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    Joined: Aug 2010
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    DS7 was considered quite low tone as an infant and we went through a lot of testing and medical hysteria as a result. Nothing was ever found and after some time in PT, he made some big improvements and walked on schedule. He is now a fairly athletic child who nonetheless fatigues rather easily and is clumsier than typical with small motor tasks such as eating and buttoning/zipping. His handwriting is okay, not great, and slow. Art skills are average to low average. I find him hard to assess because DD was extremely advanced in handwriting and art.

    I am having spend a little bit of time writing occasionally this summer because I know from experience that he is going to enter the gifted magnet he will attend next year behind his classmates in writing. Expectations are high for writing in the program. One thing I notice is that he lays his head on his desk or rests his head on his hands almost always whenever he writes. When asked, he says he it makes him tired to write. He says it's not his hands, but it's hard to sit up. I suspect low tone is still there and is interfering with his writing ability. Wondering if anyone has dealt with this. I think what he may need is some core strengthening exercises? The tricky thing is, he is doing well enough that he is unlikely to qualify for anything (he can write some nice sentences with lovely vocab that make sense, but it takes him a long time and he flops and slumps and looks physically ill at ease).

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    We are doing a summer bout of OT with DS4 and core floppiness is one of the issues we are addressing.

    He compensates for it - but when evaluated he was ... well, floppy.

    Maybe working with an OT or PT could help. Some of the things we do:

    Have him throw balls "soccer throw in" style (over head with both hands) at targets to make it fun.

    Slam things on the floor from overhead (we have some 14" soft medicine balls - we may still get the 2 pound one as the 4 pounder is a bit much. Even pillows or other balls will work - we play "boy hulk" and slam away).

    Using the same balls as above we do "walkouts" on the hands (child lies on ball on tummy with hands on floor and walks out).

    Any kind of sled pushing exercise (you can get scooter boards with wheels for this).

    Maybe t-ball (to make it fun you can hit anything off a t - old plastic bottles, small boxes etc).


    Last edited by cmguy; 07/23/15 08:20 AM.
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    Thanks--we are assessing and treating several other things in the family right now (!), so I'm hoping to try some things at home for the moment. I am thinking maybe I can work up a little workout for him. He'll probably think that's fun.

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    We had an OT eval for much the same thing, and we were given a bunch of core strengthening exercises. You might be on the right track given the other things you describe.

    The recommendation didn't really make sense to us - he can swim 50 yds of butterfly, but has insufficient core strength? DS doesn't really tire that easily, either. However, DS would also describe the feeling of being tired when writing. (We since have a dx of dyslexia and dysgraphia, so the tired feeling in our case may be due to the mental effort required in writing.)

    We got the biggest bang for our intervention buck by making certain that the seating arrangement was at the perfect height and the feet were comfortable.

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    I've seen OTs have children write, draw, or exercise other hand skills when laying prone, propped up on their elbows.


    ...pronounced like the long vowel and first letter of the alphabet...
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    geo, doing butterfly and weak core strength are not mutually exclusive... a lot of issues with core can be coordination, balance and/or endurance. Swimming is a good exercise but does not cover all areas of core strength at all (not even butterfly). It means he can do well in what it takes for butterfly - but still have weak core in other areas - including sitting to write.

    From the session I watched with DS's OT, it is not one set of exercises but a wide range of seemingly unrelated excersises to cover the many areas that falls under the general "core strength".

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    We have also started target shooting and archery (albeit with NERF guns and arrows). You have to stand up straight and hold a posture for these to be accurate.

    For older kids old fashioned jumping rope might be good too.

    I was surprised by the core strength deficit. I was expecting fine motor issues but he was fine there. It's interesting the things that can turn up from an OT eval.

    Last edited by cmguy; 07/23/15 08:39 AM.
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    DS7 has DCD and also has trouble sitting and writing. The OT suggested to make sure he has support for his feet (i.e. feet not dangling) - this seems to help a lot. Also taking mini-activity breaks during a task seems to help.

    She also suggested doing a little warm-up before doing a task like writing. Some of the suggestions were:
    * Push on wall as if to move wall
    * Lean on desk for “desk push-up”
    * Do “chair push-up” in sitting by lifting bottom off floor or chair, holding self up with arms
    * Weight-bearing through arms via wheelbarrow walk, crabwalk, bearwalk, etc.

    DS was doing some core exercises at school this year, but I don't know exactly what they were. He enjoyed them though.

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    Originally Posted by notnafnaf
    geo, doing butterfly and weak core strength are not mutually exclusive... a lot of issues with core can be coordination, balance and/or endurance. Swimming is a good exercise but does not cover all areas of core strength at all (not even butterfly). It means he can do well in what it takes for butterfly - but still have weak core in other areas - including sitting to write.
    Interesting, and point taken. However, we really don't see much of anything that indicates core strength or endurance problems ~ swimming is just one of the areas we see strength. I watched the evaluation, and I'd agree that maybe coordination was more the issue, as he was able to do the exercises with ease beyond the goals set. However, all the exercises were strength/endurance based, not coordination, as the performance in the evaluation looked like a lack of strength. Maybe we just got a shotty OT eval? It wouldn't be the 1st time in our experience...

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    ultra, our older dd had low core muscle tone when she was younger - one of the recommendations from her OT was swinging - does he like to swing?

    I also think it might be worth asking for a med referral for an OT eval - although the issues you're seeing are most likely not severe enough to qualify for school services, if he had medical concerns and low tone as a younger infant/toddler, I'm guessing you could get a follow-up OT assessment covered through insurance now (citing the concerns you've noted), and even if it didn't result in a referral for therapy, it might help you unravel what pieces of core strength needed work, and the OT might be able to give you a list of suggested exercises that would be focused on your ds' specific needs.

    One other not - spaghetti mentioned vision. Our dd also did the head-laying down thing when she was having trouble with her eyes, and writing does make her extra tired when she's having vision issues. When she was your ds' age (just prior to her vision diagnosis), she also had sloppy handwriting, was a really messy eater and was rather clumsy. Addressing her vision issues resulted in neat handwriting, and a much cleaner place at the dinner table, as well as many less "bumps" and clumsy issues.

    Best wishes,

    polarbear

    eta - one other thing that helped with sitting up straight when dd was your ds' age was to sit on a big ball rather than a chair.

    Last edited by polarbear; 07/23/15 10:35 AM.
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    My older DD20 had low muscle tone as a baby. She crawled late and only after a 6 weeks of physical therapy and didn't walk till just outside what was considered "normal' at 19 months. What the physical therapist who worked with my DD at 1 but I imagine both these things will work at 7.

    Swinging -- A simple outside playground swing without any back support. Just like any other exercise he might not initially like swinging if it's tires him out. But he can build up. Do you have sings in a local playground, can you put one in your yard?

    Ball Pits -- You know those pits they have at IKEA, or you can rent at a party? My DD's PT used a similar type ball pit. We actually bought a small blow up one at a party when my DD was a preschooler.

    I knew my DD wouldn't qualify for PT after her she started walked. But I did enroll her in dance from 3-10. Took a while but I found a wonderful teacher who was happy to work with even the clumsiest kids. While many bosy might balk at dance classes, gymnastics or a parcour gym might be a good alternative.

    P.S. I would think swimming would also be a good for developing core muscles. Can you son swim? Does he enjoy it?

    Last edited by bluemagic; 07/23/15 12:07 PM.
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    Thank you for so many helpful posts! I knew this board would have great suggestions. I will try these.

    I have wondered about vision. His table manners really are bad and sometimes I feel like he is just not...able to do it right. He could be described as somewhat clumsy, with a tendency to fall and stumble. He drops stuff and doesn't pour, snap, or button very well. On the other hand, he can hit and throw a baseball quite well, and he's above average at soccer and a good runner and a good swimmer. He is also an incredibly good reader with no issues with fatigue at all--he will read small print for hours.


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    As a child I was very athletic but I used to rest my head on my desk while writing because I was bored. The work I was doing just wasn't interesting so I preferred to watch the pen/pencil mark the paper from very close. Sounds strange but I did this from elementary to high school.

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    Originally Posted by ultramarina
    He is also an incredibly good reader with no issues with fatigue at all--he will read small print for hours.

    Does he have good posture when he reads, or does he bend his head around, look at the book from an angle, hold his head close to the book etc? If he doesn't do any of those, I'd most likely guess vision isn't the issue.

    The things you've mentioned that could be vision could also be motor-related too. It's all such a puzzle! Another OT eval might really help smile

    polarbear

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    Originally Posted by polarbear
    Does he have good posture when he reads, or does he bend his head around, look at the book from an angle, hold his head close to the book etc? If he doesn't do any of those, I'd most likely guess vision isn't the issue.

    A really good point, but just a warning though - our ornery DD didn't do a single one of the usual signs (which is why I took so long to check out visual processing). But wave a pencil around in front of her eyes, and you can easily see the chaos.

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    Originally Posted by Platypus101
    Originally Posted by polarbear
    Does he have good posture when he reads, or does he bend his head around, look at the book from an angle, hold his head close to the book etc? If he doesn't do any of those, I'd most likely guess vision isn't the issue.

    A really good point, but just a warning though - our ornery DD didn't do a single one of the usual signs (which is why I took so long to check out visual processing). But wave a pencil around in front of her eyes, and you can easily see the chaos.

    Good point smile FWIW, the "waving a pencil" test is something you can do at home easily. It is only one clue and if it's ok that doesn't mean there *isn't* an issue - but otoh, if we'd ever known to do this we would have right away known that something was up with our dd's vision. There are different things you can do with focusing on a pencil, but one that was really obvious for our dd re tracking (or lack thereof lol) was to hold a pencil up about 3 feet in front of her, slowly trace a circle in the air (parallel to her standing body, not parallel to the floor, diameter approximately 1 yard). Have your child follow the tip of the pencil as you trace the circle and watch his/her eyes. Do they track together or do they diverge? I honestly just about freaked the first time I saw what my dd's eyes did with this - they followed for about 1/4 cycle and then looked off in two completely different directions.

    polarbear

    ps - another clue re reading and vision - our dd hated reading and wasn't progressing *but* she could read and had been tested so we knew there weren't any reading-related challenges. What we noticed was that when she read aloud to us, she would read a-ok for a bit then stumble across a really easy word that we knew she should know (something like "new" yet she could read longer more complicated words). I think that visually it was easier to put together a longer word than a short one when she was having difficulty focusing her eyes together. She also skipped lines and got lost on the page occasionally. I suspect that for a child who's verbally advanced and motivated to read, the ability to synthesize meaning from context could make up a lot for small details they were missing visually while reading.

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    Quote
    Does he have good posture when he reads, or does he bend his head around, look at the book from an angle, hold his head close to the book etc? If he doesn't do any of those, I'd most likely guess vision isn't the issue.

    He doesn't do any of these things. OTOH, he doesn't sit up nicely and read. He is almost always lying down. He is a chronic leaner and flopper as well. He will still want to sit on my lap at any lengthy event so he can flop all over me. Though he is not your classic "boy who can't sit still" (not "hyper"--he will sit quietly and read or play chess in a room full of kids running around and screaming) he also is not stationary for long, constantly readjusting his body to lean, flop, rest and lie prone in new ways.

    I will try the pencil test. I asked him yesterday if his eyes ever bother him, if anything is ever hard to see, blurry, hard to focus on, etc and he looked at me like I was insane...but IDK if kids know when they have these issues.

    Re reading, he does skip/substitute small words sometimes or lose his place, but last years he was tested at 190 correct words per minute (age 6) so he's doing pretty well! He LOVES to read...it's his world.


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    Some of that sounds like my DS - his favorite place to sit is on me. He has a very hard time sitting in a chair (although better with feet supported properly). Not 'hyper' but needs to 'lean, flop, rest and lie prone' - exactly!

    DS never complained about his eyes, and when I asked him if his eyes ever hurt or he saw double, he told me no. Yet he has a convergence insufficiency diagnosis. I think that he _can_ team his eyes together but he gets tired. So, tiredness is mostly what he complains of when reading.

    DS also enjoys reading but gives up quickly. Although I doubt he'd get anywhere close to 190 wpm reading aloud.

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