pencil grip and handwriting

[twinbirches]

When left to his own devices DS (newly 8) will hold his pencil in a fisted grasp in his right hand and “drive” the point around with his left hand.  He also forms a lot of his letters in weird ways, prefers uppercase, and has reversals.  Yes, he qualifies for OT.  The closest place is 45 minutes away and we went every week for 9 months until he was discharged for refusing to participate.  They also didn’t work on pencil grip or handwriting at all despite my specifically asking them to.  He can write with his finger in salt, shaving cream, etc.  He is decent with scissors and can build with LEGOs for hours.  He is resistant to school and anything requiring work. I’ve been scribing for him and I’ve planned a light year and so far he is doing okay actually getting his work done.  At some point though, he needs to learn to write.  Any suggestions for a program/method that will get him daily practice without causing daily meltdowns and derailing our school year?

[PeterPan]

Did you or anyone check for retained reflexes? And has anyone considered ASD? Why was he refusing to participate? Does he refuse anything else?

The reflexes may underlie the grip issues. He may have some developmental delays going on, and he may have SLDs. My ds is a pistol like that, and it hasn't just been one thing. He's had tons of OT now, and we're still doing well to get him to write single words. He's considered to have SLD writing on top of his autism, so by the time you consider he's going to be delayed anyway, has some motor planning issues, has compliance issues, has difficulty getting it out even if he tries, and oh btw also has SLD Reading so spelling issues, well... writing just isn't reality for him. Maybe someday we'll find a magic bullet or it will happen.

I doubt the OTs were wrong if they were having him do gross motor and things like that. That's probably flat where he is. I would do a super thorough check for retained reflexes and then do (psych, language, etc.) evals to find out what's going on.

As far as things our previous OT did successfully, she'd usually do gross motor, overall stuff, around her theme for the day (spy games) and then have him "code" his spy messages. He was writing one letter at a time that way. He often got through the whole alphabet and did some numbers that way. That's where he really was. You're not going to escape meeting him right where he is.

Doing that stuff, he spontaneously started writing on his own small bits, like a list of CVC words. It might take him an hour, but he would get them down. So that's clearly not a level I can harness and require significant work on. The OT said to bring doodling into our day, which we have done and could do again. I do have him writing for Spelfabet, which is a spelling workbook that has him filling in single letters most of the time. For everything else, scribe and tech. He has an IEP and his team is on board with that too. It's just where he is. 

Edited September 16, 2018 by PeterPan

[twinbirches]

He has an underlying medical condition, a long medical history and has had what feels like a bazillion evals of varying sorts none of which have been particularly useful for either daily living or academics.  At 5 he was determined by the neuropsych to have a neurodevelopmental disorder that occurs often in children with his background.  I'm sure a lot of evaluators would label it ASD, though a lot of it is anxiety as well.  He can hold a pencil in a functional grasp (especially with a pencil grip on) and has written whole (short) sentences on his own.  I believe him perfectly capable of learning to write and am looking for recommendations on programs or methodology that would be easiest for a child for whom writing doesn't come easy.  Is tracing bad or good? HWT claims to be a good program, but I have read it isn't actually the best for some children.  I was also thinking of the Kindergarten level book of Getty-Dubay.  

[PeterPan]

We've had discussions of tracing before, so maybe the person who did that will pop in. I think in her case the dc still uses tech for all lengthy writing, that writing is still hard. Also, the window I've read for serious changes in writing is age 8. At that point you're starting to see how it is. But your enthusiasm is really good! I don't think any program you try is going to be better than another. It would be helpful to you know whether they were working on those precursor skills (fine motor, gross motor, midline, etc.) because he needed them or because they didn't like to work on handwriting. 

The OT working with ds frustrates the tar out of him and doesn't make handwriting pleasant. She uses a small whiteboard and models what she wants and then he writes. She usually gets a couple lines out of him in 20 minutes. I'm hoping after she gets some training on interoception that she'll do something more worthwhile, because he's about at the point where he'll stop working for her entirely.

The stories I hear of kids in this position usually are along the lines that the kid wouldn't write, so the people stopped, and THEN the kid started writing. I think there are precursor things that have to be there and if they're not there it doesn't come together. And when they're there, the writing comes together and the kid starts doing it. So sometimes the people are doing something else entirely, like horse riding or PT or metronome work or VT, and boom all of a sudden the dc is ready.

The OT places here use HWT. I used the jist that I could figure out online for free of another program (EZ Write), but personally I don't think any of them are so radically superior. I liked EZ Write because the foundational strokes made sense. But I go back to whatever that was I read that said whatever they're doing at 8 is what they're doing. 

Did they ever run genetics on your ds? Just curious. I've run genetics on my kids and now we've participated in the SPARK study. There are so many paths, as you say, at least 80 different genes implicated, and they end up with these profiles that overall can get you an ASD label but are distinct from others. It's just interesting to me. Even the anxiety we were able to track down genetically.

I think just roll with your gut on the handwriting. Nothing I've done has made a major difference, so clearly I don't have any miraculous options for you. I just know at the IEP meeting they gave me samples of writing the 4th gr ps students do and it's pretty much hopeless at this point for writing to be a practical method of getting out thoughts. I'm just hoping for basics of independent living like can he leave a note for someone, sign his name, that kind of thing. My ds doesn't have the frustration tolerance to do much. If you've got that skill, then you might get farther and will be able to push it farther. That definitely definitely holds us back. 

The paper Spelfabet uses is pretty nifty. Is HWT paper like this? I don't remember. It has lines for the bottom circular portion of letters, so mid and bottom lines, but no top line. It has helped him notice height differences in the letters a bit. Some OTs will swear by their preferred paper. You could print out various kinds and see what clicks. There's also something called Callirobics that is cool. You can do the strokes with music or with metronome. It killed my dd, oh my, so I've never tried it on my ds. But the concept is good if it's within reach, sure.

[PeterPan]

This is what I was talking about with retained reflexes affecting grip.

https://ilslearningcorner.com/2016-03-palmar-reflex-where-the-problem-begins-with-poor-handwriting-pencil-grip-and-fine-motor-development/

Many OTs are NOT trained in retained reflexes, so you may have to test and figure them out yourself.

Edited September 16, 2018 by PeterPan

[Pen]

Can he read?

There may be a lot of other things going on, but what you are describing sounds like a variant on what for my son turned out to be dysgraphia issues.  

My son also could not read at that stage due to dyslexia issues.