Tiramisu Posted April 10, 2012 Share Posted April 10, 2012 (edited) Because I've posted in multiple threads about what's come before, I've decided to post the latest here in one thread for the sake of clarity. I spoke with the PT my daughter saw after her surgery about the OT's report about dd's handwriting issues. He asked us to come in because red flags were going off for him. He said he had time this morning, so I brought dd right in to see him. This was a completely informal, no charge, out-of-the-kindness-of-his-heart thing. First he examined dd, then he read the report, noted the deficit areas, notably trunk tone and strength and weakness of the intrinsic hand muscles, and re-tested those areas. Then he called in his hand specialist and she did her own examination. Neither the primary PT who is an expert-teacher of spine related things or the PT-hand-specialist could find any weakness at all in dd. In fact, they felt she was very strong, more so than her peers. He said the both the tone and the muscle development in her trunk/shoulders/back/arms was "excellent" and "beautiful." And mentioned in particular how he was physically unable to break dd's hold of her shoulder muscles. After this, he really emphasized how it would be a waste of time and possibly detrimental to have her do tedious, boring exercises of any kind since obviously what she is already doing is working. He and the hand-specialist made some suggestions about how to have dd develop more of a sensitivity to how hard she was grasping her pencil and pushing down to help her avoid cramping, which is a problem with her. It turns out he has some family experience with the exact issues dd is having so he was able to speak to my heart about how things work out over time, as well as give me advice not to cause frustration that could aggravate the problem--it turns out this is a hot topic in PT these days. He also strongly encouraged keeping up the piano. He feels what sometimes happens if you seek an evaluation--OT in our case--for a specific problem is that before you even go in they already have the cause in mind, so the examination is biased from the get-go. He thinks this is what happened with my dd. I think he's right because I felt there were things in the report which the OT never tested in dd. They were minor so I didn't get hung up on them. But then there were big things that I felt weren't accurate and after speaking with the PT and looking back, I agree that dd wasn't checked out carefully enough in the first place to make those kinds of statements. So, here we are...I don't know if I have a real answer, maybe I do, but I am feeling very reassured about dd's physical development. In any case, I am so amazed that this wonderful man spent so much time with us, even calling in other specialists, to help my dd. May God bless him! Edited April 10, 2012 by NJKelli Quote Link to comment Share on other sites More sharing options...
wapiti Posted April 10, 2012 Share Posted April 10, 2012 He and the hand-specialist made some suggestions about how to have dd develop more of a sensitivity to how hard she was grasping her pencil and pushing down to help her avoid cramping, which is a problem with her. It turns out he has some family experience with the exact issues dd is having so he was able to speak to my heart about how things work out over time, as well as give me advice not to cause frustration that could aggravate the problem--it turns out this is a hot topic in PT these days. He also strongly encouraged keeping up the piano. I apologize for not having kept up with the saga, but FWIW thought I'd mention that this problem, of how hard to grip and how hard to press down, would be one that our OTs said was a sensory issue. Unfortunately I can't remember what it was called, but it had to do with the ability to sense the push-back from the pencil while gripping, and from the paper while pressing. Our OTs would treat this as part of a larger SPD. That was a number of years ago. One of my kids does this though (he was only 4 when he was seeing those OTs, so he wasn't really writing yet at the time). Mostly, he types now. If you have tips for how to deal with it, I'd love to hear :) Quote Link to comment Share on other sites More sharing options...
prairiewindmomma Posted April 10, 2012 Share Posted April 10, 2012 procioreceptor feedback (the seeking the feedback of pencil/paper thing)... OP---I'm so glad that you got some insight/direction into what is going on (and more specifically--what is not going on). We've had a similar experience as well.... Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted April 10, 2012 Author Share Posted April 10, 2012 Yes, it's so cool, that even though this is a PT, not an OT, he had a better intuitive understanding that this was more of a sensory processing issue. He didn't use the jargon but he explained it in such clear terms that I automatically connected it with sensory processing. And dd has SPD, so it fits. It's much better, but it's still there. He talked about using a pad to write and having dd practice writing lightly enough so you couldn't see the imprint on the subsequent sheets. He even talked about getting a hold of some carbon paper and putting it a few sheets down and ask her to write light enough so as not to have the carbon paper work. It seems that you could almost make a game of it. The hand specialist talked to dd about using something to write with that breaks easily so she would become more aware of it. Dd joked about using an egg and dipping it in ink. I thought of getting the thinnest possible lead for a mechanical pencil. Dd chimed in that she hates to waste lead so she has noticed her own ability to control the pressure when she had a motivation not to break the lead. They said they weren't experts but they offered these helps, and I'm thankful for them. Quote Link to comment Share on other sites More sharing options...
MomatHWTK Posted April 10, 2012 Share Posted April 10, 2012 Wow, thanks so much for sharing your update. My son gets hand cramps and becomes very agitated about it and it had not ocurred to me that I could actually do some therapies to help him! We are doing so many different things right now to help him in other areas that the pencil grip problem just slipped right past me. :confused: Quote Link to comment Share on other sites More sharing options...
Murmer Posted April 10, 2012 Share Posted April 10, 2012 I am glad that you were able to find someone who was honest with you. I do know that my dd is considered muscle bound, which causes cramping and difficulty with fine motor stuff. We have been working on things to stretch the hand muscles along with massaging her hand before and during writing activities. Quote Link to comment Share on other sites More sharing options...
wapiti Posted April 10, 2012 Share Posted April 10, 2012 Thanks for sharing those ideas!!! Quote Link to comment Share on other sites More sharing options...
rafiki Posted April 10, 2012 Share Posted April 10, 2012 . Quote Link to comment Share on other sites More sharing options...
PeterPan Posted April 10, 2012 Share Posted April 10, 2012 Kelli, a while back (a year or two ago) there was a lot of discussion of fountain pens. Basic idea was the nib breaks or it makes a mess if you press too hard. When we started VT they said the same thing, that she was pressing really hard. It was like she was creating stress in her hand to compensate for the stress in her brain. They gave her a really, really thick pencil grip and had her do lots of relaxing exercises. Well that's just screwy that one OT would tell you all these things and then another practitioner would realize the first one was unjustified. It's really rediculous because, as you say, it's so easy to demonstrate. They did that armpit thing on ds at the ped and it was clearly visible. I'm just glad you're sorting it out! Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted April 11, 2012 Author Share Posted April 11, 2012 Kelli, a while back (a year or two ago) there was a lot of discussion of fountain pens. Basic idea was the nib breaks or it makes a mess if you press too hard. When we started VT they said the same thing, that she was pressing really hard. It was like she was creating stress in her hand to compensate for the stress in her brain. They gave her a really, really thick pencil grip and had her do lots of relaxing exercises. Well that's just screwy that one OT would tell you all these things and then another practitioner would realize the first one was unjustified. It's really rediculous because, as you say, it's so easy to demonstrate. They did that armpit thing on ds at the ped and it was clearly visible. I'm just glad you're sorting it out! Dh only uses fountain pens!!! What an awesome idea! I have vague memories of that discussion so long ago. Dd's favorite grip is the big, triangle shaped, sorta squishy one. Quote Link to comment Share on other sites More sharing options...
Tiramisu Posted April 11, 2012 Author Share Posted April 11, 2012 You can also use a piece of cardboard under her paper. I have learned to compensate by writing very small (as small as this print) and light (if you photocopy it will not show up). I also only use .5 ink or lead. I love the Pentel Twist Erase pencils as they also erase cleanly. Take a look again at that Super Duper Publication's Slant Board and check out Fix-It Write on Amazon. It wasn't until I read and learned that program that it hit me, you aren't supposed to write with your wrist resting on the table. My wrist strength is weak, I rest my wrist, write as far as I can, then reposition and repeat. It is tiring and such a slow way to write. It takes me forever to fill out forms or pay bills. I'm learning and improving as an adult working with my own children. Oh another thing, I love, the Staples top bound narrow ruled pads. Thanks for the great ideas! Quote Link to comment Share on other sites More sharing options...
Heathermomster Posted April 11, 2012 Share Posted April 11, 2012 Good for you and your family. Quote Link to comment Share on other sites More sharing options...
peacefully Posted April 11, 2012 Share Posted April 11, 2012 . Quote Link to comment Share on other sites More sharing options...
FairProspects Posted April 11, 2012 Share Posted April 11, 2012 Kelli, it sounds like your PT is wonderful!! I'm so glad that you received some professional input that is more in line with what your "mommy instincts" are telling you. In addition to all the other wonderful advice that you've received on this thread, you might want to consider a weighted pen/pencil to provide more proprioceptive feedback. We found a really nice, comfortable gizmo that is essentially like a soft, narrow sandbag that can velcro around any writing instrument that you want to use. Ds liked the "squeeziness" of this particular product. He presses down far less when he's using it, and it gives the hand slightly more of a workout. The other ones that we looked at seemed too large for his hand or too heavy. Do you have a link? This sounds like something that might be helpful for ds as well. Quote Link to comment Share on other sites More sharing options...
peacefully Posted April 11, 2012 Share Posted April 11, 2012 . Quote Link to comment Share on other sites More sharing options...
Jennifer-72 Posted April 11, 2012 Share Posted April 11, 2012 For ds a weighted glove was much more helpful then a pencil weight. Do you find she has trouble judging the force to use for tasks other than writing or is it just writing? Ds had trouble with judging the amount of force for snapping buttons and other tasks. With the glove he was able to try those tasks with the extra weight and start to get a better idea. For my son another component to his force grading problem was his poor visual motor skills. I think he was applying more force to get feedback instead of using his eyes to help judge things (if that makes any sense). A vision therapy activity that was incredibly helpful for that was paper tearing. ds needed to hold the paper along a pencil drawn line with his thumb and pointer finger on each hand and tear the paper very slowly inching down just one thumb width at a time. I had him positioned so that his elbows were resting on a table. Once he could manage a straight line he moved on to a curved line and then a zig zag line. It was difficult for him to master. At first we started with card stock as plain paper was too hard for him to judge the force required. Quote Link to comment Share on other sites More sharing options...
PeterPan Posted April 11, 2012 Share Posted April 11, 2012 A vision therapy activity that was incredibly helpful for that was paper tearing. ds needed to hold the paper along a pencil drawn line with his thumb and pointer finger on each hand and tear the paper very slowly inching down just one thumb width at a time. I had him positioned so that his elbows were resting on a table. Once he could manage a straight line he moved on to a curved line and then a zig zag line. It was difficult for him to master. At first we started with card stock as plain paper was too hard for him to judge the force required. Wow, I have no clue if we need it or not, but that sounds neat to try! Quote Link to comment Share on other sites More sharing options...
TippyCanoe Posted April 11, 2012 Share Posted April 11, 2012 . Quote Link to comment Share on other sites More sharing options...
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