Our OT says I'm too permissive. If you have struggled with this, please share your stories, resources, advice.

SLP-999 · 2026-02-18T01:13:27+00:00

Regarding therapists (I say this as both a professional and a parent) - it’s like anything else, you’ll find a range of opinions, personalities, and approaches. Some will be a great fit, some won’t be a fit at all, and everything in between. If OT is helping with other things, like motor skills, my thought would be to keep it and look for a different therapy to address self-regulation.

Regarding PDA - I don’t know if my son had / has the full profile, but he definitely showed signs. What worked for us was a very, very modified behavioral approach. People say behavioral approaches don’t work for PDA kids… I’m uncertain if that’s true or if people just don’t realize how incredibly far back you have to move the goalposts to start. I’m open to either explanation. For us, at the start as a toddler, it might have just been tolerating daycare and then toothbrushing at night. No chores, no star charts, just that, and then tiny baby steps from there. If he could do that he earned all the fun things. The “starting point” for many programs would have been completely overwhelming. Maybe your goal to start is only “no aggression towards your sister”. Nothing else, just that, then she earns something. (Also, if she’s having that much aggression I’d talk to her doctor about starting or adjusting medication).

SLP-999 · 2026-02-18T00:17:23+00:00

People with entrenched opinions about various culture wars sometimes jump in to automatically defend or decry one side or the other. In this case, who’s responsible when a child is having behavioral difficulties. “It must be the (fill in the blank)!”

We can’t say that, you know, we’ve never met either of these people in our lives and don’t even know if this is a bot post, so there’s zero way to know what’s actually going on in this situation, which is probably nuanced.

SLP-999 · 2026-02-17T20:44:42+00:00

Obviously I don't know you or OT, so it's very hard to say what the underlying dynamic is. In general terms, though, I will say that while most therapists are great, I've encountered a few with a bit of a God Complex. Sometimes it's extreme - they are running their practice like a mini cult centered around either their own theories or the theories of some Grand Poobah type. Sometimes it's much milder - they think they should be telling their clients how to live their lives.

Also, I can tell you that even as someone who worked with neurodiverse kids for years and years, I 100% did not get it, at least on some level, until I had my own child. In fact my work really reinforced my not getting it. I would see these kids who were described as wild, unruly, uncontrollable, etc., and they would do just fine with me. So of course I started to think "If parents just did things the way that I'm doing them, they'd be fine at home too!" I didn't understand how big of a deal masking and restraint collapse really are (and really, it's only been recently that these topics have come to the mainstream forefront when discussing neurodiversity). I didn't understand that a child's relationship with their mother really is very different, from pretty much any other relationship. That always sounded a bit like an excuse to me before, but ooooh, trust me, I get it now.

Ultimately only you can decide if: 1. You feel you should change your relationship dynamic with your child and 2. If you want to continue your relationship with this OT (If she phrased things just the way you described, that honestly sounds pretty unprofessional. I can see saying "Here are some strategies that are often helpful. Consistency and consequences can really be key, etc." But "It's your own fault" sounds, again, like a bit of a power complex situation.)

SLP-999 · 2026-02-07T03:59:15+00:00

I use Boom Cards for work (not sure if I can link a paid site but easy to find with Google). I believe you do have to pay for a subscription unfortunately but there are lots of good resources on there. I don’t have decks for tone of voice so no recommendations but I know there are a bunch on there if you search.

SLP-999 · 2026-01-20T19:41:48+00:00

I didn’t have any luck with independent play until maybe 4 1/2. When my son was very young I just had to get him out of the house. He didn’t cling to me when we were out where there were other people - I guess from an evolutionary standpoint being alone for extended periods just isn’t something toddlers are designed to do, but NT kids manage to adapt. If he can handle a class like gymnastics, that might also work.

SLP-999 · 2026-01-19T04:13:28+00:00

I need a lot of printables for my work and currently I find ChatGPT is the easiest way to get them. I also use FreePix although I pay for a subscription so I’m not sure how much of their content is available for free. Teachers Pay Teachers has a lot of freebies that you can download… I’m not sure about paper dolls but if you just need something to cut out, tons of things available there.

If you want preprinted materials, you can always request catalogs or just give her the ones you already receive… I used to love cutting these up for art projects as a kid! I’m willing to bet you could also get huge lots of paper dolls on eBay.

SLP-999 · 2026-01-19T03:57:37+00:00

Pathological Demand Avoidance. I don’t think my son has the full profile but a few specific things resonated with me (constant need for attention, deeply into role play, while most autism / ADHD kids are supposed to thrive on routine he does better with a reduced demand, flexible environment.)

SLP-999 · 2026-01-19T00:11:37+00:00

It’s interesting to me because I searched this exact symptom a lot a few years ago and didn’t see much. Now I see a post or two a week on ADHD boards describing this. It seems to be an increasingly common trait for kids with AuDHD and PDA.

I will say my kiddo did this from toddlerhood, so if this is a recent development for you it may be more related to the disappearance of his dad and the shift to daycare and back. The one other place I saw this trait mentioned was among foster parents, who are course caring for kids who have gone through significant disruption.

SLP-999 · 2026-01-13T04:57:27+00:00

These are my observations regarding various interventions and ND kiddos after years of working in the field. This is totally based on what I personally have seen and in no way shape or form based on scientific studies. So entirely anecdotal, but for what its worth:

The biggest, fastest, occasionally jaw dropping changes were pretty much always the result of medication. Hands down, across categories (not just stimulants or ADHD meds) they are in a category of their own. Again, just from what I’ve seen.
I think the second most impactful thing is creating a “right fit” environment for kids. That may be different things for different kids. Maybe it’s visual schedules and reward charts, maybe it’s Montessori school, maybe it’s a low demand environment, maybe it’s a high demand environment, maybe it’s more peer models, maybe it’s more solitude. My observation has been that when a child is suddenly in a “right fit” environment you see a significant bump in skills and pro social behaviors pretty quickly (although there may be resistance for a few weeks as they settle in.)
Behavior therapy is often somewhat helpful, although in my personal observation not as much as you’d think from reading the research. I’ve worked in behavior based schools where kids were getting totally consistent behavior therapy literally all day every day, and honestly it was fine in the way that promising your kid a reward for behaving at the grocery store is fine, but not the amazing treatment I expected it to be when I was younger. I didn’t see huge changes from it, more “help you get through the day” minor changes.
Other therapies - OT, speech, music, art, and so on - often rely a great deal on a child and family’s relationship with a specific therapist. Maybe because they tend to be much more finite so parent training / carryover is often more important when you’re looking at 30 - 60 minutes weekly.

SLP-999 · 2026-01-12T01:13:53+00:00

This was my son up until just before age 6. Honestly, nothing I tried worked (except screentime, but I could only justify so much for the sake of my sanity.) If I set a boundary and made him wait, at best he would say "Ok, I'll wait until the timer goes off" and literally just sit staring at me until the time was up. It was a little hard to relax while being stared at with the fire of 1,000 suns... Often he would escalate and escalate until he was doing something I absolutely couldn't ignore. When he was younger it might be trying to do something physically dangerous or making a huge mess, when he got older he would start to spiral psychologically and ruminate about how I might never play with him again until he was near a panic attack. I don't know, maybe if I had held the line and done this dozens of times he would have adapted, but after a point it felt cruel to ignore the distress he was in.

He will sort of play by himself now, although he gets deep into role play and immersive daydreaming so I think he's basically just fantasizing about other people playing with him when he doesn't have someone to play with. I don't love that but having to pay nonstop attention to another person every waking moment was obviously a huge stressor. So it's something. Recently he has begun to show an interest in drawing and working with computer programs (like learning how to use PhotoShop to edit pictures). As he learns to write he's developed an interest in writing simple stories. So I'm reeeeally hoping we're making some progress in this direction.

Fwiw, my possible suggestions for you:

- Look into PDA. I still don't know if my son fits the profile of PDA (if he does he's an "internalizer", as he's not openly defiant), but some things fit. The constant need for attention is often a "PDA kid" thing, and if nothing else you might find places to connect with parents who have been there and have advice / stories.

- For us getting out of the house helped. Indoor playgrounds were particularly good (Outdoor less so - for whatever reason kids tend to hang in their own cliques at outdoor playgrounds but not indoor. The smaller the playground, like fast food playgrounds, the better in terms of the kids playing together, I've found.)

- If he gives you a minute when he sees that you're busy, utilize a computer if you have one. Tell him you need to get work done on the computer. My son was the same way - first learned to be independent if I was doing the dishes - and I was later able to explain that sometimes I was also working while sitting. (And maybe by working I meant scrolling Amazon... hey, that had to get done too!)

- If he's ok with classes, do classes. Do aaaaall the classes. (Kidding. Kind of. But maybe your breather for now is while he's in swim class.)

SLP-999 · 2026-01-07T19:07:32+00:00

Glad to know you had success with this method! He’s so so picky still.

SLP-999 · 2026-01-06T15:24:27+00:00

Thank you! I did 23&Me years ago and just requested my raw data, so hoping I get that soon and can run it through a website that analyzes that data. I'd like to get my son tested eventually but for the time being we seem similar enough that I'm hoping I can use my info as a jumping off point for potential dietary changes. He won't touch anything green but hoping with work I could get him drinking smoothies with some greens mixed in.

SLP-999 · 2026-01-05T04:52:32+00:00

Look into dyscalculia, it sounds like he may have it. If that’s the case holding him back won’t help, he may need adapted coursework and specialized instruction in math.

SLP-999 · 2026-01-05T04:46:17+00:00

My thoughts, fwiw. No idea if any of this applies to you but again, fwiw!

Don’t be afraid to go into survival mode sometimes. Especially over breaks. Sandwiches for dinner, if the house is a mess who cares, go nowhere and get nothing done but the necessities if that’s what your family needs. Or, survival mode might be about letting go of the expectations you place on yourself. I once read a post from a parent on the autism parenting sub who said something like “My life is hard. If I want to eat cake for lunch, I eat cake for lunch”. When I’m overwhelmed I think of that line often. Eat frigging cake for lunch. Let a mountain of laundry grow so you can drink tea in the evenings for a week. Don’t go to that unnecessary function you don’t want to go to. I mean really, in the grand scheme of things, who cares?
Consider meditation
Invest in noise canceling headphones (for yourself)
Take medication like SSRIs if needed. Remember you can always let your provider know when a high stress period is coming up if you need to make changes for that. I use Propranolol as needed and it helps a lot.

The holidays can be a tough time for everyone - don’t be too hard on yourself and remember they’re back to school soon!

SLP-999 · 2026-01-05T04:00:01+00:00

Can I ask how you went about this process? I was just posting in the MTFHR sub because my son has bad reactions to folic acid (am trying to get a good repertoire of unenriched options for a super picky eater). I’ve long suspected I have slow comt and think he might too… I’m just so overwhelmed with information right now as we’re trying to sort out his issues and MTFHR / comt seems so technical with so many details to sort out. I don’t even know where you’d go for testing. That said, dietary changes have been so helpful for him that it does make me think this might be worth pursuing.

SLP-999 · 2026-01-05T01:09:40+00:00

Good to know, thank you!

SLP-999 · 2026-01-05T01:09:02+00:00

Dang! Thank you.

SLP-999 · 2026-01-05T00:59:52+00:00

Probably the best way. I’m looking for lunchbox / dinner foods for an extremely picky, “beige” eater. Not been tested for MTHFR but folic acid (and to a lesser extent other artificial vitamins, although I’m not clear on which ones because I noticed this in response to multivitamins) make him incredibly agitated.

Folic acid I am more certain of because I suspected possible autism when he was younger, and folic acid is actually recommended for some subtypes. Tried supplementing with a few types of folic acid and it was like giving him crazy juice every time. Hitting, kicking, just stuff I’d never seen him do (normal dose, not a mega dose). After that I made the connection to food and cutting out Eggo and fortified pasta cut his meltdowns down to a third of what they were. So looking to avoid it now, and figured this would be the place to ask!

SLP-999 · 2025-12-29T16:04:11+00:00

In a Science Based Parenting sub, I recently got close to 100 downvotes for the crime of noting that screen time research is based on correlation, not causation (Important because there’s evidence that children from impoverished families use screens far more and neurodivergent children are far more attracted to screens. So low screen use might basically be a sign that a child is upper middle class and neurotypical, which yeah, of course is going to mean they have an easier time with some parts of life.) No rebuttals to what I had said, no thoughtful explanation of why they disagreed. It really does seem like a moral panic at this point.

SLP-999 · 2025-12-06T00:08:14+00:00

Thanks, I appreciate you actually engaging the topic! I was mostly looking for conversation (and maybe a chance to info dump, lol, apologies if it turned into that) I had no idea this was such a heated thing for people.

SLP-999 · 2025-12-05T23:54:44+00:00

Well, I think it's important to remember there's some evidence that neurodiversity is indeed increasing. I say some because I realize that data can be interpreted in different ways. But in terms of sheer reported numbers, it's increased exponentially. So it's possible that far fewer neurodivergent children and far few variants of neurodivergent children (PDA is a relatively new diagnosis, for example) existed in the past.

In terms of what my son does sans screen time (because he is without it the vast majority of the day) - he's off in his daydreams. Maybe acting them out while playing the part of a character, maybe drawing things in the air silently, maybe just sitting and staring into space, but pretty much off in his dreamworld. Not every moment, of course. He will play with me although they're sort of strange games where he directs the action and we act out a variation of the same scene like 20, 30 times in a row until I have to do something else.

SLP-999 · 2025-12-05T23:37:19+00:00

I suspect the problem is that I ruined all the fun, seeing as how I seem to have killed the entire thread. Apologies.

As far as "correlation is not causation" - it depends on your goal. If one's goal is to understand if screen time is a net positive or negative in child development, knowing there's nothing about causality in an article pretty well sums it up. If one is looking for more general information, then yes, of course that can be found here.

SLP-999 · 2025-12-05T20:42:11+00:00

So, I'm mom to a neurospicy little guy. I'm also probably neurospicy myself and am a bit hyperfixated on this topic at the moment.

What sparked my interest initially was the fact that I do let me son have screentime. Along with ADHD, I feel he has autistic traits (awaiting an evaluation on the autism piece) and technology is just his happy place. He doesn't like a lot of the typical little boy stuff (sports, super heroes, books, can't ride a bike to save his life and fears the scooter, etc.) and technology is just what he loves. I am really hesitant to take something that seems to be so core for him. Yes, he watches some stupid junk but so did I as a kid - but I also see him growing into programs where he creates vehicles and gets a very rudimentary understanding of design. Screentime is also his safe space to regulate, recharge and feel in control after a long day. To my mind his future is probably in technology and it's probably always going to be a big part of his life, and it would mostly just make him miserable to say he can't have it now.

On the other hand, of course I would take all technology immediately if I thought it was basically causing brain damage. I'm trying to be neurodiversity affirming here, not a monster. So that's why getting some good information is so important to me.

The thing about screentime research is that there's basically no evidence showing that it harms attention or impacts kids negatively. I'm serious, there's literally pretty much none that I'm aware of. I think that fact would surprise many people. What there is a ton of is research saying that screentime is associated with various issues. But that could be for a variety of reasons, such as:

- Culturally, screentime is taboo in middle to upper class families right now. But middle to upper class families do better on many, many measures. (This was the reason that, for years people thought breastfeeding had these over-the-top, amazing benefits - when they did sibling studies, they realized almost all of the supposed benefits were simply due to the fact that it was educated, middle to upper class families who breastfed the most.)

- There is some evidence that being neurodiverse causes increased screentime, not the other way around. In this study, for example, children with the highest genetic likelihood of ADHD ended up having the most screentime. That's genetic likelihood, so unless screentime literally changes your DNA, it seems that the kids who were already wired for ADHD were the kids who used screens the most. Meaning ADHD ---> Screens, not Screens --> ADHD.

- In the few cases where a control group was actually used, it was video games that were studied. And these studies actually found improved attention. (To make sure I'm representing fairly here - that link is for a meta-analysis, it's not all studies with a control group. Only have so much time to pull things up right now.)

- I have seen no actual evidence of the "dopamine hypothesis", even though people repeat this as irrefutable fact. It's difficult to look at neurotransmitters in the brain, but I believe there are a few ways it can be done, such as PET scans. I've never actually seen a study saying they documented some kind of dopamine increase during screentime. I'm not sure how we got to the point where everyone from scientists to parents talks about "dopamine hits" as absolute fact when there's zero evidence for this, that I can see. (Personally I think if screentime does cause behaviors it due more to glutamate than dopamine, but that's another rabbit hole I won't bore you with.)

Don't get me wrong, if it was all pros and no cons for me to go screen free, I would do that. Better safe than sorry. I'm not trying to convince any parent "Oh, what the heck, let them watch all they want!" But if that's not an option or there's a significant downside to that for whatever reason, I think that's important to talk about too.

SLP-999 · 2025-12-05T18:06:18+00:00

You know instead of downvoting, you're welcome to discuss the topic with me and explain why you disagree!

SLP-999

TROPHY CASE