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What the OT said about dd's writing issues


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It comes down to an ocular motor issue, with the left eye being worse. She sees signs of convergence insufficiency and tracking problem with eye jumping at the midline, but no visual perceptual issues, no motor issues. VMI is age appropriate.

 

She thinks she can do things at home that will help. I know the VT doc disagrees with that but he wasn't pushing for me to bring her in when I brought the issue up with him last week. He recommended seeing what the OT says and then taking her into our regular optometrist who picked up my other dd's symptoms of CI so insurance will cover it.

 

I don't know if this dd has the wherewithal right now to go through VT and of course there's the money involved, but it's nice to know it's something that's fixable. 

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My son had the eye jumping, too.  He did not have signs of CI as far as I know (he had when he was younger, but apparently grew out of it).  He did have/has visual perceptual and VMI issues. They are improved but still on the lower side.  No motor issues.

 

His eye jumping did improve with just OT.  The VT we saw thought it might -- he was like, if it doesn't, maybe the things he would do would help.  But he thought the same thing could happen vice versa, with trying VT and then seeing it not work, and then finding OT to be effective.  That was what the one in our town said.  The OT we saw said about the same thing, too.  She said -- if we didn't see any improvement in 2 months, she would think I should try VT and see if it was better for him.  Right at the time we were looking at that, he did start to improve in OT, at around 3 months, and  I cancelled the VT appointment.  (It sounds fast now, but it did not seem fast at all at the time.... it seemed like difficult appointment after difficult appointment.)

 

His tracking is good now, it did improve quickly after the first sign of it improving. He moved into chapter books.  His coordination improved.  

 

His handwriting improved but it is still poor, but I think more b/c the other issues.  

 

Good luck!!!!!!!  I saw a lot of improvement with the eye tracking, it was very good.

 

My son learned to skip, and she had him doing things like hitting a balloon with a bat, then he worked up to hitting a ballon with a bat while she pushed him around on a platform swing.  I did not observe though, I do not know all the things.  

 

He is someone who can have an attitude when he is very frustrated and being asked to do something that is very hard for him..... this qualified.  I am very glad our insurance could cover it.  Our insurance would cover OT but not VT for him.  The OT he saw let him earn Wii time for the last few minutes of his session.  He had a few times when he did not earn his Wii time, but he did really want to do it in general.  Sometimes that was not enough for him to try hard even with the frustration.  I think the OT got to know him and see how to work with him, too, which can take a little time.  

 

I did not think the VT we saw for that eval was someone who would be able to deal with my son if he was being emotional or difficult in any way.  His practice was oriented towards older teens.  It was just not his thing to deal with not-totally-motivated 8-year-olds.  He did not seem like he would even be very good with this age range with a child with great behavior.  

 

But then later, from the OT, I got a name for another VT, about 40 minutes away, that she said would be a good fit.  But I had not seen his name when I searched the COVD website.  

 

The OT we saw was very good with my son's age, and very used to working with very frustrated kids who could be difficult.  She told me she had a lot of kids who would start crying when she asked them to do certain tasks, so that is like -- the focus of her job, and what she likes. She was very good with him!  Though early on it was rocky and I wondered if it was going to work out.  (A little earlier, I had pulled my younger son from OT with a different person, she was really not good with him, and so I may have been more suspicious than usual, I don't know.)

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This is for the 8th grader or 2nd grader?  That would definitely spin how worried I'd be on pushing that envelope.  If it's the 8th grader, you might consider some serious bribery and getting it done so she's ready for school in the fall.  If it's the 2nd grader, you could consider a slower pace or wait a couple months till whatever is making life hard passes...  Is this the same dc where you're making food changes?  That would be a lot to do at once.  

 

You know, just as an aside, sometimes I wish I wasn't always so gung-ho and aggressive about things.  It would be nice just to sit down and do 10 minutes a day and have it take months longer but be gentler and less painful, kwim?  I'm supposed to be going through stuff with ds, and I think that would be a good tack.  

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This is for the 8th grader or 2nd grader?  That would definitely spin how worried I'd be on pushing that envelope.  If it's the 8th grader, you might consider some serious bribery and getting it done so she's ready for school in the fall.  If it's the 2nd grader, you could consider a slower pace or wait a couple months till whatever is making life hard passes...  Is this the same dc where you're making food changes?  That would be a lot to do at once.  

 

You know, just as an aside, sometimes I wish I wasn't always so gung-ho and aggressive about things.  It would be nice just to sit down and do 10 minutes a day and have it take months longer but be gentler and less painful, kwim?  I'm supposed to be going through stuff with ds, and I think that would be a good tack.  

8th grader is finished VT and CI and tracking are fixed. Now I'm talking about my second grader. This one has no food allergies, thankfully.

 

My plan is to take dd to the regular guy and see if he sees signs. Then I'll get a better sense of things, I think. It will probably have to be done but her frustration tolerance is low and I'm afraid the money will be wasted if she doesn't do the homework. That's something I have to think over a little more. I just wonder if another year of maturity will help with that.

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We did not have OT homework at first.  We have some to work on over the summer, now.  

 

The handwriting program the OT chose for him says "for children with visual perceptual challenges" or something like that.  He didn't start on it, until after he had made a lot of progress with his tracking.  

 

We did not have homework for his tracking.  

 

I know that the way she approached it with OT was different than how the VT would have approached it, different methods to get to the same result (hopefully, though both said, sometimes the other specialty could have better results with a certain child, and neither thought they could predict that ahead of time ------ but again I am in a smaller town, in a bigger place they might be able to predict that).  

 

I did not have to do any homework with him for tracking, though.  

 

I doubt that I could have worked with my son, he will not work well with me for things that are very, very hard for him.  And, I have done major reading with him.  I really have.  But this is more in the speech therapy category -- I couldn't do speech therapy for him, I couldn't do this for him at the early levels.  I could do the homework when he was farther along, and when, b/c he was farther along, he was having an easier time and his frustration level was lower.  I have seen this with a few things ---- sometimes the beginning is so, so, so hard, but once the beginning is over, it is POSSIBLE to go at a nice, easy pace and do things in a less-frustrating way, that is pleasant, and where there is that feedback loop of feeling like -- it isn't too hard, it is okay, etc.  

 

When I was looking, I was also subbed to a dyslexia group on yahoo, and there was some feeling there that OT was easier for kids to go along with, compared to VT.  

 

Otoh, there were people there who thought that VT was foundational to OT, and should really be done first.  

 

It did work out here, to do OT first, but I think some of that was chance with my son.

 

For your daughter ----- maybe you can investigate things like -- a slightly shorter session, snack in the middle, really special snacks, really special treats for after a session where she made a good effort, making sure the VT is being positive and noticing when she is trying hard, anything like that. It can go a long, long way.  

 

My son's most difficult therapy was speech therapy, he was EXTREMELY frustrated.  For a while I was getting him a McDonald's happy meal after a session where he had good (acceptable) behavior and effort.  That is NOT the kind of thing I do ----- it was a BIG DEAL.  I have also taken him to Sonic to get a hot dog -- again, NOT something he usually gets.  

 

These are the things that work with my son.

 

But -- he has to feel like he can get it for effort or behavior, that he is capable of.  It cannot be tied to results or he will have anxiety and also he will be SO SAD if he tries but does not get the result -- it is like poison to him, it is the worst possible thing.  

 

But even with that, it is HARD.  

 

I wish we could have waited for his speech therapy, but honestly, in that area, his frustration was only increasing with age, b/c the gap between what he wanted to express and what he was able to express, was only growing.  

 

So if you see that she has a low frustration level, if part of the cause of that, might be tracking (and I don't know if it is or not ----- speech for my son was pretty clear cut, I have no idea with the tracking) then waiting will not help, there will just be more instances of frustration, and that frustration will go into the therapy session where the thing is worked on.  And -- yes, maturity goes up, but so does the frustration.

 

If you think she is not very frustrated over it, or you are able to accomodate times it would be frustrating, and there are not natural times (not b/c of school, frex) that it is frustrating to her, then I think waiting for maturity does make a lot of sense.  

 

But if it is just innately frustrating, that may not change as much.  

 

For the speech therapy my son did, to some extent, they felt like he was at a point where they could work with him in ways that took advantage of his maturity and level as a 7-year-old, vs what they could do with a younger child, so there is that, on the side of an older and more mature, longer-attention-span, etc. child.  

 

 

 

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Everything OhElizabeth said.

 

We've started VT again and it's rougher every year he gets older. We do our VT homework 2x a week instead of the prescribed daily, but that's all we can manage. Still, there are gains, whew.

 

For CI, we were sent home with a computer program - http://www.homevisiontherapy.com/. It's playing games wearing red/green lenses and shooting at some image on the screen that isn't apparent to anyone not wearing the lenses. It sort of teases out a 3d of the image, so the brain has to work hard.

 

While I completely agree with OhElizabeth about taking it easy, I can't help feeling that I goofed somewhere along the line and need to make up for lost time. VT is working. Tk goodness. So is OT. And the structure we have at home. Ds does NOT agree with me that he needs VT etc, but for now, he's taking it in his stride without complaining too much (it's all relative!). I shudder to think if we have to do this at 14 (please, no!).

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Tiramisu, yes, that's what I'm concerned about with my ds.  He's a really odd duck, doesn't handle losing, is sort of oddly emotional, etc.  I think with him there's going to be that tolerance and avoidance thing, and that's what I was saying about really short sessions where the task would be kept just barely stretching beyond comfortable, never into uncomfortable.  Yllek used to talk about this with her boy and his therapies, how the therapists had this nack of making the tasks just slightly stretching and not uncomfortable, just such a slight stretch they didn't realize it was happening, kwim?  It might be something to try, even if it takes longer.  We both know 2nd/3rd is not the end of the world.  It's ok if it takes longer but stays gentle enough that it actually gets done.

 

I don't know what bribery would work with my dc.  I think bizarre matter of factness, keeping it as painless and brief as possible, and following it up with something he really likes would help.

 

We did paper therapy and some activities, but there were also things the therapist suggested I could do like wearing the red/green glasses as you read your everyday books.  There might be some basic things like that you could sneak in too, sort of getting it in while they're doing something they enjoy more.

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I think it can be such a catch-22.  It sounds like maybe there is not a perfect age.  

 

There have been a few things with my kids, where there just is not a "something is happening, but it is not too uncomfortable" level.  I don't know if that is b/c of other frustration from before therapy, or if it is just, that is how it is at the really low level to get to even square one.  

 

I have always seen it get better after square one, and be able to be "not too uncomfortable."  

 

 

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