Jessica sought me out for 1:1 parent coaching to help her make sense of the discrepancy she was seeing between school and home— not an uncommon experience for parents of neurodivergent kids. Here’s what she said in her first email to me:
“My son Miko is in 1st grade, and we are really struggling, mostly after school. His teacher says he’s “a delight” and “so focused,” which honestly shocks me, because the second he gets in the car he falls apart. He screams if his little sister (she’s 3) talks to him, he kicks the back of my seat, and once we’re home he either melts down over something tiny (wrong snack, the TV being on the wrong show) or hides under the dining table with a blanket and won’t come out for an hour. Some days he says “I hate everything” or “my body is too loud.” I don’t know what that means but it breaks my heart.”
On her intake form, here are the main areas she wanted support with:
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After-school meltdowns: Miko holds it together all day at school, then falls apart in the car and at home.
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Getting dressed: Socks are a daily battle because the seams “bite.” He’ll only wear two pairs of sweatpants and refuses jeans, collars, and anything new. Mornings drag on and often end in yelling.
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Crashing and rough play: He jumps off furniture, body-slams his mom, wrestles his little sister too hard, and chews on collars and hoodie strings.
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Bedtime: Getting him to bed is a process, and even when he’s in bed, he never seems settled. The whole bedtime routine can take up to 2 hours or more.
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Whether to pursue OT: His pediatrician called him “just an active boy,” and her husband thought she was overthinking it, but Jessica wanted an outside perspective and guidance on what to ask for in an evaluation.
My initial thoughts:
As someone who also masked throughout the school day and now has a child who does the same, this is very relatable. We hear it all the time: “You’re their safe space,” “You should feel lucky that they feel safe enough to unravel around you.” Listen, Becca, idk if “lucky” is the right word here 😅 but I get what you mean.
The rest of Miko’s profile is giving mixed threshold vibes: sensitive to tactile input (through the clothing challenges, and perhaps whatever is going on in the classroom) and also maybe some under-responsiveness or seeking of proprioceptive input.
I needed to ask her more questions about the bedtime stuff because that particular behavior (struggling to fall asleep) can be extremely nuanced and complicated. Namely, I wanted to ask her what his after school and pre-bedtime routine looked like, because we might need to work backwards from there.
Coming up:
Over the next 3 emails, we’ll dive into:
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What we know about his sensory profile from his parents’ POV. We’ll take a look at the behaviors Jessica notices and use this to inform us about what his nervous system is trying to say. We’ll also talk about how to educate a skeptical parent who’s not totally on board.
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Miko’s daily socks and pants battles
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Miko’s after school meltdowns and if we can rewind during the school day to pinpoint some areas that might be adding to his dysregulation (even if going unnoticed by the teacher)
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His bedtime routine and if there are any areas that we can tweak or adjust to help him access a state of calm before bed.
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Whether or not OT seems to be a good fit for Miko
Disclaimer: These case studies are inspired by real-life clients I have worked with, with permission from their parents to share. Some aspects of the case are authentic, and other details are added to include more variability for our discussions. None of the strategies and advice here substitutes medical advice, diagnosis or intervention with an Occupational Therapist.
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