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What do we know about fine motor and fine motor intervention?


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I want to wrap my brain around this. Ds has previously tested fine every time the OTs tested his fine motor, and this time he did not. He's also had a stupid boatload of OT over the years. Now I have an OT I'm hoping to connect with in July, assuming he gets registered as a provider. But for now (or if that doesn't work out), I need to wrap my brain around WHY this is happening. Lack of use? Hand structure? Neurological/developmental?

He's done tons of gross motor, but when I got him some of those things where you move balls through fabric (like this https://www.therapro.com/Stars-Hearts.html )he totally shied away. I thought it was too easy and boring and that was why, but I guess that shows I'm an idiot and why we use DATA, lol.

And I'm trying to understand what the intervention is actually trying to accomplish. We need precision pathways in the brain for motor planning? Strength? The intervention seems so random to me, just looking at all the types of things they sell on Therapro. Are there cateogories or a game plan? 

Maybe ds was playing enough legoes previously that it was keeping the fine motor in check and as he's dropped that he has regressed. Is that possible? It would be really ironic. But then, why is that regression happening? And if so, what life skills would keep it in place once we get it back? I don't see how he's going to be driven to write much anyway. It has never gone well, no matter how much OT we do.

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https://www.amazon.com/Fine-Motor-Skills-Children-Syndrome/dp/1606132598/ref=sr_1_4?dchild=1&keywords=fine+motor+therapy&qid=1619938383&s=books&sr=1-4  Our library has this book, so I'm going to give it a try. 

Just scanning through her chapters, I think there are some issues on ds that got missed. That's why I was saying I think I finally need an approach that's thorough and not just saying playing with pincers is enough. He has odd things about his life skills (how he stirs something in a bowl, for instance) and apparently this falls under the bilateral coordination component of fine motor, which would not have occurred to me. 

So we'll see what the book says, but I'm kind of hopeful this might get me answers.

Edited by PeterPan
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What you're describing sounds to me like stuff that we did in VT would help--lots of cross-body work for my older kiddo with convergence issues. We were happy that the vision was fixed and bit surprised/bemused that it also fixed some problems he had with bilateral coordination while swimming. I think they focused on gross motor bilateral exercises and convergence, and the rest sort of fell into place.

He had mixed fine motor skills--some were awesome and some were not. 

Motor stuff can get funky around growth spurts. 

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It also can be the case that your motor skills were kinda borderline OK, and then you hit the next age group and kinda borderline OK is now not OK. I hit plateaus on all my motor skills about age 12, so every eval after that point went down, but it really was that I'd hit my personal best, and, skill wise, just plain didn't change much after that.  I don't know if that was because the therapists I had weren't used to working with teens, or what...

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Thanks @Dmmetler that makes a lot of sense. And given that last year was the end of having articulation goals on his IEP, it was easier to accept "ok" than to dig in on the odd things we were seeing. I'm just glad the school did such a thorough job this time. The OT spent a lot of time and was decent and the whole process was just so much more congenial than before. 

So yeah, it sorta sucks to have another thing, but at least it's not a dreadful thing, lol. Do you type? How do your lingering symptoms show up? Or shouldn't I ask?

Edited by PeterPan
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I pretty much type everything, or use text to speech, which is a lot less of a hardship now when I can just carry my IPad everywhere. I can’t type on a cell phone, but I do pretty well on an iPad. Everything I do for kids is pre-done and printed, and I have lots of cute little incentive cards and pre done notes to send home. I pre print my music assignment sheets a book at time and check off what to work on for that unit, and have lots of little things on stickers that I can stick into books. Debit cards/credit cards vs checks (not a big deal now, but I was probably the one 16 yr old who had a credit card for their first job back in the 1980’s!). E-mail was awesome and so is texting, and I use text to speech a lot, and have my phone trained. Adaptive tech that was hard to get in the early ‘90’s is now on everyone’s phone.

 

I learned to type on typewriters and IBM keyboards with springs that took significant force to press down. It was so ideal that I kept using the same kinds of keyboards, with adapters, until it was impossible to make them work anymore. I still buy gaming keyboards that are very "clicky". 
 

I actually really enjoy crafting, but have a lot of extra holders and stands to help compensate-my DH is really good at making them, and there is a whole industry designed to help senior adults. 
 

When I did my last eval before graduating, and again when I did one in grad school, the folks could not believe I was a musician. My level of motor skills, and my down in the basement visual-spatial processing should not allow it. Somehow, it works. I’m currently field testing a line of pre-band/adaptive instruments and absolutely love them. They're designed more for elementary schools to use as a classroom intro to band, but they are so light, the keys are enlarged in just the right places to make them easy to hit, the holes are closed except where needed and usually have tiny openings if they need to be open...it truly is about the perfect adaptive tech, from a company that was thinking about 5 -9 yr olds, not adults or older kids with reduced motor skills or seniors. (They also have a closed hole recorder!!)
 

Honestly, it’s like my speech-something I am used to and have a whole army of skills to compensate for, but it’s to the point I barely even notice. 

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Fine motor—I would look at this through the framework of ADLs—dressing, grooming (like flossing teeth), managing medications, managing simple home repairs (like using a screw driver) or household affairs (applying tape or glue).

Fine motor is generally precision, not strength. I do agree that demands are higher with increasing age, but I told you about the puberty blip, right? We had to redo some therapies. 
 

ITA with whoever above mentioned bilateral cross body activity. I never knew that bouncing a basketball was a valuable skill, but right/left handed ball bouncing was huge in unlocking stuff. Same with some balance work. We called it PE (basketball, swimming, yoga, etc) but it was really therapy.

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On the ADL's stuff, there also are a lot of work around and adaptations. For me, flossing is hard with a piece of regular dental floss,but I can use a floss pick or a waterpik fine. There are types of containers I just don't buy, or have my DH open and transfer contents. Medication is available in non-child safe containers, and I have been known to buy OTC pills, take them to the pharmacy, and ask them to transfer them for me when I didn't have someone at home who could do it for me (if you want me to squeeze AND push down AND Turn, it's not going to work-one of my prescriptions that comes straight from the manufacturer comes in ridiculous packaging, so DH gets to help me transfer them once every 3 months). 

Combination locks were the devil when I was in school, and most of the people with lockers near mine knew my locker combination. I haven't used a combination lock since graduating high school. I don't know when the last time I had a shirt with buttons that actually needed to be buttoned, but it's been awhile. 

 

So yes, work on what is needed with an OT or at home-but also keep in mind that there are a lot of tools out there and it isn't worth torturing a kid if that skill just isn't coming. 

 

Ironically, one side effect of spending years working on handwriting is that I'm actually really good at teaching it. Because I have to think of every single step slowly in order to maintain muscle control, so breaking it down for a child is natural, and when someone is struggling, I can probably see why because I do the same thing. But at the same time, I'm the first person to tell a parent that handwriting isn't really that big of a deal, but that having some way to interact with digital devices used daily is. 

 

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On 5/4/2021 at 6:27 PM, prairiewindmomma said:

I told you about the puberty blip, right? We had to redo some therapies. 

If you told me, I obviously needed to hear it again.

11 hours ago, Dmmetler said:

flossing is hard

I may have completely forgotten to work on this with him. And you're right, picks at best.

11 hours ago, Dmmetler said:

But at the same time, I'm the first person to tell a parent that handwriting isn't really that big of a deal, but that having some way to interact with digital devices used daily is. 

Thanks. 

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On 5/13/2021 at 12:25 PM, prairiewindmomma said:

Combination locks are hard!  We JUST got that one sorted this year.  Ds has needed to bring his own 4 digit combination lock to school every year because there is no way he would be able to use a dial one....until last week.  He got one open---here's hoping it wasn't a fluke! 

 

The thing that drove me nuts was that in high school, the locks were built in and we weren't allowed to substitute them. In college, I had a locker for band instruments, and was always allowed to bring my own lock, so I just brought a keyed one.  It was one of a myriad of little things that made school really hostile. In 20/20 hindsight, we probably could have had bringing my own lock included in an IEP-but it was something that my parents didn't think of (and neither did I, once I started being included in IEP meetings). So, half my homeroom knew my locker combination, and from 7th grade on, would regularly open my locker in the morning and afternoon. 

 

Similarly, typing, and then using a computer, was this big deal thing when I was in school, and I had teachers who absolutely swore that everything needed to be handwritten, forcing me to have to deal with scribing or write myself, which strongly abbreviated what I said because of writing limitations. I remember dictating my college essays to my mom because the forms were not set up to be able to be done easily on a typewriter.  In undergrad, it was a big deal to be allowed to use a portable computer (strapped to a luggage cart, and limited to sitting by an outlet, which was often in a place that didn't necessarily let me see the board well). As a teacher, I provided my own computer, and before big monitors/projectors, would purchase transparencies so I could type my visuals and print them and project them. As soon as teacher stations came into my district, I wrote a grant to get one for my classroom-and found all sorts of educational justifications, but the fact is, it really was so I could "write on the board" in real-time. Now, I have a $100 projector that connects to my iPad. Problem solved.  I don't think either L or S has ever done a college class that expected handwritten anything, and, indeed, it would have been next to impossible to do the college application process without being online and typing. 

 

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