Gifted Issues Discussion homepage Forums Twice Exceptional Motor planning questions

Hi,

My daughter seems to really be benefiting from her OT. It is for motor planning only. I am self paying (which isn't easy for us), so I have some questions.

1) Does your school provide OT to students who test highly on academic tests (the motor planning primarily affects social and emotional). They're not getting grades yet and teachers just think she's not trying or caring. If you can get OT what did you have to do to get it? Is private worth it, even if it is difficult to afford? (We are paying $200 a week.)

2) Is there a difference between poor motor planning and dyspraxia?

3} Has the OT helped your child in school? If so, how?

Thanks

Also, the reason for question #1 is because the OT gave me some materials I'd like to give to the teacher, but they all mention that dyspraxia often includes delay or weakness in verbal processing/verbal skills and my daughter's big strengths are in the verbal area. I'm afraid if I give them this stuff they'll look at those few lines and think she's been incorrectly diagnosed because she doesn't fit that description. She has physical issues.

Hi. My son has dyspraxia - the neurologist calls is "Motor apraxia" He is very gifted verbally and it NEVER affected his verbal skills, speech or anything. As part of his dyspraxia (and EDS), however, he can not write (he has dysgraphia). He has been getting OT at school since Kindie. The private is WAY better. The school OT doesn't do much as far as I can tell. In addition, the school OT will tell me he is way better off than he really is (not sure why - but I'll show his private OT what the school's OT comments/reports and they'll cross their eyes LOL). Neither private nor school OT has in any way cured his dysgraphia. However, private has definitely been worth it and has helped his coordination and other things immensely. So, in order to get the school OT to be less of a waste of time, I insisted they start teaching him to type during OT. We'll see how that pans out.

I would just do a letter to the school describing your daughters condition and how it affects her. Explain how it your daughters case her verbal is not affected, etc. And give the materials with that.

Here is the catch with the federal law...(state laws might over ride this).

OT is a therapy that supports access to Specialized or Regular instruction for a disabled student. It isn't a primary disability. So if you don't have an IEP for some sort of primary disability where you are receiving specialized instruction, interventions and/or accommodations, then your regular run of the mill kid can't get it at school...and it has to be educationally relevant not medical per say.

Now if the disability is Physically Impaired then chances are the related therapies will include OT and PT to help access the education provided.

My state has education plans for the gifted and groups them under ESE. I did get an OT evaluation for my son and he didn't qualify for therapy but they did make a bunch of recommendations for accommodations. But she actually couldn't find any real reason why his handwriting is as delayed as it is.

My older son actually has hypotonia and is gifted but you can read his hand written stuff...he is just slower at it that the average bear... and now has a 504 which allows for extra time on assignments and testing as needed and allows for technology usage as needed (which isn't really so much as an accommodation these days because all the kids are using devices, it is more that a teacher can't say no, if they have a problem with technology, if he asks).

There are people who have Developmental Coordination Disorder (or dyspraxia) who don't have speech issues. The kid who plays "Harry Potter" (Daniel Radcliffe) has dyspraxia...you would never know it watching him in the movies.

I am not sure where you are located (in the US?)...but we ultimately had a neuropsych diagnose DS with DCD, then we took that eval to the school system and told them we want a school evaluation. They ultimately put him in the "physically impaired" spec. ed category, which is fairly flexible and he qualified for adapted phy ed, and OT (among other things--he already had a speech IEP). He gets regular phy ed in addition to the adapted phy ed. He had to test something like 1.5 or 2 standard deviations below the mean on a test of motor development to qualify for adapted phy ed (or DAPE). Has your DD had a test of motor development like the BOT? The private OT/PT did the BOT but the school did another test of gross motor skills where he scored even lower (I can look up the name if you want).
I have mixed feelings about OT and how helpful it has been. I think DS benefited a lot more from private PT than OT. Most of it I feel like I could have easily done at home myself. But we had insurance coverage and it's easier to get cooperation from DS from anyone but me, so we just went for it(we had an $18-23 co-pay so it wasn't bad). I did watch most of the sessions so was able to see that there was nothing magical about what they were doing, and was able to incorporate it into what we were doing at home. So that might be an option for you. A good OT will actively train the parents and give you exercises to do yourself, because most of the benefit will come from what is done at home.

In terms of your question about dyspraxia and motor planning, I think that dyspraxia can involve motor planning issues and/or coordination issues...so if a child has a problem getting their bodies to do what the want them to do, and they are significantly behind or impaired with motor skills compared to peers with no other explanation, then it's dyspraxia.

Questions202, my ds has dyspraxia and related fine motor dysgraphia. From what I understand in researching dyspraxia, no two cases are exactly the same in any two human beings - dyspraxia can impact a wide number of motor systems that impact how a person functions, but exactly how the impact plays out is going to be very *very* individual. I have some sources of info on this that you could include in what you provide to the school, but they aren't things I can easily put my hands on at the moment. If you do some googling on dyspraxia you might be able to find something you can use. If not, and if you can wait a few weeks, I can send you the notes I have.


I would be cautious at this stage re looking at the impact of your dd's dyspraxia as purely social and emotional. That is most likely how it plays out at her age, but if you try to frame it from the perspective of how OT is addressing a necessary motor skill you will most likely be more effective in advocating at school, plus that's truly what the OT is for - learning how to either accomplish of work around the skill, which in turn reduces the social/emotional impact (plus gives your dd the ability to perform necessary tasks that she must do in school or in life).

I will add though - the social/emotional challenges didn't end for my ds after his diagnosis and initial therapies. They did fade *tremendously* but they are still, today, as a teen, something that he has to deal with. It's not easy feeling different from other kids, and you'll most likely find as the years go by that there will be additional motor tasks that will crop up as challenging that you hadn't anticipated. Perhaps not - hopefully not! But it's definitely happened with my ds.

Another poster above has described when/why OT services are required to be provided by schools. Our ds was not eligible for OT through our schools (although he did qualify for an IEP for written expression and organization in spite of having high test scores and good grades). The key in advocacy is to understand the constraints that are in place due to policy, to understand what your child's individual needs are, and to understand how your child's disability impacts their access to their education and their ability to learn. It helped me a lot in advocating to read the wrightslaw website and also to consult with a local advocate (which I was able to find at no cost through the wrightslaw yellow pages). The guidelines in my school district for qualifying for OT services were *not* tied to grades on academic tests, but to scores on OT-specific tests.


This is something that happens often with students who have a disability that the teacher is either unaware of or doesn't understand the impact of. I understand you are wary of giving your dd's teacher information that mentions verbal challenges when your dd doesn't appear to have them, but it sounds like giving her information and the name of the diagnosis is going to be important to getting past her (teacher) impression that your dd is not trying.


We did a 9-month course of handwriting OT for our ds, but that was it. It included a few exercises aimed at tying shoes etc, but the primary focus was handwriting. We did it through private OT as he didn't qualify at school - yet he definitely needed it. Because it was a therapy that our insurance company felt should be covered by the schools, our insurance didn't cover it. We were given a few options by our therapist - including no sessions at all with her after his eval, but a set of exercises we could do with our ds at home. Another option was every other week sessions, or once-a-month (or even less frequent) with us doing home exercises and using the sessions with the OT as check-in and progress monitoring. We opted to just do the straight once-per-week sessions and they were invaluable for a few things - ds went from having severe wrist pain when using handwriting to no pain (although eventually the pain returned), he learned good posture and grip while handwriting, he no longer wrote with extreme pencil pressure (used to rip up paper while writing plus break pencils), and came out of OT with legible handwriting. So all of that was good, and I'd pay for it again if I was back in the same place once again. OTOH, it's equally important to realize what our ds *didn't* get from OT - it's not a cure for dysgraphia or dyspraxia. He still needs repetition to learn motor tasks, and he still needs accommodations for academics (handwriting in particular) and some of the skills of daily living. What he needs in terms of those accommodations really isn't much different than what it would be if he'd never had the OT - the OT basically improved muscle tone, but didn't "cure" dyspraxia. Big difference - so if I *had* to have cut back on any of our expenses at any point in time, the OT is the thing I would have dropped. But again - that's for my ds and for his particular case of dyspraxia. Each child's needs are going to be different.


There may be other diagnoses that include poor motor planning. I think though that difficulty with neurological connections required for motor planning is at the heart of dyspraxia.

I answered this above, but would add - if you want to advocate for school to provide the OT, you need to be very specific in correlating what the OT addresses with an academic impact - i.e., if you are trying to address handwriting impact, measure how slow your dd's handwriting is relative to same age peers, look at actual handwriting samples for evidence of reversals, poor spacing, irregular caps/punctuation etc, watch how she forms her letters - is it consistent and is it the same way your school teaches, etc. Also watch her grip and posture - do they look normal or does she need help learning proper grip/posture while writing. Things like that - and if it's not handwriting that is the issue, do the same type of observation and evidence-gathering for whatever area you want the OT to address. Basically have "data" to support the request. Data doesn't have to be limited to test data!

Best wishes,

polarbear

Veering a bit OT here, but just throwing this out there fwiw - when my dyspraxic ds was your dd's age, I didn't think he had any "verbal" issues. He was extremely talkative and sounded totally like the high-IQ kid he is when he talked. He scored high on any type of verbal ability or achievement test (as long as handwriting wasn't involved lol!). But his dyspraxia *was* and does impact him verbally - it's just not obvious at all - and this was an area that was soooo so tough to help teachers really understand, and the area that he most appeared "lazy" in to people who didn't know about his dyspraxia or who didn't understand the impact of it. As his parents we didn't even realize it until he finally understood it enough himself to tell us what was going on, at 10 years old. In his case, it's not only subtle, but it's also far and away the area that dyspraxia has given him the most challenge and frustration.

Hopefully your dd won't ever be impacted verbally, but I just wanted to throw that out there as something to watch for. Just because you don't see an impact now doesn't mean there won't be an impact later.

Re worries that the teacher would decide that your dd really doesn't have dyspraxia due to the mention of verbal impact in the materials you have provided by your OT - I am guessing you also have the written report with diagnosis from the OT or another private provider. I would provide that report along with the informational materials. If the teacher says they don't believe the diagnosis, gently remind them that this is a board-certified (or whatever credential fits!) professional who's career success is dependent on making correct diagnoses.

polarbear

Thanks to all of you guys for taking so much time to answer my questions. Lots to read and digest here. I really appreciate it.