OT

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I know I have asked questions about this before, but I am still confused about this.

My son has problems with using a proper grip. His handwriting can be good when the stars align, but he really prefers the shovel grip because his letters look better. He is very resistant to using a correct grip. He does not like the grips etc. He also has trouble with buttons, snaps, shoelaces all of that. They want to decrease OT because his handwriting is supposedly good(If it is good with a grip that will not work for longer writing samples, I am not sure why that counts-- and I really doubt that, anyway.)

I am inclined to keep the extra OT, but how do I know if this extra time is helping him or not. If it isn't than I would rather he be in class.

What should they be doing with him, and how do I determine what a reasonable amount of OT is?

I had tons of issues with handwriting as a kid. Did the exact same thing as yours with the whole shovel grip and horrible handwriting. Then I discovered the magic of a keyboard and computer . So I brought one of those to all of my classes. If that is something that seems like it would suit him, check out the AlphaSmart.

Sort of gave up practicing handwriting after that.

My son gets OT as well, and I totally see the idea of a keyboard helping with handwriting, but for my son and lots of kis who have poor fine motor, there is more involved. For instance, does he tire easily when doing fine motor tasks of all kinds? Such as cutting, brushing teeth, tying shoelaces, buttoning, snapping or zippering his clothing, etc...

It also involves stamina and coordination. I know for my sons OT they work on a ton of other htings then just handwriting. But if your sons ONLY issue is handwrtiting then maybe its worth looking into, just make sure that is the only thing they working on.

Not all services need to be pull-out. Could the OT work with him in the classroom during instruction time to support his handwriting? While keyboarding will eventually be a good solution for him, it isn't a realistic option in the early elementary years unless you are lucky enough to be in a school where everyone has an iPad!

To me, it's a tough call. First, I'm not sure when the school's obligation ends; they aren't obligated to fix everything, just that which interferes with education, so you might have a tough fight on your hands, and we always have to be findful of picking battles. Second, I really can't decide how much the OT accomplishes. We got an IEP specifically because my son needed help with writing, and 8 years later he still needs help with writing ... what was accomplished helping his motor skills was never particulary visible to me, even though I'm sure it was something. The year OT taught him to type was amazing, but that has to wait until the hand development is ready; you'll definitely want to get that service when the time comes. On the flip side are others who have felt OT accomplished a lot, and recently I've heard more about kids with hand issues that under improved OT techniques did learn to write well.

Basically, a lot of factors weigh into it, and remember that what you release now can be difficult to get back in the future. All the skills are moving targets so what is "graduated" from today may be needed again tomorrow.

What does your instinct tell you?

Thank you for all the responses. My instincts say to keep it where it is, but then again I do not know for sure. Part of it is that when I talk about my perceptions of his issues, they have started suggesting accommodations that I do not want or need; They have responded by wanting to reduce homework so I can concentrate on fine motor skill work and then send fine motor skill work home with him.

That does not sound good to me because I also need to work on sustained attention and I use the homework for that. I am not sure that subbing in fine motor skill work would help in the same way. The teacher is already flexible with homework for mood issues etc. anyway. We rarely use that flexibility at this time, because I do not want him to get into the habit of thinking homework is optional, because other teachers will not be so accommodating, KWIM. He gets used to things so easily.

The only reason I brought up homework in the first place was to illustrate issues he has with writing at home. They have also suggested keyboarding as an accommodation for homework, but that doesn't help him with writing, and given his lack of ability at keyboarding, it seems to introduce a new level of difficulty. He is only 7, and it seems early to give up on writing especially if they think it is so beautiful.

They are supposed to be working on handwriting and functional issues. like buttons and snaps, and shoelaces. They claim he can do buttons and snaps, and can tie shoes on a board but gets frustrated with shoelaces IRL. I have seen no evidence he can do any of this (not that we have a shoelace board, but I can make one from old shoes.) I will have to convince him to show me so I can see if he can do the buttons and snaps and such. I am going to trick him into showing me this weekend.

He does not brush he own teeth because of sensory issues. It does not have to do with fine motor skills. We do that. He uses a shovel grip with eating utensils, though he prefers finger foods, so has not had a lot of practice.

He has gotten better a little at willingness to use the pincer grip, but it is a struggle, and sometimes he just won't. When he does use it, I have to stand over him and constantly prompt. They consider willingness to not be an OT issues because he knows how to form the letters and can make them look good when he wants to, which is true. His fingers have gotten a little stronger. I do not know how much. Do they have tests for this? Endurance seems pretty bad, but it is hard to tell because he also complains of boredom etc. during his work.

I guess I wish there was an actual metric for finger strength and endurance so I could know if they are blowing smoke up my bottom or not. I wish there was some standard formula for what help he should get for what his deficits are, so I would know what is fair, I do not even know how to translate this to number of sessions or minutes per month.

I would be fine (would prefer) her to come into the class, but the whole point is they are trying to save money. I don't know that anyone else in the class needs OT or would benefit from that. That is why they pull him. He also gets a consult for sensory issues, too. They are not pulling that. They do want to halve his pull out time.

I was always told my son didnt like to color cause he has no interest in it, and granted he has no interest in it, but watching him color and write and do fine motor tasks, you will see there is more then lack of interest.

I do see improvements in my sons abilities due to OT. In fact, even with coloring he has learned how to color, at age 7...finally!! ! And he will quote the OT as he colors, all her reminders and tipe...lol. I wonder if it is just a bad match for your son. Is there any way to request a different OT just to see if antyhign improves???

What about a provate consult.

The OT evals were able to tell me that my son has weakness and low stamina, based on his posture, how quick he tires and goes for supports, etc...I got a lot of info and it sounds like for whatever reason your sons' OT isnt giving you much. Maybe look into a private eval to bring to the school??

Good luck, this sounds awfully frustrating for you and I bet for your DS. My son is 7 as well.

No doubt there is still a long road ahead, and every point you make is valid.

Somehow these experts come up with semi-measurable standards, but I can't say I've ever fully understood them. I don't remember that whole journey as ever feeling like solid ground; we were always going by instinct. I'm not sure I would want most of it any other way; each child is so different, and you are busy balancing in so many intangible things like patience, desire and stress level; you have to be able to adapt in the moment as needed.

I, too, turned down many offers of accomodations. You want your child to do all that he can, and just use the flexibility when you need to, because one thing we are teaching our kids is to try, to face challenges, to understand that life isn't ever a super smooth road, and if you want things you have to push for them. And then we watch carefully as they make those attempts, so that we know and adjust when necessary. A lot of trust is involved, that your child learns and understands that you wouldn't push if you didn't really believe it was something he was capable of, and that he probably IS capable of.

Seven is too young to successfully keyboard, so what we did back then was a combination of reducing written work and scribing. Our IEP gave us permission to use our judgement for these items, and I liked that. We got to see each day how things were going, what we could get done and how. Some days go better than others, and you want to push when the openings are there for it, but accommodate when your child needs you to for any reason. As a thoughtful and watchful parent, you want that decision making to be in your hands, I think, and for the school to trust you with it. If you have that agreement, maybe you could get both the regular homework AND a few extra writing exercises, and then decide each night what your priorities are going to be based on what you are seeing from your child.

Looking back, I feel really really good about how we handled things and how it all turned out for my son. He is doing so well in High School. The one possible reget is that he will probably never really handwrite legibly, and there are times he wishes he could. I don't know if he could have improved that with better techniques or not; there just isn't any way to go back, and his issues were always more severe than it sounds like your child's are. Flip side, however, is that we won the war, even if we had to concede a battle. I have a child that is very comfortable transferring his thoughts onto paper, even if only via keyboard, who has a spark for school and learning, who has a great relationship with his parents, and who has a decent overall outlook on the world, people, and his place in all of it.

Forgive the ignorance but what is an OT? Every time I see this topic I think it is OT = Off Topic.

Occuational Therapy...usually covers issues dealing with fine motor and sensory.

If his hand strength is an issue, you could try piano/keyboard lessons. Very good for strengthening hands and improving coordination.

Not to belabor the point too much but when I suggested that she work with him in the class I meant that would count as the time she is assigned to work with him (if I understood you correctly they wanted to reduce the OT time not take it away completely?). It should still be his individual time, she shouldn't be working with any other students. DS's OT at school actually suggested working with him this way, using her assigned OT time with him to support him in the classroom. I was thinking you could get the best of both worlds that way because he gets the OT time AND he doesn't miss as much instruction time. Of course the school and the OT have to be willing to operate this way and they may not be.

On a separate note, have you tried giving him only short pencils to write with? Short enough so that he is forced to hold it in something like a pincer grip. Its not exactly the same as a real pincer grip with a regular sized pencil but it is a closer approximation than the shovel grip.

Does he play with Legos or other small toys at home? DS was always just to the "no services" side of motor skills and proprioperception - they would say there is a deficit there, just not enough of one to warrant therapy (even private therapy.) I did notice that his fine motor skills improved drastically when he was doing something he liked (like Legos)

Keep in mind that at 7, Legos were totally frustrating for him and we used the preschooler-style Mega Blocks instead. However, I at least felt like we were exercising those skills, if not in writing.

Thanks, again for the responses.

We did get him to finally use Legos over the summer, without bursting into total frustration mode. (We found special interesty ones) I need to get him to use them again. During the school year, he really does default to the computer because it is calming. Maybe on the weekends I can get him to do it. During the week it is difficult to integrate frustrating things if you know what I mean. The keyboard is a good idea, too.

Bombaloo, I don't even know if his OT is individual. It did not even occur to me that it would be. They do not do a good job of communicating things and I probably make assumptions. It makes sense, though. I will have to talk with her and the teacher about your suggestion. (I want to make sure it would be supporting the teacher and not a disruption.

The little pencils are "different" as are the triangle ones. He wants the ones he is used to.

He does not like working on things that are hard. He does work with the OT because he is captive with no other fun things to do around him, so he does what he needs to in there. At home, he has so many things he would rather do. So, I don't think it will be so easy to substitute home fine motor work for OT fine motor work. I guess I can see where they could argue that that is not their problem.

So, I guess what their argument boils down to (reading between the lines--which I am not so good at) is that he knows how to form the letters, so he does not need so much instruction as just practice and for just practice he does not need as much OT.

Sorry but what is a "shovel grip?"

My understanding of this anyway is when a person holds the pencil the way you would a small shovel or spade like if you were digging a hole to plant a flower. Not a great way to hold a pencil but it is what a lot of kids who have motor planning/coordination issues resort to.