Brain Trust
| August 27, 2014Tuesday morning, the appointment book showed three back-to-back appointments for occupational therapy (OT) evaluations. Eight-year-old Pinchas, nine-year-old Meryl, and 12-year-old Shaindy arrived separately with their parents.
Pinchas, a sweet boy with a history of delayed milestones who’d received OT services from birth, used to enjoy reading. Now, he’d agree to a book only if it was read to him; when forced to read himself, it took ages.
Bright and imaginative, Meryl excelled in verbal expression. Academics had always come naturally to her, but she’d recently begun showing difficulty reading and writing. A three-page exam took her hours, teachers complained.
Shaindy had trouble reading both Hebrew and English. At age eight, a therapeutic movement program improved her reading for a while, but as she got older and intensive board-copying and complex reading assignments became standard, she started drowning.
All three presented with the identical problem — reading issues — and a lightweight evaluation by novice professionals might have yielded similar treatments. But for Friedy Guttmann Singer and Roizy Guttmann, veteran occupational therapists who believe in comprehensive, exhaustive testing, the commonality ended there.
“You have to look behind the symptoms, find the underlying issues,” Roizy says.
Together the sister-colleagues run Hands on OT Rehab Services, established in 1999 in the heart of Boro Park. With over 5,000 children evaluated, and hundreds more treated to date, the practice has earned a reputation for effecting lasting change in children with sensory, anxiety, social, or behavioral issues. Its magical approach? The fact that there is none.
A Career Grows in Brooklyn
These days, occupational therapy is hardly a unique career for frum women. But for Friedy and Roizy, the field is deeply personal.
“I had sensory integration issues as a child,” Friedy shares, though at the time, she couldn’t label them. “I did very well in school — top SAT scores, got accepted to an Ivy League university — but I felt intense anxiety about everything. Going to noisy stores, tags on clothing, riding in a car for long trips — they were torture. I learned to control and hide my anxiety, but the suffering was there.”
After high school, Friedy launched a promising — if unconventional — career as a Wall Street commodities trader. But as she immersed herself in the financial markets, something gnawed at the 20-year-old’s soul: a need to understand what she’d been through and help others get past it.
While retaining a part-time position in finance, Friedy applied to the OT program at SUNY Downstate Medical Center and plunged into her studies. There, she joined Roizy, who’d initially pursued an accounting degree but also changed course.
“Occupational therapy had always interested me, but my logical side said, ‘There are so many therapists out there — do we really need more?’ ” Roizy relates. “I was about to take my CPA exams when I decided to follow my heart instead, choosing a profession that helps people more directly.”
Upon graduation, the newbie therapists worked for the New York Board of Education and pediatric outpatient clinics. But as the years passed, they developed a simmering discontent.
“We were seeing a certain set of clients who were stuck in the system,” Friedy recounts. “No matter how long they’d been there, their issues were not ameliorated.”
Roizy and Friedy began asking questions: Where is the craving for sensory input coming from? Why do some children need the jumbo ball to get calm, or the down comforter to self-regulate? What’s missing in the brain physiology?
Both unmarried at the time, the two had the freedom and resources to pursue answers with extensive post-graduate study, attending numerous courses, and nearly every certification program in the field. But much of their learning came from experience.
“I was very naïve at first,” admits Roizy. “I would tell the agencies: ‘Send me all your handwriting kids.’ I knew the treatment protocol cold from school. But with experience, I discovered that poor handwriting is often one symptom of poor sensory integration. You can treat handwriting and see results, but if you don’t address the root of the issue, the sensory shadow lingers — for the rest of the child’s life.”
“We also began making connections between sensory, social, behavioral, and anxiety issues,” Friedy chimes in. “These aren’t isolated problems.” The child who’s uncomfortable in his rigid desk will act up. The child who sees recess as a sensory tidal wave will develop anxiety about it — and become unable to play or make friends.
Well-intentioned parents and teachers offer children coping tools, she adds, but these crutches are only effective short-term.
Take Tirtzah, a chronic thumb-sucker. To eliminate the behavior — repulsive to peers — her school implemented an intense reinforcement program. Tirtzah, who badly wanted the reward, indeed stopped sucking, but moved on to pulling her hair and touching parts of her body.
“Kids want to please, so they’ll stop Behavior X,” says Roizy. “But if you haven’t eliminated the need for the behavior, they’ll move on to Behavior Y. They’re still desperate for that sensory input.”
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