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Posted By: Mom2277 7 y.o. Cannot Trace a Curve with his Finger? - 02/13/13 01:50 AM
I have a 7 year-old who cannot trace letters with curves. His efforts are WAY off. Does anyone know anything about this, including who best treats this?
Thank you!
No I have not heard of that specifically. I would start by telling your pediatrician and seeing what they recommend, esp. if there are no responses here. Are there other issues, or is this pretty stand-alone?

Maybe a vision issue?
Thank you so much.

He was born premature and has hypotonia, which is low muscle tone. We he had lots of OT for several years following his birth to deal with sensory issues, hypotonia, and what I consider fall-out from prematurity. We took a few years off (with the blessings of a psyiatrist (sp?) who encouraged us just to continue with swimming, karate, etc., as both fun social and therapeutic activities.

I recently resumed OT because I wanted to aid his handwriting. This new OT told me at the end of the session that he was having an inordinately difficult time tracing curves. He did fine tracing straight lines with his finger on an Ipad, but was WAY OFF when she asked him to trace curves.

I asked her if it was the hypotonia (which affects his hand-strength), but she said she thought it was more visual-motor. This is just a very new issue for us.
Oh! Yeah, you better get him checked by a behavioral optometrist... Only go with one through the COVD http://www.covd.org/ My 7 year old son also has hypotonia and hypermobility. He has hypotonia mainly in his fingers and he has postural weakness as well. (When I last saw the neurologist at CHOP said they would catagorize it as mild now YAY)... Anyway, he also has intermittent convergent strabismus (basically, his eye crosses in intermittently. I only discovered this last year but apparently (according to the neurologist at CHOP) it is VERY common in kids with hypotonia (it is also a neuromuscular condition like hypotonia is). He's has been getting OT for a few years but once we added in the vision therapy for the convergence disorder I saw huge improvements in his hand eye coordination and visual motor integration, writing, drawing, etc. He couldn't trace before vision therapy, now he can. It wasn't until after vision therapy that he would color at all. The OTs do some stuff for it on their side, too. But the combo of OT and VT has really been wonderful.

If you live in the Philadelphia, PA or Wilmington, DE area I can give you some great recommendations for optometrists that are reputable and do a very good job but will not sell you on things they can not help with. I also know a few that take certain insurances.
See a pediatric behavioral optometrist. That's a vision issue and one we had with DS7 before he had vision therapy. At 4 yrs old, DS knew his shapes and letters but barely scribbled and still had poor eye-hand coordination despite 4 yrs of OT. During the first months of vision therapy, DS did a lot of tracing with circles, squares, and triangles.

DS was also born with hypotonia, sensory issues, dyspraxia, visual deficits, etc. Then again, DS was also born with torticollis and that was also tied to visual deficits and a reason why we sought out a behavioral optometrist.

An OT will help only to a point. A pediatric behavioral optometrist, on the other hand, will be able to address the visual issues more directly with ambient lens glasses, yoked prism glasses, and specially designed daily/weekly vision exercises. Between the glasses and exercises, a child's brain and eyes can be re-trained and re-wired.

OT should be able to refer you to a pediatric behavioral optometrist, but they don't always. Ironically, I got the name of my son's former behavior optometrist from some mothers who shared the same OT office as us. So word of mouth can be effective too.
A HUGE thank you for everyone for such informative and helpful replies.

My DS does have tremors, which I realized I never mentioned to the OT. Once a neurologist diagnosed it as a benign genetic tremor (identical to mine!), I forgot about it. (Before that, the concern was brain tumor, so benign tremor didn't seem that bad.)

He had had FIVE years of OT and has never colored, scribbled, etc. He HATES doing anything of the sort.

This OT is very seasoned. She's wonderful with an extremely intelligent little boy who hates to have anything in his hands. She impresses me as quite good. She did not, however, give him tests as part of the evaluation (perhaps believing she was experienced enough to discern his issues and thought she had a good grasp of the issues, given his extensive treatment history.) I'll ask her, though, if she would mind giving him a standardized test to parse the issues, so we can determine the need for further referrals.

I definitely will look into a behavioral optometrist because I know on his final test of visual-motor issues he and his twin sister were in something like 1st to 8th percentile.

Is a neurologist someone we should see, too? He hasn't really had the hypotonia worked up. We briefly saw a neurologist to determine if the tremors signified a tumor, and when they didn't, that was the end of it. (long story.)
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