UPDATED Dysgraphia, or what-looks-like-dysgraphia, woes

[Tiramisu]

Working on writing is one of my major goals this year. However, dd is now in vision therapy and I don't expect much until that's taken care of. 

 

I went back and compared writing samples from the end of first grade through third (this year), and I don't see a lot of progress in terms of handwriting or content. It was actually very depressing realizing that. She's had consistent writing instruction all during that time. She's done WWE1 to halfway through WWE3, along with other interest-led story writing, copywork, basic paragraph writing, and regular letters to friends. Her writing is just the most simplistic sentences in sometimes illegible handwriting. In sorting through old work I also found writing samples from my older children from that age, including one who had writing difficulties and needed VT. And this dd's writing is so much less developed. And until the problems hit this winter, we always maintained a very regular daily work schedule with writing every day.

 

 After VT is done I'm going to get another OT to evaluate for dysgraphia again. The thing is that dd's hand movements are not what they should be, in my opinion. They just seem so awkward when she writes even though the OT said her grip isn't bad. 

 

I have a neuro-developmental pediatrician appointment scheduled for the fall, though dh expressed concern about overloading her when I talked to him about it.

 

Typing is on the schedule when we start back into school in September.

 

I have a niece who is a ps school teacher in an affluent district. Her boyfriend is a very bright attorney. After spending time with dd, they always have positive comments on how well she expresses herself and what she talks about. She just finished reading the Hobbit. So she can read and speak well, but her writing isn't comparable at all.

 

Dd tells me it's not her vision, she just doesn't like writing. Dh, on the other hand, who is doing VT with her, has really noticed her eye control and speed are really off when she does the exercises. I don't know if he bought into VT in the beginning or just trusted me, but from doing the therapy with her he's convinced there's an issue.

 

You know, I've been through these types of things before, so I shouldn't feel so frustrated and trust that things will work out, but I'm feeling kind of down right now.

[Lecka]

Focus on the positive!  There is a lot of positive there!  

 

You are addressing the VT, you are looking back into OT.  You are adding typing.  You have consistently worked on writing, so there IS exposure there, and sometimes I think that we have to believe that there is a lot of exposure percolating around and in the future it may be expressed.  

 

It does sound really frustrating, too.  It is not really "oh, there is no problem here."  

 

But it is a problem that is limited in scope in a lot of ways, and it is a problem you are addressing.  

 

She sounds like she is a charming kid. 

 

I read The Hobbit to my son last year (while he was in 4th) and he was not close to reading it himself, and he also needed some help in understanding some parts of the plot and some of the descriptions.  And he is a good reader in public school!

 

Now I am having to get my act together (he was just officially diagnosed, privately, with dysgraphia a few months ago, and he does not have an IEP yet, but I am working on it for when school starts again)....... but the thing that you might see if she was in public school:  the good really does outweigh the bad for this kind of thing.  You are not seeing her strengths as much as her weaknesses, but if she was in public school, you might see that she is at the top of her class in reading and in expressing herself.  I am fortunate my son has had nice teachers who have not aggravated his handwriting and who have given him informal accommodations so far.... but the truth is, they see him as somebody who learns well, and who participates well when it is oral.  That counts for a lot.  His written work -- it is not that it doesn't matter, but it is his weakness, but it is only one part of him, and it is not the most important part.  

 

 

 

 

[merry gardens]

(((Hugs)))

 

Even if her eyes and vision were 100% perfect, she still might not enjoy writing.Take heart in the fact that she expresses herself well verbally. It's a good start.

 

This summer, we're taking it easier but still working on things like writing. My husband just told me yesterday he never had to do the kind of writing I'm asking of our children when he was in school-- including at college. He's an engineer, and his job now involves lots of technical writing. He may not "enjoy" writing and he didn't seem get particularly good writing instruction, but now other things motivate him to write. Somewhere in heaven I suspect one of his old English teacher must be laughing with joy.

[wapiti]

FWIW, in the big picture, there are cases where the same nervous system issues that can cause certain types of developmental vision issues (say, tracking) can also cause handwriting difficulty.  In other words, ocular motor issues are a subset of sensory processing issues.

 

I would definitely shoot for typing ASAP.  Though some dysgraphics may have difficulty with that too, it might also help a whole lot.

 

(It also just so happens that dysgraphia is a symptom of PANS)

 

You might consider seeing a neuropsych rather than a neuro-developmental pediatrician.  I'm not terribly familiar with the bailiwick of a neuro-developmental ped outside of spectrum stuff, but I'm guessing your thinking is along the lines of 2e possibilities, in which case I imagine you'd want IQ testing as part of the package of delineating possible LDs.

[Tiramisu]

FWIW, in the big picture, there are cases where the same nervous system issues that can cause certain types of developmental vision issues (say, tracking) can also cause handwriting difficulty.  In other words, ocular motor issues are a subset of sensory processing issues.

 

I would definitely shoot for typing ASAP.  Though some dysgraphics may have difficulty with that too, it might also help a whole lot.

 

(It also just so happens that dysgraphia is a symptom of pans, though in our house, the pans kid has not had any noticeable change there; the sensory/handwriting issues pre-date the other pans symptoms.  Unless, of course, I go back much further in time, which makes its own sort of sense...)

 

You might consider seeing a neuropsych rather than a neuro-developmental pediatrician.  I'm not terribly familiar with the bailiwick of a neuro-developmental ped outside of spectrum stuff, but I'm guessing your thinking is along the lines of 2e possibilities, in which case I imagine you'd want IQ testing as part of the package of delineating possible LDs.

 

Sensory processing disorder is THE STORY OF MY LIFE. It precedes the pans possibility. All of my kids have sensory issues, and they come from me! With dd it affects sleeping, eating, bathing, dressing, all of of life's necessary activities. But I had no idea of the association with ocular motor dysfunction and sensory stuff. Wow!

 

The neuro-developmental pediatrician would be covered by our insurance. I'm afraid of investing in an np eval right now because I could see dd going in there and completely shutting down. And there goes thousands of dollars down the drain. I may walk out of the appointment with the neuro-developmental doctor second-guessing everything she says but at least it would only be a $30 co-pay wasted. I'm just really going to rule out ASD. The psychiatrist highly suspects it. I doubted it at first. But then the therapist is encouraging us to go. The more I learn, the more of a possibility I think it is, for dd and for me. Of course, it goes back to the same thing--does it interfere with activities enough to warrant a dx?

 

I had a cute conversation with my mom about rigidity tonight. Oldest dd brought it up, and then I talked about my own rigidity and what causes me to shut down. My mom said, "Oh, that's why you always acted that way in certain situations! I never realized that!" It only took about 45 years for us to figure this out. And my mom's a therapist!

 

[Tiramisu]

Focus on the positive!  There is a lot of positive there!  

 

You are addressing the VT, you are looking back into OT.  You are adding typing.  You have consistently worked on writing, so there IS exposure there, and sometimes I think that we have to believe that there is a lot of exposure percolating around and in the future it may be expressed.  

 

It does sound really frustrating, too.  It is not really "oh, there is no problem here."  

 

But it is a problem that is limited in scope in a lot of ways, and it is a problem you are addressing.  

 

She sounds like she is a charming kid. 

 

I read The Hobbit to my son last year (while he was in 4th) and he was not close to reading it himself, and he also needed some help in understanding some parts of the plot and some of the descriptions.  And he is a good reader in public school!

 

Now I am having to get my act together (he was just officially diagnosed, privately, with dysgraphia a few months ago, and he does not have an IEP yet, but I am working on it for when school starts again)....... but the thing that you might see if she was in public school:  the good really does outweigh the bad for this kind of thing.  You are not seeing her strengths as much as her weaknesses, but if she was in public school, you might see that she is at the top of her class in reading and in expressing herself.  I am fortunate my son has had nice teachers who have not aggravated his handwriting and who have given him informal accommodations so far.... but the truth is, they see him as somebody who learns well, and who participates well when it is oral.  That counts for a lot.  His written work -- it is not that it doesn't matter, but it is his weakness, but it is only one part of him, and it is not the most important part.  

 

You sound just like dh. :)

 

He says he sees lots of positives now. She's doing VT, so we shouldn't get into anything else right now and give her a chance to let her enjoy those positive things and let them develop.

 

She started out reading the Hobbit as part of her VT. We needed a book with very small print for her to work with, and dh suggested that. And it took off. He would also read to her from it at night so it was a collaborative effort.

 

I think you are right in my seeing the weaknesses. I think it comes from anxiety, thinking that "the authorities" will find out she can't write well and blame it on homeschooling, or rather my homeschooling. I think if I had a dx of some kind perhaps I would relax a little. Even mom, usually the family cheerleader, looked at her writing and made negative comments about the content. :(

 

I have had a couple of issues at coop due to her being talkative during class and inappropriate (talking about poops and farts) but I've also had positive feedback about her knowledge.

[Tiramisu]

Focus on the positive!  There is a lot of positive there!  

 

You are addressing the VT, you are looking back into OT.  You are adding typing.  You have consistently worked on writing, so there IS exposure there, and sometimes I think that we have to believe that there is a lot of exposure percolating around and in the future it may be expressed.  

 

It does sound really frustrating, too.  It is not really "oh, there is no problem here."  

 

But it is a problem that is limited in scope in a lot of ways, and it is a problem you are addressing.  

 

She sounds like she is a charming kid. 

 

I read The Hobbit to my son last year (while he was in 4th) and he was not close to reading it himself, and he also needed some help in understanding some parts of the plot and some of the descriptions.  And he is a good reader in public school!

 

Now I am having to get my act together (he was just officially diagnosed, privately, with dysgraphia a few months ago, and he does not have an IEP yet, but I am working on it for when school starts again)....... but the thing that you might see if she was in public school:  the good really does outweigh the bad for this kind of thing.  You are not seeing her strengths as much as her weaknesses, but if she was in public school, you might see that she is at the top of her class in reading and in expressing herself.  I am fortunate my son has had nice teachers who have not aggravated his handwriting and who have given him informal accommodations so far.... but the truth is, they see him as somebody who learns well, and who participates well when it is oral.  That counts for a lot.  His written work -- it is not that it doesn't matter, but it is his weakness, but it is only one part of him, and it is not the most important part.  

 

What kind of specialist dx'd the dysgraphia?

[prairiewindmomma]

Fwiw, it's our OT who specializes in sensory stuff who is making the most progress with ds in handwriting. VT helped with reading fluently, but OT is helping with handwriting. Essentially, OT concludes that ds is so focused on maintaining basic physical functioning that he has little brainpower for academics. He is wildly 2E and I see some truth in that. She is focusing on ATNR right now.

[PeterPan]

Dd, who didn't get a dysgraphia label (when I asked specifically this time, because I really wondered) used to say the same thing when she was your dd's age.  I think in her case she has just enough of everything to be problematic and not enough to get a label. Typing for her made a BIG difference.  Around 7th grade she went from saying she hated writing to writing for monthly contests, go figure.

 

I suggest you stick to shorter amounts for her own hand, do dictation, work on typing, get the fresh eval, do metronome work and working memory work, and give it time.  Don't freak out today about what might improve tomorrow.  And it won't be tomorrow, but it might be in 4 or 5 years it will.  If she can compose with dictation (Siri, whatever), you at least have that.

[geodob]

Perhaps you could do a simple motor control test from gross to fine, with her?

Which begins writing large letters on board, 'from the shoulder'.  With an extended arm.

 

Then writing letters about 2 inches high on paper, with the elbow resting on the desk but not the hand.

Where the letters are formed from movement of the elbow.

 

Next, keeping the elbow still, and the hand held above the paper.

Form the letters with movement from the wrist.

 

Then with the hand resting on the paper, form letters about an inch high.

 

Finally, to small letters where the hand stays still on the paper and letters are formed by movement of the fingertips.

 

So that basically this tests motor control, from the shoulder down to the fingertips.

[displace]

Fwiw, our developmental Peds dx dysgraphia, not the Neuropsych or Ed psych. He basically read the OT Evals and saw DS write and said Dysgraphia/dyspraxia. IME MDs are much less reluctant to diagnose. For us the psychs were wishy-washy but I realize not all psychs are like that.

 

Maybe you can look into Dianne craft's course? It takes about 15 per day. It's a lot of crossing the midline and OT type exercises.

[Heathermomster]

I just want to encourage you.  FairP posted a webinar by Dr. Charles Haynes about the subroutines of writing, and the very first subroutine of sentence composing is handwriting.  You know that your child has dysgraphia associated with the sensory issues.  Otherwise, your DD speaks well and has plenty to say. The work around for handwriting is to scaffold and scribe for her.  Don't be burdened emotionally by what she cannot physically or developmentally do now because all that will change with supports, time, and explicit instruction.  Start looking at text to speech and typing software.  She may require a more explicit writing program.  Also, try not to compare your kids and don't be down on yourself.  The last 6 months have been overwhelming for you and your family.  PTL that your DH sees the need for VT and is helping you work with her.  I'm thrilled that you discovered that she required the VT.  You are heading in the right direction. :001_smile:

 

 

[MerryAtHope]

Third grade is still so young, I wouldn't be overly concerned. She's still a baby writer. You are addressing her needs through VT (and that will make a difference in her frustration level with writing), and then you can look at dysgraphia this year. You are taking good, proactive steps. She'll make progress over time. Let her do some writing orally where she talks and you scribe, and then let her copy it into her own handwriting (gradually, over a few days, if it's something more than a few sentences). Let her build up stamina gradually by separating the process from having to generate thoughts and think about spelling, grammar, punctuation, capitalization etc... all at once. If spelling or other skills are a struggle for her, work on those separately as well. Many kids really aren't ready to put all of these skills together until about junior high. She has lots of years to work on this, so don't get discouraged.

[Tiramisu]

Third grade is still so young, I wouldn't be overly concerned. She's still a baby writer. You are addressing her needs through VT (and that will make a difference in her frustration level with writing), and then you can look at dysgraphia this year. You are taking good, proactive steps. She'll make progress over time. Let her do some writing orally where she talks and you scribe, and then let her copy it into her own handwriting (gradually, over a few days, if it's something more than a few sentences). Let her build up stamina gradually by separating the process from having to generate thoughts and think about spelling, grammar, punctuation, capitalization etc... all at once. If spelling or other skills are a struggle for her, work on those separately as well. Many kids really aren't ready to put all of these skills together until about junior high. She has lots of years to work on this, so don't get discouraged.

 

I think a big part of my difficulty with being patient is knowing how much kids are writing in ps at her age. I still have this little voice in the back of my head telling me that maybe if she were in ps she'd have to push through her problems and be writing like everyone else.

 

I can't have her scribe to me like I did with dd#2 because she won't work with me. She wants to be independent or work with dh. I think I'm going to have to have her use a voice-to-text software instead. 

[LaughingCat]

Regarding scribing --  I had DD speak her writing into an Ipad app and then scribe from that (self-dictation so to speak).

And I agree that separating the process of writing from the process of composing can be key.  So if that doesn't work, then I would look for other ways to keep the two separate

 

Plus just have to add -- that little voice is just wrong, wrong, wrong -- being in public school does not force a kid to 'push through their problems'.

[Love_to_Read]

I pulled mine out of public school around that age because of how poorly they were handling dysgraphia, honestly.  Her school OTs were mostly wonderful, but her last classroom teacher fought me on whether or not she could be allowed to type those longer writing pieces that you're talking about.  And you know what I found out about them from dd?  The first several multi-paragraph essays were "written together as a class."  IOW, they hand-copied what the teacher put on the board, entire paragraphs at a time. Her IEP consisted primarily of accomodations...such as shortening what she was required to write, or allowing certain things to be scribed such as essay questions on tests...but because of the 2E issues of appearing "smart enough to do this" and general ignorance or inconvenience, it was rare for her classroom teacher to follow through on implementing those accomodations.  Because of the general one-size-fits-all nature of school, other than the OT sessions (which often caused her to miss other subjects), little was done to change the actual instruction to target her weaknesses better.

 

So, homeschooling....give her some assistive technology if she won't let you scribe.  I haven't had much luck with accuracy on the Windows 7 speech-to-text, but you can find it for free under Ease of Access. For a better top-of-the-line option, Dragon Naturally Speaking is worth the cost...they recommend the premium version for dysgraphia students, and if you sign up for the newsletter or call customer service to inquire about details, you can get a coupon for about half off. And someone mentioned Siri as another option, if you have a device with that.

 

Back at your dd's age, when everything was handwritten, her written expression was very fragmented and poor like you're describing.  As the school diagnostician explained, she was putting forth so much effort into physically forming the letters and trying to remember what they looked like visually and trying to spell...(all of her fine motor, VT-related, and phonological issues at once)...it was crowding out her train of thought as to the ideas that needed to get onto the paper.  You KNOW that your child can think and express herself orally in ways more complex than you're seeing in her writing.  Once you can get her comfortable with a reasonably accurate speech-to-text program, and hopefully comfortable typing, you'll start seeing her writing quality become more like her oral voice, especially if you've already gotten her in the habit of speaking in complete sentences for narrating with WWE. (No one speaks in complete sentences all the time, lol, but being able to do so when in academic mode without feeling too stifled...that's the key.)  Don't forget that you can also enlarge her typed work to any size font if that helps visually.

 

Looking ahead, dd got an excellent score on her standardized testing in this area this year (Language Expression).  We've been doing the Outlining books from Remedia this year that Susan recommends for the logic stage in TWM.  We also did a lot of sentence combining with Daily Grams a couple years ago, and that helped her expression quite a bit as well. (In retrospect, I might have chosen Easy Grammar lessons instead of Daily Grams, but anyhow...the grammar from that author seemed to help.)  We're looking at whether to use Bravewriter materials next, or Writing With Skill.

So, all that is further down the road than where you're at with a third grader, but just giving you a glimpse of the future...your child is not doomed by 3rd grade.  Once it's all on the screen typed, you can work on the higher order skills of revision...elaborating on details, rearranging to find the best order, evaluating whether details are relevant, etc.  That kind of real, individualized work on writing skills is a lot better than what she'd get in ps in most districts, and forms the heart of quality writing so much more than the lower order skills of handwriting and proofreading.  There are actually a number of dyslexic authors on the market, most of whom found their own way long after graduating, or with the help of just one supportive teacher after years of school failure.  (Your child's dysgraphia might arise from physical sensory-processing issues, perhaps related to ASD, rather than from the phonological issues of dyslexia, but just saying...those authors probably qualify as dysgraphic as well, and probably wrote similar quality work as your dd in 3rd grade.)

 

Listen to some of the podcasts over at Bravewriter for encouragement regarding reluctant/poor writers going through the stages of writing development, and maybe check out www.dys-add.com for more about using accomodations that help a student express himself in writing.  That one is more about dyslexia, but since dyslexia affects spelling so severely, much of the best advice on dysgraphia comes from sources on dyslexia.

[Love_to_Read]

I agree that further testing is a good idea. There are lots of causes for dysgraphia, and having documentation can really help both you and the authorities recognize that this isn't your fault, presuming of course that you can find a doctor who doesn't automatically assume that you haven't tried.  Bring along a list of what all you've done, such as working through WWE1-WWE3, handwriting programs you've used, etc., being sure to mention how long, how frequently, etc.

[Tiramisu]

I agree that further testing is a good idea. There are lots of causes for dysgraphia, and having documentation can really help both you and the authorities recognize that this isn't your fault, presuming of course that you can find a doctor who doesn't automatically assume that you haven't tried.  Bring along a list of what all you've done, such as working through WWE1-WWE3, handwriting programs you've used, etc., being sure to mention how long, how frequently, etc.

 

Thank you for everything you've shared.

[Tiramisu]

I just went through this year's OT report. Dd tested at a six year old level in visual-motor integration in this year's testing. She's nine. The OT noted that she didn't think she was trying her best.

 

Somehow seeing this again made me feel better since I know I'm not imagining it.

[Love_to_Read]

It could be that she had an attitude that day, but one thing I learned working with struggling students is that an attitude often indicates an area of weakness.  It's HARD to do something you aren't good at. It's hard to fail, it's embarrassing, it's discouraging, it's fatiguing, etc.  Kids put up an attitude as a self-defense mechanism designed to hide/avoid their weaknesses.

 

Occassionally, they also put up an attitude due to what they perceive as unfairness...such as being pulled out of class to be tested, if they were embarrassed or looking forward to some classroom activity they'll now be missing during the testing.  But, a three-year delay in skills sounds pretty significant, even for a kid who is resentful of being there.

 

You're not imagining it. (((hugs)))

[Tiramisu]

OT eval tomorrow! I called the highly recommended place that doesn't seem to take insurance. I explained the situation and asked for a therapist who really understands sensory issues and dysgraphia, and they called me back an hour later offering appointment times. The price isn't terrible and worth it at this point. My mom, the therapist, offered to help if we decide to continue with therapy there.

[displace]

GL! A great Eval made it possible for us to have the diagnoses we needed.

[PeterPan]

So how did your OT eval go?  :)

[Tiramisu]

So how did your OT eval go?  

 

I don't know. Thanks for asking.

 

 

 

 

 

 

 

 

 

LOL.

 

Dd started to shut down in the car going to the eval. Dh and the kind OT were pulling her out of it--the shut down not the car. She didn't want me to go in with her so I had to wait in the waiting room. I didn't want to make an issue of it and mess it up, so I just dealt with it even though it was very hard. At one point, dh told dd that he felt bad for mom waiting alone and he asked if she would be okay if he went to get me. She didn't want that so he came out and gave me an update. 

 

Coming back to add more: Dd was actually very cooperative and tried very hard during the eval. I know the OT mentioned that she has no automaticity in her writing and that she needs to work on that more. I was afraid she would attribute that to hsing, but dh spoke up right away to make sure she knew dd writes every day. She also mentioned that the grip wasn't bad but the movement in her hand to write is coming from her wrist. The funny thing about that is I remember that my other dd who had sensory and writing issues has/had the same problem.

 

During the eval there was a lot of positive feedback about dd and how she was doing. "Perfect!" "Perfect!" So it was hard for me to get a sense of what was wrong. But there was something, I'm sure, because the OT told dh she may need dd to come back for further testing. I think she got through everything she planned to test and was running a bit late for her next client because of it. My suspicion is that something came up that she needs to re-check or do further tests to clarify, but she might need to go through the scoring of the tests first. We couldn't talk after the eval because of the time so I'm just waiting now.

 

One thing that was weird that dh mentioned during the vestibular testing. They spinned dd clockwise and conter-clockwise and watched her eye movements afterward. The duration of the eye movements was not the same on both sides. I tried to google and get information on what this could mean. I wonder if Geodob knows what that means. I hope he sees this.

 

One more weird thing: After we left the office, dd asked me if she would have to go back because she heard the OT mention that to dh. I don't know how she would have expected me to know that because I wasn't in there and she saw that the OT only had time to say good-bye to me.

[PeterPan]

It's normal to need several sessions, so I wouldn't read too much into it.  If your dd was willing to work for her, that's a good sign.  That she's talking to you is good, whether she's looking for answers or a way out or whatever.  

 

OT isn't adding more to your grief, in the sense that you already know things are going on and that SPD, retained reflexes, gross and fine motor, etc. will be part of that.  It's more about problem-solving and moving forward.  OT has been putting my ds in a better place, so hopefully it will your dd too.   :grouphug: 

[Love_to_Read]

It cracks me up the way kids always expect mom to have all the answers, even when you weren't there!

[Heathermomster]

It cracks me up the way kids always expect mom to have all the answers, even when you weren't there!

especially when they don't believe you 99.1% of the time.

 

I recall looking at DH last year and asking him at what time did our children learn more than me...

[Guest2]

I think the O.T. was looking at her nystagmus response.  I can't remember much about it or what is does, but it is an eye movement that S.I. O.T's will check after vestibular movement.  HTH.

[Tiramisu]

I think the O.T. was looking at her nystagmus response.  I can't remember much about it or what is does, but it is an eye movement that S.I. O.T's will check after vestibular movement.  HTH.

 

Thank you. :)

 

Yes, that's it. Hers wasn't normal, I think. Either normal when clockwise and prolonged on counter-clockwise. Or, short on clockwise and normal on counter-clockwise. I just know the counter-clockwise was longer.

 

I looked at signs of vestibular issues and they describe her to a T. And it seems, in the OT world, if the vestibular system is disordered, the integration of the other sensory systems will be affected. And you can have ocular motor and handwriting issues and anxiety!  It certainly would explain a lot. It would be so nice to have an explanation that fits so well with my reality.

[geodob]

Tiramisu, that 'spinning test', is actually a VOR Vestibulo-Ocular Reflex test.

Which tests the vestibular connection with the eyes.

Though each eye, uses the vestibular system in its own ear.

So that the prolonged or short VOR with one eye, indicates a vestibular problem with that eye's ear.

 

Where it would be interesting to know which eye it is, and if it is on the same side as her 'writing hand'?

Their is a simple test to determine a vestibular problem on one side?

It just involves having her stand up straight, and then closing her eyes and keeping them closed.

Where typically people will fall to side with the vestibular problem, as they have a sense of balance on the other side.

 

Though the vestibular system is made up of various 'mechanisms'.

For example,  look at any word on the screen, then:

1: Keeping your eyes focussed on the word, turn your head left to right, back and forth a few times.

2: Keeping focussed on the word, tilt your head left and right a few times.

3: Keeping focussed on the word, tilt your head up and down a few times.

 

When you did those movements, each of them used a different vestibular mechanism, to detect the movement.

How it works, is perhaps you could imagine some U shaped tubes, with some fluid in the bottom.

Then in the bottom of the tubes, are some 'hairs' sticking up.

So that if you tilt the U tube either way, the fluid will flow to one side, and bend the hairs that way at it flows.

 

It is those 'hairs' that the brain recieves signals from, to keep us balanced.

With VOR 'spinning test', perhaps you can imagine how it forces a lot of fluid to one side of the U.

Then when we stop spinning, it takes time to flow back to a balanced level.

Where we feel dizzy as it flows back.

As we are getting wrong signals about where up and down precisely are.

This creates confusion for eyes, as the fluid flows back?

Which causes a 'fluttering movement of the eyes'/ vestibulo-ocular response.

Where the eyes don't just stay still and wait for the fluid to settle down?

This 'eye fluttering', is actually a rapid checking process, as the eyes look back and forth until the fluid has settled down again.

 

But with the difference in duration with both sides, that you mentioned?

This indicates that both eyes aren't working in sync, as they move.

 

Though their is a basic exercise that can help with this?

What it involves is simply focussing the eyes on something.

Then keeping focussed on it, rotating the head in circular movement.

[Tiramisu]

Tiramisu, that 'spinning test', is actually a VOR Vestibulo-Ocular Reflex test.

Which tests the vestibular connection with the eyes.

Though each eye, uses the vestibular system in its own ear.

So that the prolonged or short VOR with one eye, indicates a vestibular problem with that eye's ear.

 

Where it would be interesting to know which eye it is, and if it is on the same side as her 'writing hand'?

Their is a simple test to determine a vestibular problem on one side?

It just involves having her stand up straight, and then closing her eyes and keeping them closed.

Where typically people will fall to side with the vestibular problem, as they have a sense of balance on the other side.

 

Though the vestibular system is made up of various 'mechanisms'.

For example,  look at any word on the screen, then:

1: Keeping your eyes focussed on the word, turn your head left to right, back and forth a few times.

2: Keeping focussed on the word, tilt your head left and right a few times.

3: Keeping focussed on the word, tilt your head up and down a few times.

 

When you did those movements, each of them used a different vestibular mechanism, to detect the movement.

How it works, is perhaps you could imagine some U shaped tubes, with some fluid in the bottom.

Then in the bottom of the tubes, are some 'hairs' sticking up.

So that if you tilt the U tube either way, the fluid will flow to one side, and bend the hairs that way at it flows.

 

It is those 'hairs' that the brain recieves signals from, to keep us balanced.

With VOR 'spinning test', perhaps you can imagine how it forces a lot of fluid to one side of the U.

Then when we stop spinning, it takes time to flow back to a balanced level.

Where we feel dizzy as it flows back.

As we are getting wrong signals about where up and down precisely are.

This creates confusion for eyes, as the fluid flows back?

Which causes a 'fluttering movement of the eyes'/ vestibulo-ocular response.

Where the eyes don't just stay still and wait for the fluid to settle down?

This 'eye fluttering', is actually a rapid checking process, as the eyes look back and forth until the fluid has settled down again.

 

But with the difference in duration with both sides, that you mentioned?

This indicates that both eyes aren't working in sync, as they move.

 

Though their is a basic exercise that can help with this?

What it involves is simply focussing the eyes on something.

Then keeping focussed on it, rotating the head in circular movement.

 

This is great. I am so thankful that Geodob visits here and answers our questions. I always get so much out of his explanations. 

 

I had to eat two bowls of crunchy raisin bran to process all this information. 

 

I thought the fluttering was prolonged with both eyes when she was spun counter-clockwise. ??  I'll have to check when the report comes in.

 

She is right-handed. All dominance is right sided, and I remember the previous OT did find more difficulty with the left eye when it came to convergence. And the covd optometrist confirmed an eye teaming problem, in addition to a tracking and focusing/accommodation problem.

 

I am curious to test which way she falls. I know I always fall to the left.

[Heathermomster]

I don't know whether my comment is relevant, but DS performed a ton of static and dynamic balance exercises with PT. I wonder whether your DD will need something like that in addition to the VT. ETA..Son seems less clumsy and his all around carriage is much improved after the exercises.

[Tiramisu]

I don't know whether my comment is relevant, but DS performed a ton of static and dynamic balance exercises with PT. I wonder whether your DD will need something like that in addition to the VT. ETA..Son seems less clumsy and his all around carriage is much improved after the exercises.

 

I think PT might be easier to get into and get coverage for. And I just love our PT. Interesting thought.

[Tiramisu]

Okay. I got message from our VT optometrist. It turns out he tested dd's VMI before she started VT and this week, which might be six weeks or so into VT. He said her VMI was 47th percentile and now it's 60th. So, obviously, he does not think a visual-motor problem would explain the handwriting issue. I actually think any testing she did with him is probably rather reliable. She's trying very hard to do her VT well, and he said she's making gains.

 

I posted on the other threat that the OT isn't done the report yet, but one finding is a mild vestibular processing issue that doesn't need treatment. She said she wants to discuss all the results with us once she finishes the report.

 

If the VMI isn't an issue and she only has a minor vestibular processing issue, and the OT said her visual processing was good. What is left to explain the problem? Could ADHD alone explain it? But I have another with ADHD who has very nice handwriting and loves to express herself in writing. I can't wait to talk to the OT.

 

[Heathermomster]

I think PT might be easier to get into and get coverage for. And I just love our PT. Interesting thought.

DS and I just started science today, and his handwriting is a hot mess.  I don't want to discourage you; however, DS has had IM, OT, and PT.  All the retained reflexes are reintegrated.  Sometimes no amount of remediation is going to help.  Just prepare yourself, and you have a couple of years to decide what to ultimately do about the handwriting.

  

 

DS can read cursive and sign his name.  I gotta say though, this kid will likely be typing from here on out.  

[Tiramisu]

I got the report. I still have to talk to the OT.

 

Coordination disorder.

 

Motor and visual motor-scores were average to excellent, which was somewhat confusing given the final dx. It seems to be primarily sensory-based. Lot of recs included, but IM is the top one that will hit a lot of the different issues (sensory, motor planning, regulation, attention), along with a good sensory diet. 

 

I guess I have my answers and a clear place to start. For that, I am thankful. 

 

And because of Heathermomster, metronome guru, I can even start things at home! :)

 

[Heathermomster]

I got the report. I still have to talk to the OT.

 

Coordination disorder.

 

Motor and visual motor-scores were average to excellent, which was somewhat confusing given the final dx. It seems to be primarily sensory-based. Lot of recs included, but IM is the top one that will hit a lot of the different issues (sensory, motor planning, regulation, attention), along with a good sensory diet. 

 

I guess I have my answers and a clear place to start. For that, I am thankful. 

 

And because of Heathermomster, metronome guru, I can even start things at home! :)

As in Developmental Coordination Disorder? 

[Tiramisu]

As in Developmental Coordination Disorder? 

 

No. The code numbers are different. I wasn't sure what she meant at that point, so I checked with her when we got a chance to talk this afternoon. She said it wasn't dyspraxia/DCD because her motor skills are so good. It's mostly a sensory integration problem. She said the best way to describe her difficulties is a dis-ogranization of her systems. A brain integration issue. I asked about working memory because something in the report seemed to suggest that, but she said it was more of an executive function issue than working memory. She believes there are visual perceptual problems, too.

[Heathermomster]

No. The code numbers are different. I wasn't sure what she meant at that point, so I checked with her when we got a chance to talk this afternoon. She said it wasn't dyspraxia/DCD because her motor skills are so good. It's mostly a sensory integration problem. She said the best way to describe her difficulties is a dis-ogranization of her systems. A brain integration issue. I asked about working memory because something in the report seemed to suggest that, but she said it was more of an executive function issue than working memory. She believes there are visual perceptual problems, too.

So what are the prospects? Can this issue be resolved? Outside of behavior and handwriting, what other subjects are being affected?

[Tiramisu]

Just sharing more stuff from my talk with the OT. 

 

She said dd was complex and if you just looked at her scores from the testing, you wouldn't get a clear picture of her. She said it was because of the very thorough way I filled out the questionnaire that she knew what to look for and how to tease out the issues. For example, she had dd write (and she had a lot to say about that) for a few sentences and then she purposely created an auditory distraction. She could see how her writing, which wasn't great to begin with, completely deteriorated with that input, the size and formation of letters, the spacing, etc., even though she seemed to keep focused and continued writing.

 

I asked about motor planning and she said it wasn't the planning, it was her inability to integrate that disturbed the planning and carrying out of the plan, not the motor planning itself.

 

She thinks further evals are a good idea, but she said dd is very mature in her thinking and she's processing a lot right now. She agrees it might be better to put them off for a bit. The OT was really amazing in that she saw that this is dd's stuff to deal with, not the OT's, not mine, or her dads. It's HERS. And for any interventions to work, she has to be invested in it. That is the approach I have taken with school work and sometimes people seemed to think it was wrong and would say, "You're the mom." But I always thought that I needed her to buy into it or it wouldn't work, so it was quite a validation. Related to this, the OT said she has a strong personality and that's a big part of what has helped her so do so well. 

 

And get this: The OT told me that she knows nothing about homeschooling. (At that point I got nervous.) And she said that she doesn't know our plans for the future and she doesn't want to influence that. (Uh, oh, what's coming?) But she thinks that homeschooling was the best choice for dd because things would have gone very differently for her in a school environment. She said we have done amazing things. We have brought out wonderful strengths and have given her a great ability to compensate. She called dd bright and articulate. It was quite a moment for me to hear that. I don't know if anyone knows how very much I needed to hear that at this point in my life, when the last six months have been so very hard and made me doubt my ability to do anything right, and from an objective party who seems to understand all the issues.

 

I don't know if anyone knows how I've been praying to know what to do about dd's future, if she'd be better off in school. When I first became aware of the possibility of homeschooling and it seemed to be something I was being called to do, my prayer was this, "Lord, make it clear if this is what you want us to do. And change dh's heart." (Dh was worried it would be too stressful for me.) And, oh man, when the answer came, it was clear! And it came through dh himself being confronted with one dd's nutty teacher. That's how it all started and I've always been so grateful for that clarity. So I prayed the same prayer again, and I believe this was my answer.

[Tiramisu]

So what are the prospects? Can this issue be resolved? Outside of behavior and handwriting, what other subjects are being affected?

 

Her overall functioning is affected so it affects all subjects. I've been planning ways to get her independent because I knew scribing like I did for my other dd wouldn't work for her, so I think I'm on the right track. I almost think anything that's not too long will work if she can do it independently. 

 

I think the OT thinks she can work with her. She really thinks IM might help her. She's going to give us help in developing a sensory plan for at home. If we do OT sessions, she doesn't want to use up the time with a lot of sensory stuff, she wants to use it mostly for IM and handwriting.

[prairiewindmomma]

I am so happy for you that you have some answers, direction, and peace!

[displace]

Sounds great you have some answers and direction. It sounds like you've found a great OT as well.

[PeterPan]

Your OT sounds like a gem!  Glad for you to finally be getting some answers!  And OF COURSE you do a good job with your kids!!  We already knew that!!  :)

[BooksandBoys]

OP, what is IM?

[displace]

IM is interactive metronome. Used for a variety of conditions, most common (I think) attention, coordination, rehab. There are a few threads you can research on it.

[Tiramisu]

Because I always need to process in stages, I asked the OT again about dd's writing problem. She said she's calling it coordination disorder because that covers the sensory-motor piece and overall organizing/motor planning difficulties.