Friday, April 9, 2010


I've been thinking a lot about this lately. Number one, I am pissed at my insurance company- I got a letter from them yesterday saying they were denying payment on any more Occupational Therapy (OT) for Frank. I've had to call them and harrass them every three months or so for the past two years to get them to approve twelve more visits for him, but never a denial letter like this before. I called them immediately and asked them what was going on; the guy I spoke with said it was possible the way the provider submitted the claim was written differently- a different diagnostic code, perhaps. I doubt it, but I called the OT place, as the insurance dude suggested, to ask them to call insurance's utilization managment line to get the appeal going on the denial.

The woman at OT who handles all this is on vacation until Monday. *sigh* So I had to cancel Frank's appointment for today. With my husband still being out of work, and my job tenuous, I'm not looking to spend $200 out of pocket and then going through the wringer of trying to get that money back from insurance.

One year from now, he'll be in kindergarten screening. Frank will be five the following September. Everyone around us is advising us to postpone kindergarten for him until the year he turns six. Frank is very bright, and learning a great deal in preschool; I fear that if he had to spend an extra year in pre-K, he'd be bored. Physically, he's tall for his age, and he's pretty good at most physical skills he should be good at. I just worry that the SPD will make kindergarten difficult for him. I spoke with my local Board of Education last summer about getting OT through them, and was told that he'd have to go to their preschool disabled class to be able to get any kind of service. Both my husband and I agreed that would not be the best placement for Frank, unless it was a class full of kids with SPD! He loves his school now, and has been going there since he was five months old. The staff is great, and very understanding and willing to work with his SPD "quirks".

I have to admit, though, one reason I'd like him to start kindergarten the year he turns five is so I can push for him to get OT in school and therefore not have to deal with arguing with insurance about it anymore!

Number two reason this has been on my mind a lot lately is because of Potty Training. It's been a miserable failure. He has all the physical abilities They say he should have to be ready for it, but, because of the SPD, he has an aversion to change, which means he will never be emotionally ready for it unless we tell him it's time, and even then, he's fighting us on it. Last weekend, we had him in underwear (that he helped pick out) most of the weekend, and he sat on the potty pretty well, but five minutes after he got off the potty, he wet himself. (Yes, clearly he actually has control over his bladder!) I feel bad for saying it, and it flies against what so many more experienced parents are telling me, but we are going to force him to potty train. (None of these more experienced parents have kids with SPD!) I expect it to be a painful process, and am not looking forward to it.

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