Sunday 13 January 2013

A Little Bit Dyspraxic

Last year we started the process of getting Sam observed by medical professionals to see if he was considered dyspraxic (or having Developmental Co-ordination Disorder, the new term for it), and to get him (hopefully) some Occupational Therapy help with his hand - he's unable to make a pincer grip without it causing him pain and discomfort which means he holds a pen in a rather unusual manner.

One of the problems with dyspraxia is that it is difficult to diagnose - so many symptoms of the disorder are very much part and parcel of being a six year old boy: clumsy, lacking focus, disorganised etc.  This is Sam in a nutshell, but throw into the mix the problems with his handwriting, his previous diagnosis of verbal dyspraxia, the fact that he had no real friends and often displayed a lack of empathy, we felt we had grounds to worry.  All of these are classic symptoms of the disorder.

That said, in the year since we started this, many of these fears seem to have been allayed somewhat; in Year 2, Sam started to get invited to birthday parties, he brought home friends for tea for the first time, we heard from his teacher that he was a popular boy in class.  His Year 2 teacher seemed much less concerned that his handwriting was poor, taking the long term view that with the increasing prevalence of computers and tablets in school life, Sam is likely to type rather than write most of his schoolwork.  But his handwriting was still an issue, if only because we didn't know whether he should be attempting to write with the "correct" grip as his previous teacher had insisted on, and if so, how to get around the problem with it hurting his hand.


We went to see a senior OT specialist at the hospital and spent a highly interesting 90 minutes discussing what Sam can do and what he struggles with, and what can be done to help him.  He performed a variety of tasks for her, did some writing and generally chatted away to her in his usual disarming manner.

The headline that I brought away from the meeting was that he doesn't warrant a diagnosis of DCD  as they only give these to children whose quality of life is seriously affected by the condition. (This probably boils down to the fact that a diagnosis has a financial implication somewhere along the line.)  That said, it was recognised that he does have difficulties acquiring new skills that require co-ordination, and to do so will require extra effort and motivation on his (and our) part. So, a little bit dyspraxic.

I did come away with some interesting ideas and tips about how to help him with non-school co-ordination tasks like riding a bike, swimming, and using a knife (to cut his food, not to join a gang or anything).  And I suppose that when he does have a new skill to acquire, we'll have to do lots of research beforehand to find the best way for him to approach it.

What was interesting, and totally contrary to what his Year One teacher had said is that he shouldn't be made to write with a pincer grip, but to be allowed to write in a way that is comfortable for him.  I was expecting to be given fancy pencil grips and OT exercises for his hand to enable him to achieve the requisite grip, but it turns out that guiding his pencil using his middle finger is perfectly acceptable as it is still controlled by the radial nerve.  If he had used his fourth or little fingers to guide, that would have been an issue, as they are there to steady the hand when writing but the using the middle finger is fine.

This leaves me with some irritation at his teacher for making him do something that would have caused him pain and discomfort; as the OT specialist said, it was worth coming to see her just to have this dealt with.  This means we can start working towards improving Sam's handwriting without worrying that we might be making his hand hurt; that fact alone is very reassuring.

If these things follow the same pattern, OT will write up a summary of the appointment and pass it to the relevant parties (GP, school, me) and I'll definitely be hanging on to it for future reference.  Having some experience of the lack of communication between Infants and Juniors, I can already envisage a situation in the future where I have to go and bitchslap a teacher who insists Sam holds his pen "correctly" or a sadistic PE teacher who shouts because he can't throw or jump or co-ordinate a series of actions.  But that is all in the future.  For now, we're in a good place that we can move on from without too much worry.

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