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If you want exercises to do with him at home, let me know and I'll point you in the right direction.

OT would be awesome... If your insurance covers it, go for it.

Growing up with crappy handwriting makes school suck more than it should... learning to tie his shoes will take longer... etc. etc. w/ poor fine motor.

xoxo

Sort it out now. In primary school the teachers give you so much crap about bad handwriting and poor fine moptor skills that it gives the kid low self-esteem. It seems to be a common theme in boys early childhood education. My kid is only now coming into his own (15) after being harassed so badly by teachers in prep school that he thought he was stupid. When I had him evaluated he's in the top 2 percentile of IQ etc...he still has shitty handwriting but at least he doesn't think he's stupid.

son had similar problems he is now 6 and has glasses since and it improved much.We choose to let it go.. But when a remedial teacher adviced playing on the wii half a year ago it was an excuse we couldn't ignore (we wanted to play too) and it seems to work! At three I would let it go for a while.. Has he had his vision checked becasue that makes puzzles hard!!!!!!!!

I would have an OT evaluation done. It doesn't hurt to have the eval done, and if he needs it, then you will know. If he doesn't, you haven't lost anything. I would deal with it sooner than later, particularly given that he is not below average, but near the bottom. Given his other sensory issues, you may find that this is somehow tied to those. My daughter is four, and we just started OT this spring for sensory issues (sound and tactile, originally, but when we had her evaluated, they determined that she also has gravitational insecurity, vestibular something or another, and some supine posture control issues). In any event, my theory is that anything we can get addressed and worked out before she starts school and that will make kidnergarten easier on her, I should do. And we start kidnergarten over here at 5, which is in one year for us. So I would vote to call up the OT people pretty quickly, or at least ask your pediatrician what they think (which is what I did first before scheduling the OT eval).

Please, please, PLEASE send him to an OT!! You've posted a few times about Adam having problems, now's the time to stop writing about them and try and help him.

Yeah - agree with the other assvice above. Either do exercises at home or do OT, fine motor skills are VIP when they get to pre-school, so rather have it sorted now than him getting behind in pre-school. My two cents worth :-) Good luck!

I'd definitely give the OT a call - this is something that's right up their alley and the fix could be as easy as a few more sessions. My daughter (4.5) also has various sensory issues. Hers are a bit different from Adam's but among them is a bit of trouble with small motor skills. She started OT a few weeks ago and that's one of the key things they're working on. The OT has all sorts of great games for improving pencil grips, boosting small motor skills, etc. and of course since it's play all the child knows is that he's (she's) having a ball.

A while back I got a note from my girls school that my one triplet, Hannah, is behind with her puzzles and when she gets frustrated she tries to tear the puzzle into pieces. I reacted EXACTLY the same way you did with Adam. The other two are ahead of the class with puzzles. Hannah does go to OT once a week at the Durbanville Family Care Centre (sensory issues, small motor skills, perception and planning problems etc. etc.) - I immediately spoke to the OT about this and she has focused her sessions around this problem and it has improved immensly. What I also do is buy stacks of puzzles and goodies through SMILE - Hannah can now build a 15 piece puzzle on her own, albeit the same one over and over - but she can do it. Her sisters are on 35-piece puzzles. Now I have to encourage her to start building a new one. What I have also noticed is that if we do not brush her for a while she becomes agitated and it effects everything else around her, especially her concentration.

What does Adam's teacher say? She must have a sense of whether this is normal'ish or whether she's concerned?

phone the OT

and chill... you are both doing the best you can :)

My daughter had similar issues and we procrastinated, thinking it would improve as she got older. We ended up only taking her for OT when she was 7. The OT worked so well, we saw improvement within a couple of weeks and she loved going, she thought it was great fun! I have always wished that we had gone for the OT earlier and saved her the frustration she went through.

Get a thorough evaluation for Adam as soon as you can - this could be intellectual, it could be physical, it could be plain old laziness and stubbornness. But it, coupled with his sensory issues, could be part of a much broader underlying syndrome. Talk to an OT, talk to the ped, and, if it won't freak you out too much, even talk to a neurologist. One little thing, not a big deal. But there seem to be enough little things (and I love puzzles enough that, sad to say, my kid being last in the class at puzzles wouldn't be "little" to me - but that's my issue!) to suggest Adam could benefit from some careful evaluation and intervention.

I am an OT working in a mainstream school in the Southern Suburbs, and my advice would be to phone the OT who already knows Adam and ask what she suggests. If it was just puzzles, I would say leave it for now - I dont know a lot of 3 year old boys who will spend the time really mastering puzzles - they have too much else to do! But fine motor skills in general are important, and the OT might suggest an assessment, and some activities to do at home, or else a period of therapy. She might also say give him another 6 months. It's important to catch it early, but my opinion is that 4 is also fine. Good luck and keep us posted!

Definately talk to the OT and get his or her suggestions. In the meantime, here are some fine motor activities to do at home: puzzles, kid safe scissors, colouring books, painting, counting beans or beads or something else involving pincher grip, those cardborad lacing things, those dolls that help kids learn to zip, button, lace, tie knots and do up snaps. These activities don't have to cost a lot of money. Make it fun and get Kat-e-e involved as well.

I wouldn't mess around with something like this. The thing that throws up a red flag for me is when you said his hands are stiff and splayed. It's probably very frustrating in many ways for Adam, and there might be issues underlying it. Go see the OT and then you should have a better idea what is going on. That's what's great about going to an expert, you don't have to worry so much any more.

The fact that you mentioned Adam's hands are stiff and splayed concerns me already. Yes, I think you should have him evaluated to see what's going on. The earlier you intervene, the easier it will be for Adam to improve his fine motor skills. Good luck!

Fine motor skills are really important. I agree with everyone above - it's much better to address it early before he "feels stupid." I have worked with kids in school who had issues and by the end of Kindergarten or grade 1, their self esteem really does take a beating.

That said, it doesn't have to be puzzles to do it! My son's Montessori does a lot of fine motor work and a lot of is it fun, like pricking holes in paper with a pin following the lines.

I agree with the others. Puzzles really aren't a big deal, but the fine motor skills for eventually learning to write, tie shoes, etc. will be very important soon. Early intervention will be much better for A's self-confidence and self-image. Best of luck!

OT would help since Adam's sensory issues have already been identified & this sounds related. The splaying of the fingers & stiffness sound like a sensory defensive issue....Maybe he doesn't like the feel or texture of things in his hands? That makes it hard to handle items & effects the outcome of what one is trying to produce (ie: puzzles).

Things like playing with playdough (pushing, pulling & cutting it), playing in shaving cream, finger paint, & working with textures in an upright (vertical) visual field help him to see what he's doing & put his hand & wrist in a more mature position & thus strengthen the forearm muscle needed for writing, typing etc down the line.

He needs the BASIS to be able to higher level fine motor skills. Vision is also a fine motor skill. Visual-motor skills are what the hands & eyes do together. Puzzles are a visual-motor skill & also involve motor planning ~ what your body does in space & preplanning. ie: looking at a puzzle & then looking at the all the pieces & figuring out in your mind how or where they fit together....this is pre-handwriting as when you write on paper you use your eyes, your hands & your motor-planning to "know" where to write the letters, how big to make them, etc.

It gets complex fast & Adam needs the basics (hand strength, ability to handle textures, visual skills) to pull this all together. He looks so delightful I'm sure he'd love OT ~ it's fun :)

Tam ~ Pediatric OT & hand therapist in another life & missing it :)


As a parent of a child with special needs I vote for OT...right away! It's a lot easier to withdraw from services that your child doesn't need than to add services at a later date when the need is high!

ps ~ please, please, please do not put him in front of video games or a Wii. He could benefit from lots of physical gross motor movement. Video games make kids so passive & isolated & do not improve fm skills when kids don't have the underlying components (hand strength, dexterity, sensory awareness)

You're SUCH a type A personality, Tertia. First off, puzzles, although requiring fine motor skills, are NOT a bench mark of fine motor skill. Puzzles are a cognitive skill as well...which before you get all nutty about...is not a skill that all kids acquire. I have one twin who kicks ass at puzzles, and another that can't be bothered . It is really more of a patience thing than a fine motor skill thing. If you are really worried about Adams fine motor skill, start him on stuff like working with clay or play dough, finger painting or Lego building, or stacking blocks. These activities require less patience than puzzles, but still work the fine motor skills. Another good one is a doll with lacing, buttons, zips, and snaps. I am not sure why your teachers have a puzzle board to keep track of 'fine motor' skills, but here in the US observations of this nature are strictly confidential. We have meetings with parents to discuss their strengths and weaknesses, which should be done strictly on an individual basis, not comparing them with other children, especially a twin. Bringing Adam to a specialist every time you think he's lagging in something behind Kate, or other kids, will start to work on his psyche after awhile...he's a smart boy. Try the blocks, playdough, at home and watch him carefully, if it seems that he gets frustrated with all fine motor games, then take him to a specialist. At this age playing in preschool IS fine motor training and therapy, if the teachers are working with more than puzzles.

My daughter always hated puzzles with a passion, but has decent handwriting and at six plays piano on a 10 or 11 year old level. So i guess as a mom, i don't see the puzzles being the be all end all of fine motor skills.

How does he do with manipulating small objects? Have you given him things like Legos to play with? How was he with holding Cheerios and stacking blocks? When did he start to color?

I think i would look at all of those things first... I mean, sure if you're worried, call an OT. Therapy never hurts. But they may want to know the answer to those questions too.

Good luck, Tertia!

Given that you are such an aware mom and have noticed difficulties in other areas besides puzzles AND given the fact that you know Adam has sensory processing issues, I say go with your first instinct. (Sensory issues often go hand in hand with fms problems.) I wish, in hindsight, that we'd been more firm about Jeffrey's fms problems, because--as a smart boy--he is very aware of the fact that he can't tie his shoes, use scissors, or write as neatly as the other children. Plus, his lack of control makes it hard for him to express himself artistically. So. Call the OT and you can do some sort of cool, "Just checking up to see how you were doing. How's the family? Oh, and by the way, Adam is having some fms issues. Problem?" Good luck to you. You're doing great.

I'm going to agree with the above posters and say call an OT. This may be one of those things that just isn't "his" best thing.

Like you said, you don't like puzzles... some people don't like math vs science, etc.

The OT will be able to let you know if this is just natural dislike or if there are some sensory related exercises that could help him handle the frustration.
:) Becky
(http://stinkylemsky.typepad.com/)

Call the OT who's worked with him before and ask about it. There is no possible downside to doing so. At the worst she says "Don't worry about it," and you go on your merry way.

I wouldn't be concerned about the dislike for puzzles, or about the frustration. (I have an easily-frustrated son too. It's just part of his personality.)

I would, however, look into the stiff hands and splayed fingers. That sounds uncomfortable and problematic. And yes, fine motor skills are important. (Think writing, typing, etc.)

Good luck! :)

Do you think this is SI or a seperate issue? The splayed finger thing sounds like he may not like the texture? (I remember that I never liked board puzzles much because I didn't like the smell of the wood).

Since he's had a history of issues I think probably it's best to check in with the OT. The OT has a professional duty to tell you if he's fine, and if he needs something the sooner the better in most cases.

Totally random but very personal story:

I had terrible fine motor control as a child. Just awful. As a result, my handwriting was just terrible. For years it was a constant battle. I never learned cursive. As I grew up, my handwriting eventually became ok, but never great.

Flash forward to college, where I decide I want to learn to speak Russian. Come to find out that that means writing in Russian cursive. I cannot even tell you how hard this was for me - since I'd never learned normal cursive, or worked on my writing. It was a nightmare.

Please have Adam evaluated for a spectrum of issues, including an autism spectrum disorder. You have raised many concerns in the past few years, and they could be adding up to more than just SID. Do not procrastinate any longer. Said with much love, but much concern.

Fine motor skills are very important--get thee to the OT!

Tertia, my youngest has SID, like Adam, and we did OT for a year. She was discharged but we still do both gross and fine motor work every day. Do playdoh, hide marbles in shaving cream and have him fish them out, thread beads onto pipecleaner, do the Kumon books - these are some of the things that we do.

I agree with the above - if you don't address it now, it'll snowball. Good luck!

Another vote for OT, from a mom whose DD has SID.

I vote for OT. All my kids get OT, even the one who is great with puzzles, but he has other sensory issues.

I would say to have him evaluated. Can't hurt, could help.

Whether or not Adam likes puzzles or can do puzzles "in general" is immaterial. If he can't do them and/or doesn't like them because it's too hard to get his fingers to cooperate as they should, then I think that could be a problem. (It sounds like you've already noticed that his frustration is with physically manipulating the pieces -- if someone works with him, can he direct them where to put pieces? Just a thought ...)

Anyway, if he were my kid, I would get him looked at and probably do some practice fine motor stuff at home. Fine motor skills matter a lot, because in a couple years he will be learning to write. This will be very tiring and frustrating if he isn't at a normal spot with fine motor -- his hands will hurt and he won't be able to write as quickly as he's thinking.

It's funny actually -- I have a dear friend whose child "hated" puzzles as a toddler, and now in 3rd grade has a firm diagnosis of fine motor issues. The school lets him type on a laptop to write papers, and then he really shines in his writing. If they make him write by hand, it is a huge struggle and he produces very little actual writing.

I don't know about fine motor skills but being on a chart where everyone in the class can see that you are way behind is a disaster in the making. My son's saddest day ever was when his class was doing standardized tests and he realized that everyone else was done while he was on the first page. He stood there with tears in his eyes and said, "Mom - don't even tell me I'm wrong 'cause I know. I'm the stupidist person in my class". My heart still breaks thinking about that. He was 7!!!

So - tell the teacher to get some puzzles that are appropriate for a kid with fine motor skill problems or change her standards so that Adam's problem with this doesn't stick out like a stiff, sore thumb.

I would probably have OT looke him over if he were mine-- but I might not start on therapy-just to have them help me with things that would help--better to get help with him early rather than wait.

Both my boys have had OT for years. We love it. It rarely feels like work to them, they really enjoy the activities. OT will definitely help Adam, and he'll likely love the one on one attention. OT has really helped my younger son who has sensory issues. If you can swing it....do it! It's very very worth it.

I knew what that chart would say before I looked at it and I think it's a boy/girl thing. My girl at that age was much more advanced than my boy. And, I think that is all it is with Adam. But, if you'll feel better having him checked than do so.

Your mind will be at rest if you consult an OT, so I would do that initially. Looking at the chart, although Adam is low down, he is not the only one there - looks like one child hasn't done any?? Or am I reading it wrong? And there are a couple of others who don't seem that bothered with the puzzles from looking at their scores.
A little sad that the school is so comparative though, it could be very discouraging for Adam as one commenter noted.
Adam is lucky to have you as a mum looking out for him.
Does Marko like puzzles, maybe Kate is a Daddy's girl and Adam takes more after you...

An OT will be able to give you exercises you can do at home, AND probably hone in on what difficulties he's having specifically... is it gripping? Matching up with the hands and the eyes? Muscles too slack? Muscles to tight? Etc. etc.

It's worth giving him things to practice (cutting thick paper, lacing cards, etc), because as he gets closer to school age, fine motor skills do become important.

Even toys like Mr. Potato head are good fine-motor builders. A friend of mine who worked a lot with the preschool set had a peanut butter jar (empty) that she'd cut a slot into the top like a piggy bank, and she'd have kids pick up and insert poker chips for some fine motor practice.

There's lots of easy things you can do beyond puzzles. It's probably worth the consult.

Boys sitting peacefully doing puzzles? I'd bets that the other names erased that haven't enjoyed doing puzzels are boys too?

My girls might give them try, but my son was not interested and he is now a straight A student.

If your gut says worry then make the call otherwise leave him to get involved with stuff he loves for now.
Take care.

Hi,Tersh. Teacher here. His fine motor skills will come in time. Don't stress about this! Every child develops at the rate at which they are supposed to develop. Think back to when they were babies - what if Adam had rolled over two minutes before Kate did - would you have panicked and called in the National Guard to stage a "Rolling Over Intervention" for Kate? (Well, actually, YES, you would have, HA! ;)Don't call the OT about this. Breathe deeply. Here, have a sip of wine. It's OK!

Hey T! As a grade 2 teacher, there is nothing like early intervention but no need to panic. Fine motor is important not critical but if it's not sorted out, children with poor fine motor generally write slower, often don't finish work because it's a mission and their fingers don't work as well as evryone elses! Play dough is great for them to play with just to get those little fingers moving.
I do wish all mothers would be as concerned as you are, often they think we're overeacting!!! You are brilliant, but of course you know that!!!

T, for me it's not so much about the puzzles but about the other fine motor activities- as you and others have said- maybe the thought of doing a puzzle bores him to tears- I'd stil get an OT assessment though!

At first I thought "no harm calling the OT" like many others ... but I liked Chickenpig's comment that if you run off to the OT every time Adam is a bit behind, it could make him feel badly/affect his self-esteem. Maybe give the OT person a call and find some ways to reinforce fms at home a bit? At least for 6 months to see if he catches up on his own.

I thought that chart was a bit tacky, though. No reason to make the kids feel bad by displaying their progress!!!

As a teacher - my first thought was EARLY INTERVENTION is key for improving or overcoming certain challenges. If you have the means to obtain help - by all means - do it right away. This is certainly not, not, not earth shattering - but if you can help ease the struggle, why not?

I would try home exercises first. When he gets into school, you will want him to have some higher abilities or he may get put into a special ed system that can slow down other aspects of his learning. If he needs it, that's fine; there are some great special ed programs. But if one aspect can pull his whole learning down - which in my experience has happened a lot - this is something to work on. There's tons of writing, drawing, configuring, etc. in school, and he may not like it, but part of life is fine motor skills.

That said, get puzzles of pictures he likes. Pick crayons suited to his hands (ie: really fat, really slim, etc.) and make it fun. Let him help pick out what puzzle to do, buy, etc. If he gets excited about these skills, he may do better with them. Just try to think of activities that teach him how to get comfortable utilizing the abilities of his hands, and don't be afraid to start small. You might just start out finger painting, getting him to make a face, then a tree, then a full body, and so on. The bottom line is you have to start somewhere, so make it fun and realize patience is a virtue!

I'd get him in soon too. I will say that my oldest boy had quite a hard time with fine motor skills and frustration. Turned out to be ADHD and obsessive disorder. Either way, if help is available use it!!!

Wow, some serious advice going on. Enough to make me lose myself in a few bottles of wine if I was in your shoes :)

Please PLEASE take a wholistic view of Adam's situation. Going off the deep end every time he is 'different' or 'other abled' ( kinder label than disabled!) WILL give him the idea that he is faulty and incapable. But, leaving serious stuff undiagnosed will likely lead to lifetime problems. Talk to someone who can give you an overall view, WITHOUT involving him in any way.

Also, whatever you do, make sure that Adam gets the message that it is ok to be different. That it is ok to have different skills and interests to the other kids. That the world will not end because he can't do some stuff as well as somebody else does. Celebrate his 'Adam-ness.' Not being able to write as well as other kids won't make his life a complete failure. Feeling that he has a lower value than others because he cannot do things as well as they can WILL hurt him immensely.

Being different is not bad in itself; neither is being behind others (who determines what is bloody well behind and what isn't? ) is not bad.

I had learning difficulties at school that were undiagnosed until was in my 30's. This lead to being labeled difficult and lazy, and being a 'naughty girl' much of the time. By the time I was 12, I was truanting on a regular basis, and unable to complete most classroom tasks, let alone homework. I flunked out at 14, and ended up in menial low intelligence jobs.

However, I ended up in therapy in my early 30's, and addressed my past. For the first time I queried the 'labels' and dismissed many of them, graduating from university with a degree at 38 years of age, finally knowing my learning style; FINALLY knowing that i may not learn the same way as others do, but that I can learn - MY WAY.

The learning difficulties themselves were not the problem; BUT the LABELS stuck, and they permeated my entire being. I ended up with huge behavioural problems. The labels shaped my self-perception and affected my life profoundly, predicting the problems of my teen years and my first unpleasant and violent marriage. I saw myself as flawed and damaged, lower than anyone else, and really believed myself to be dumb and useless. I did not feel entitled to ask for or to seek anything better. This leaked into the way I managed my own children; fortunately they have questioned any negative labels they have acquired at a much earlier age than I did.

As a kid, and as an adult, I needed the skills to be able to ask for help; to be able to say 'this is difficult for me, or impossible for me, please help me.' But, the labels that I had acquired so early in life prohibited that. And I was so often punished for getting it wrong. Charts in classrooms can be a huge punishment for kids like me. a constant sign that I was not up there with the other kids.

My parents did not notice the learning issues I faced. I got hidings for fidgeting, and told off for constantly asking why; belittled when I did things differently to my standardly bright older sister. I ended up with shingles at 7 because of the profound stress I was under.

The key for me has been seeing myself, my different-from-others self, as valuable; seeing myself as other-abled, but also as OK. Knowing that I don't respond the same way as other people, that I don't acquire knowledge via the same paths, but that my way of doing so is right for me; that it is OK to be completely unique in feeling or thinking or doing something the way I do.

Adam is so lucky, you already see him as different, and you know that he has an alternative path to learning than Kate does. But, please don't make the mistake allowing him to get the feeling that he is flawed and faulty because of this. He is different for sure.

Let him hear you say (and mean it) 'who cares' when he gets things wrong. Let him see you model acceptance of mistakes and flaws in yourself - which you do so beautifully through this blog - let Adam see the flawed and crazy and off-beat Tertia who loves herself, crazy anal perfectionist procrastinator huge-hearted ego-maniac humanist profound thinker that you are.

Let him see you celebrate yourself - as different as you are - with all the learning and sensory difficulties you have - you are OK.

He will be fine; why, because his earth shaking tiger-mother will make sure he is.

He is lucky you know him so well. And so are we. You invite us to share your life and your concerns, and in the process of so doing, little bits of personal healing and awareness take place.

Thanks T. I would hug you if you didn't wanna barf at being touched! How about I just raise my glass to you instead? :)

Feeling as though he is less than others because he can't do what they can do IS bad. Believing that he is stupid or dumb or clumsy is also harmful.

Whatever action you take, tread softly

Tertia, I am an OT and truthfully, earlier is generally always better. I did not read the earlier comments but the longer you wait, the more time the child has to develop adaptive behaviors that have to be changed in addition to addressing the underlying problem. Furthermore, he falls behind on the super important skill of puzzle completion (yes, kidding) and may begin to lose confidence in himself.
Good luck,

Elizabeth

I'd call the OT - it falls under the couldn't hurt, might help category.

Take him to the OT and book immediately. My autistic four-year-old has that very same problem. After a year of hard work with an educational therapist we have only gotten as far as "will accept help with puzzles without screaming in frustration." Not "can now complete simple puzzles" but still, better than the kid trying and trying and trying and destroying the puzzle and everyone's piece of mind.

Not sure where you're based, but there is an absolutely brilliant developmental physiotherapist in Newlands -- eina-expensive but I have seen her work wonders with kids who have serious developmental problems as well as my own elder daughter's motor skills. And, to add to the comment above re. video games etc, she has strong opinions on the need for kids to do lots of whole-body play in three dimensions, for very non-obvious reasons like being good at maths later on. She says if you can't manipulate objects and yourself in space you'll never get the abstract math stuff, so the neural pathways they're laying down while building forts, climbing trees etc are irreplaceable. Mail me if you'd like contact details.

Fine motor skills are important for writing, tying shoelaces, buttoning buttons, picking up coins, and even typing. All very important skills in everyday life. Your OT will be able to give some wonderful therapies that can be fun for Adam. But you already know that.

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