Back to handwriting problems....child issue
Net1964
My 8 year old has very bad handwriting. It has always been bad despite
Occupational therapy, practice, or whatever. The problem is that on occasion a
"window" of decent handwriting opens up but as quickly as it was opened it is
closed again. However, all of his teachers now think he should be able to
write decently all of the time. He did it before so why can't he do it now
kind of thought. He just isn't trying, he's being lazy, he just doesn't care
enough (yadda yadda yadda). I know all of those thoughts are plain wrong. He
does do the best he can and he is trying. How can I get through to them that
the window will stay open when he has fully developed the proper control?
Until that day they should just be glad that the window will open at all. I
have explained this to them until I am blue in the face but they just don't get
it. How can I explain this to them so that they will get it? Thanks all.
Nannette
BB2
seem to indicate that visual-motor integration deficits -- showing up as
handwriting difficulties -- may actually be a hallmark of TS. Or to maybe even ask
them to give him the Beery or other tests of VMI ... There is an entire chapter in
Leckman's new book, but I'm not sure if the TSA has a brochure or something that
you can put in front of the school to convince them that it truly is part of him --
not laziness, etc. Even if the TSA does have a brochure, I think the more recent
neuropsychological findings may be better summarized in Leckman's book, since it is
so recently published. My son also has these "windows" where his handwriting is
much better, but it's quite possible that that "window" will never stay open as
long as we'd like it to. How about calling TSA to ask if they have any brochures?
Always, BB2
Net1964
>seem to indicate that visual-motor integration deficits -- showing up as
>handwriting difficulties -- may actually be a hallmark of TS. Or to maybe
>even ask
>them to give him the Beery or other tests of VMI ..
Been there did that.........He had a full in school and private OT eval. I
have given them the flyers from TSA on handwriting. They just can not get past
the fact that they saw the window open. They thought that was that and his
handwriting problems are over....wrong.
Nannette
BlessedBy2
>have given them the flyers from TSA on handwriting. They just can not get
>past
>the fact that they saw the window open. They thought that was that and his
>handwriting problems are over....wrong.
>
>
>Nannette
ah, Nanette, I see the problem :-) Yes, my son too has days, and even longer
stretches where his handwriting seems fine, and then it deteriorates somewhat
again ... I'll look in the Leckman literature to see if there is anything that
will help convince the school ... studies or any words describing why this may
happen. Take Care, BB2
BlessedBy2
>will help convince the school ... studies or any words describing why this
>may
>happen.
OK - this is all I could come up with, and I'm not sure if it will help, but
it's worth a try. This is based on a model that is presented in the
Leckman/Cohen book which explains all of the components of VMI (visual-motor
integration), which is necessary for smooth handwriting. I hope it is OK for
me to present a model, which is not quite like a hypothesis. (Leslie, can you
please jump in here and explain how the word "model" should be interpreted in
this sense? I don't want to get into trouble again for trying to present
helpful research, but I don't know how to explain the limitations of presenting
a "model" ...)
Anyway, the reason I present this is that if there are FOUR different
components which need to come together for visual motor integration, then
possibly the child can have days ("windows" as you called them) where, for
example, two of those components are working better, leading to better
handwriting during those "windows." The components of motor inhibition and
sustained attention are probably components that are variable (that's me
talking, not the book) -- and on the days when the child is having less of a
problem with motor inhibition or sustained attention, perhaps the handwriting
can improve temporarily.
In other words, handwriting may be variable depending on how much the child is
ticcing or suppressing tics and how his sustained attention ability is that day
.. again, that is me talking, not the book ...
p. 86
"Tests of visuomotor integration are compound measures, calling on
visual-perceptual ability and fine motor coordination, in addition to the
integration of visual-perceptual analyses into motor programs for successful
performance (refer to the figure 5.1) Deficient visual-motor integration could
be a function of suboptimal capacity in ONE OR MORE (emphasis mine) of these
component processes. An important issue, therefore, is whether individuals
with Tourette's syndrome have difficulty in these more rudimentary component
processes that could explain their visuomotor integration performance, or
whether the deficit is specific to the integration of visual and motor
processes. In addition to spearate visual and fine motor processes,
performance on tests of visuomotor integration also requires intact sustained
attention and motor impulse control. Vigilence and motor inhibition are the
two pillars of attentional ability. Effortful maintenance of attention is a
prerequisite for adequate performance on any test. Motor inhibition can be
distinguished from fine motor coordination during a copying task in that the
latter refers to the continuous coordination of the small muscle groups
employed during a skilled pencil movement, and motor inhibition refers to both
the cessation of activity when appropriate and the delayed onset of activity so
as to allow for planning of the motor sequence. Thus, at least FOUR SEPARATE
(emphasis mine) subprocesses may contribute to visuomotor integration ability:
visual-perceptual processes, fine motor coordination, sustained attention, and
inhibitory motor processes."
Then they go into lengthy discussions of each of these components, examining
which seem to be significantly affected in persons with TS (significant in the
statistical sense) and how each of these areas relates to the overall VMI
scores obtained by samples of children with TS -- they look at the role of the
basal ganglia in the underlying processes, and they discuss executive function,
showing that the shift (difference) in children with TS is slight, before
concluding:
p. 101
"The shift is small enough that the majority of children with Tourette's
syndrome performed within normal lmits, broadly defined. However, there are
practical implications for these findings. Many children with Tourette's have
great difficulty with penmanship, and this is likely a direct manifestation of
visuomotor integration difficulties. The consistency with which drawing
difficulties have been observed acorss all studies in the literature suggests
that this domain of functioning be routinely assessed for all referrals with
Tourette's syndrome ..."
So, even though the children may technically test within normal limits (as
Leslie mentioned on another thread), the shift may be small enough to be having
an impact. So if your school claims that your son tests within normal limits
for VMI, that doesn't explain it all. (I think my son tested at 58%ile on
Beery, and the neuropsych called that "normal" ... maybe it is, but it's not
commensurate with his other abilities.) Anyway, maybe knowing that there are
four different things that go into VMI helps explain why there are "windows" of
days with better handwriting.
Leslie, I put your name in the subject line, hoping that you'll see this and
check my logic !
BB2
Cansas
Hi BB2,
I just want to say how blessed I feel to have run into you on the net and on
aol. You are such a loving and giving woman. I am constantly amazed at the
time that you take to type all this info out. You have helped me so many
times. You were a ray of sunshine in the midst of the storm that I was going
through. Thanks so much for being you. Thanks so much for taking the time
with us newbies. I desperately needed to hear your words.
Blessings,
Candice
Phil Schrantz
year old son with Chronic Lyme Disease and Tourette Syndrome. He has had
the neuropsych evals done and has the motor-visual integration problems
which show up as horrible handwriting. He is a little clumsy, but has good
fine motor control (been playing violin since he was 4). I have never had
motor-visual integration problems explained so I understand what is wrong
with the brain. I don't understand why we can't train the brain to re-wire
itself and develop these centers or whatever it is that is damaged. If they
can treat stoke victims,( parts of their brains die), and teach them to eat,
walk, and talk again, why can't we train the brain to work properly with
these problems? OT, practice, and keyboarding do not help my child. I
guess speech recognition programs are next, but since he's pretty smart and
not far enough behind in school, I'll get to foot the bill. Junior High
comes next year and I'm very afraid he won't be prepared. Any help will be
appreciated. Thank you.
Net1964
>it's worth a try.
Thanks for your response to my handwriting post. I printed your model out and
am trying to write it up in terms the school can understand (piece of cake
right <grin>). I meant to thank you sooner for your response but got side
tracked. (sorry)
Nannette
J Valencia
can tell you two major differences. 1) Stroke is an example of sudden
trauma. You were "normal" before and quite suddenly you're not. But you
retain the memory of having been proficient to serve as a baseline to
regain prior skills. A weak arm may keep you from getting a spoon to your
mouth but you DO know how it's done. It's an old skill, being re-learned.
TS, on the other hand, a developmental disorder.....occurs at the time the
child is striving to achieve brand new skills. He has no baseline memory of
how to do it. It's easier to re-learn something that you did well for many
years. 2) Another major difference is that give or take the proverbial
"bad day," when I get up each morning, I can pretty much depend on the fact
that my remaining deficits are going to be the same as they were
yesterday.....and will probably be tomorrow. So when I go through the OT
process, my abilities are likely to steadily improve. TS is not that
reliable. Symptoms and abilities wax and wane....not just over weeks or
months, but sometimes from hour to hour. The child with TS who writes
beautifully Monday morning, may scribble on Tuesday with the same effort.
This makes the OT results harder to assess. (I don't know that there's been
any study of Occupational Therapy benefits for the child with TS.) Even if
a child's progress continues to wax and wane, OT offers a structured time
and place to work on these skills in a setting most children find "fun,"
with the additional benefit of extra one-on-one with yet another caring
adult. My son also played the violin well as a young child....but
Tourette's seems a syndrome of contradiction....and gifted as he was in
music....other skills of daily living were dramatically impacted by motor
deficits; and even with childhood OT, some deficits remain today at age 22.
You would, for example, have no difficulty recognizing that Jason just
shaved this morning! If your son has an IEP in place, you should be able
to get OT services for him at school. If not and you pay for it, you might
want to make a list of areas that you identify as "clumsy" or specific
skills that he chooses as ones which could make his life easier. Then after
the initial assessment, ask the OT to work just on those listed areas.
Others may have different input on keyboarding, but I have to say that as
important as writing is to Jason, we knew early on that he was never going
to master correct fingering so we didn't frustrate him with continued
efforts in that direction. Instead, we left him to develop his own method.
He uses four fingers, hunt-and-peck fashion, and he's both fast and
accurate. One strategy that does apply equally to TS and to stroke recovery
is .....first you try rehabilitation; if that fails, you resort to
adaptation. Jeanne Valencia
Phil Schrantz wrote in message <78drch$e...@news.voyager.net>...
> If they can treat stoke victims,( parts of their brains die), and teach
>them to eat, walk, and talk again, why can't we train the brain to work
>properly with these problems? OT, practice, and keyboarding do not
>help my child.....