Double-jointed and Poor Handwriting - Connection?

[Slipper]

My youngest dd has very poor handwriting. I suspected dysgraphia but an OT we hired last year said that she didn't have that. (I still suspect it). She randomly uses capital letters, her spacing is awful, she writes an 'a' by writing a 'o' and then drawing a stick somewhere beside it (but not close enough to look like an 'a').

 

I just realized she is double-jointed in her fingers (her thumb can almost touch the back of her hand and she can do these weird popping things with her fingers that gross out all her friends). Would that have any connection with her handwriting?

 

(My current plan is to insist on neat writing daily in her journal and move her to cursive asap).

[Mama Anna]

I can't speak to possible dysgraphia, but my oldest was called double-jointed by her pediatrician (She likes to gross out adults by doing "first position" for ballet while turning her toes out so far that they actually point backward.) and her handwriting is pretty neat. Of course, she's also a little perfectionist and generally writes slowly enough to make sure it's that way.

 

My dd6 is much less concerned about her handwriting. She's sloppy as all get-out in her exercise book, but she'll be careful when she's writing a letter. For her, she just doesn't see the need for neat handwriting unless someone is going to read it. Once I figured this tendency out I lowered my expectations for neatness in her exercise book, but still ask her to do obviously dreadful letters over again. Most copywork, correspondence, or spelling exercises must be better, though. She has asked to start cursive now, though it was originally slated for half-way through next year. I'm moving her into it. If she can't keep it neat, she'll lose it, though. :D

 

HTH!

Mama Anna

[Joshin]

This is purely anecdotal, but I am extremely double jointed in my fingers (I can bend my fingers almost completely back at the second joint on all ten fingers). I cannot hold a pencil the "correct" way, or my joints pop out and my grip ends up awkward and uncomfortable. I had very, very messy handwriting until about fifth grade, when I finally found a comfortable position to hold the pencil and the teachers quit fretting over our pencil holding methods. Cursive is still hard for me, something about flowing all the letters together and not picking up my hand makes it more likely for my joints to pop or my hand to tire, so I tend to write in very blocky print, although it's now neat.

 

Some of the problem may be with finding a comfortable pencil grip, which will take time because I am sure it differs from person to person and probably has a bit to do with the extent of the double jointed-ness. I tend to favor certain letters as caps because they are easier to write, as well. For some reason, my joints are less prone to popping or fatigue drawing straight lines as opposed to curves, so I tend to skip curvy lowercase letters (like writing E instead of e) unless I am paying attention.

[wapiti]

Certain types of excessive joint flexibility may be due to low muscle tone (hypotonia). Yes, the same muscle tone issues can contribute to handwriting issues, not just in the hand but in the torso and arm/shoulder, as they play a role in handwriting as well.

 

AFAIK, for a dysgraphia diagnosis, officially that would need to be diagnosed by a psych, as it is a disability in the DSM. An OT may be able to do specific tests that may have an affect on such diagnosis. This is confusing for me, as I have a couple of kids with handwriting issues that dramatically affect their score on the Coding subtest of the Processing Speed section of the WISC. (They do not have low tone issues and their sensory issues are more minor. However, my dd has low tone. I do not think her handwriting is at a low enough level for a dysgraphia diagnosis at this point, though she will have one more round of testing with the psych to see what's up with her processing speed.)

 

An OT should be able to help low tone, but the expertise on low tone and SPD varies widely among OTs.

 

FWIW, the handwriting issues you describe could also stem from developmental vision issues, which could likewise be due to low tone (affecting ocular muscles which can affect not only vision but also the development of vision processing). Those types of vision issues can be ruled out with a developmental vision eval by a COVD optometrist.

 

I think your plan to move on to cursive is excellent. Also start typing at a young age. You may want to post on the Learning Challenges board for more comments and suggestions.

[Momof3littles]

Agree that lax ligaments can sometimes coexist with low muscle tone. In order to have good fine motor control, you also need good proximal muscle control to offer the stability needed. So even hand issues aside, if she is low tone in her core or lacks strength in her abs, back, shoulder girdle, wrist, etc. that will affect handwriting. If she's very flexible, she may not have enough stability to get the fine control needed for good handwriting. If it is due to that, there are exercises appropriate for strengthening the abs, back, shoulder girdle, wrists, etc. and an OT would be able to show you some of those. They may also be able to work on tone a bit.

 

I agree that vision and other perceptual issues can come into play with handwriting as well. So many things really can impact handwriting-strength and muscle tone, bilateral integration, visual perception issues, crossing midline with the eyes, etc.

 

Are there any other OTs in your area who do work on handwriting and could screen the other concerns (core strength, muscle tone, visual perception issues, etc.?

[Slipper]

Thanks or the responses so far. At the moment, we're having an evaluation done by the school system to look for learning problems (trying to determine if her struggle is due to problems or anxiety - we suspect anxiety). I requested an OT evaluation as well to address her handwriting and her problem distinguishing left from right.

 

She doesn't have any vision or hearing problems according to testing done last week by the school and other testing by Children's Hospital (hearing) and our eye doctor.

 

She's a bit on the clumsy side but plays soccer and participates in dance. I would consider her intelligence average or a bit above. I wasn't sure whether to bring up the double-jointedness with the OT, but I probably will.

[Momof3littles]

Just as a heads up, visual acuity is one thing, but a lot of standard screenings don't catch things like visual perception problems. Clumsy, lack of ability to determine left vs. right can also be brought up with OT if they weren't yet. Could be a motor planning issue or several other things.

 

These are things you could talk to the OT about possibly:

http://occupationaltherapyforchildren.over-blog.com/article-spatial-awareness-108726104.html

http://school-ot.com/Handwriting.html

http://therapyfunzone.com/blog/ot/visual-perceptual-skills/

 

Obviously you need someone to take a look and evaluate her thoroughly, but just thinking of a few things you can ask about as part of OT evaluation.

 

A school eval may or may not get into enough depth for some of these issues. Private OT and school OT focus can be quite different at times.

[HSmomof2]

:lurk5:

 

Interested in responses as well....DS(10) has poor handwriting and is double-jointed. He also has SPD and low tone in his core and upper body. We worked on that in OT, so it is now within normal range. We've been working on cursive for two years with very little progress. He is learning to type now, and we are working on getting his printing to be as legible as he is able.

 

BTW, I also am double-jointed, but never had handwriting problems.

[GoVanGogh]

Just as a heads up, visual acuity is one thing, but a lot of standard screenings don't catch things like visual perception problems. Clumsy, lack of ability to determine left vs. right can also be brought up with OT if they weren't yet. Could be a motor planning issue or several other things.

 

These are things you could talk to the OT about possibly:

http://occupationalt...-108726104.html

http://school-ot.com/Handwriting.html

http://therapyfunzon...ceptual-skills/

 

Obviously you need someone to take a look and evaluate her thoroughly, but just thinking of a few things you can ask about as part of OT evaluation.

 

A school eval may or may not get into enough depth for some of these issues. Private OT and school OT focus can be quite different at times.

 

My DS passed visual acuity tests, but had a vision issue due to a neuromuscular (muscle tone) issue.

We went to a pediatric opthamologist that specialized in this issue.

Several PPs mentioned hypotonia, which can be the cause of double-jointed. It certainly does affect penmanship - not just because the hands struggle to hold a pencil, but also because arm, shoulder and core stabilizing muscle tone may be lacking. All of those muscles need to work together for fluid penmanship.

The bolded part above struck me, as that is my child. I would try to find a private OT for a full evaluation and mention all of those issues. My son does have motor planning issues and is slow to gain muscle memory, especially on one side of his body. (The side he uses for writing, of course. :tongue_smilie: )

[PeterPan]

Thanks or the responses so far. At the moment, we're having an evaluation done by the school system to look for learning problems (trying to determine if her struggle is due to problems or anxiety - we suspect anxiety). I requested an OT evaluation as well to address her handwriting and her problem distinguishing left from right.

 

She doesn't have any vision or hearing problems according to testing done last week by the school and other testing by Children's Hospital (hearing) and our eye doctor.

 

She's a bit on the clumsy side but plays soccer and participates in dance. I would consider her intelligence average or a bit above. I wasn't sure whether to bring up the double-jointedness with the OT, but I probably will.

 

Have you talked it through with a good ped? The ped can screen for low tone, and they may refer you to an neurologist. That "clumsiness" could very well be vision, and your regular eye doc isn't adequate to check for it. You have to go to a developmental optometrist to check that, because it's a developmental vision issue. COVD is where you find the dev. optom. Vision isn't the only explanation, but it's certainly a very possible one that you haven't eliminated.

 

OT's through ps can vary, and they legally only have to diagnose and address things that specifically affect school work. She has more going on. In your shoes I'd be asking for private evals.

 

Btw, the anxiety thing means she needs a screening by the ped and a referral for a psych eval. Like I said, don't stick with the school system if they aren't doing full evals. Neuropsych or ed psych, complete OT, COVD, you want these things. Switching to cursive won't necessarily help or cure it. There could be working memory issues, motor control, etc. going on. Start looking for the actual answers. It's not going to be as simplistic as switching to cursive. (I taught my dd cursive first and am a proponent of it. It just doesn't make medical problems go away.)

[Slipper]

The OT we had who said she didn't have dysgraphia was one we hired privately. My daughter sees a psychiatrist and therapist that we pay for privately. Sorry, I didn't clarify that earlier.

 

No, I haven't discussed it with our pediatrician, but we have a well-child visit in two months. I'm putting it on my list to talk to him about it.

 

Thanks for all the other suggestions. I'm making notes and googling away!