If your doctor is recommending this, then by all means listen to their advise, and ask them any questions of your doubts.