I did not notice it all at once. First it was quieter rides home. Then hiding behind the bookshelf at the clinic. Later, fewer jokes at dinner and long stares at the floor. Staff called it a calm day. I knew it was a shutdown.
“If I stay small, can we finish faster?”
The room was full of demands and timers. Tokens for quick answers. Fewer stims got praise. My child learned to fold into themselves to make the day easier for adults. That is not learning. That is a nervous system saying, this is too much.
We ended up here because a doctor printed a referral in minutes and insurance approved a big block in days. OT and Speech were offered later, capped, or waitlisted. The schedule followed what was easy to authorize, not what helped my child feel safe. **Covered does not mean appropriate.**
If your child starts withdrawing in sessions, treat it as real information. You are not imagining it. You are not overreacting. **Withdrawal is communication.**
What helped us turn things around
- Track the pattern. Log sleep, appetite, play, and willingness to go the day of and the day after therapy. Note hiding, whispering, or silence.
- Watch a session. Ask how the team responds when your child retreats. Space, comfort, and a pause should come before more demands. A clear no should be honored.
- Request Occupational Therapy in writing. Ask for a sensory plan: movement before work, big squeezes, push-pull jobs, and softer sound and light. Change the room, not your child.
- Ask for Speech Therapy that models language during play and honors AAC. No pressure to perform on cue. Waiting counts.
- If eating drops after sessions, seek feeding therapy that protects safety and moves in tiny steps. No “one more bite” battles.
- Start smaller. Shorter visits, predictable breaks, choice of activities, and one or two steady people. Consistency matters.
- Push insurance with functional needs. Write requests tied to real life: safer mealtimes, communication at home and school, regulation for mornings. Ask about out of network if only huge ABA blocks are offered.
Real-life signs we missed at first: hiding under tables when the timer beeped, skipping favorite snacks after “great” days, speaking less unless prompted. If your child suddenly avoids the building, asks for headphones, or stops initiating play, that is not progress. That is survival.
It can feel overwhelming to change course. You are not alone. Approval arrived fast for us, but it pulled us into care that drained our child. When we centered OT and Speech, with feeding support when needed, our home softened. Fewer hours. More comfort. Communication that showed up in our kitchen, not just at a clinic table.
Your child deserves help that builds safety, not silence. If sessions make them shrink, pause. Choose partners who listen to bodies, honor consent, and grow skills that live at home with you.
