Tag Archives: occupational therapy

The OT


Yesterday was D’s long-awaited trip to the occupational therapist. I say long-awaited as it was last June the whole process began to get him looked at after the school thought it would be a good idea because of his wonky fingers – which have since been diagnosed as hyper mobility.

His appointment was after lunch, so he had the morning at school, and wasn’t too happy at that prospect! I think the thought of seeing yet another new person to prod him about was worrying him ever so slightly. He was fine though when I picked him up, and despite the rain, we went to have a picnic with Hubby – he works in a building right next door to the hospital.

As the time of the appointment approached, he began to ask what they would be doing to him – I of course couldn’t give him an exact answer, just that it was to try to get him some help for his hands because of his funny joints. He was happy with that explanation.

We were a little early and he was happy to play a few races on the Mario Kart wii game in the waiting room, but held tight to my hand once his name was called.

The occupational therapist was only about 12 – I think that is a real sign I am getting old when everyone seems to be so much younger than me!, but she was very pleasant, and spoke to D, only including me in the questions when he wasn’t being responsive. When asked if he knew why he was there he said “because I can do this”, and proceeded to do his party piece of bending his fingers the wrong way – makes my stomach churn every time he does it!

There was a second OT in the room, observing from behind, and making notes. It was a huge room and we were sat in the corner, and I don’t know about D but it did feel intimidating being observed from both sides!

Firstly they had him doing some writing, as this is our major concern. His school work suffers because he finds holding pencils so painful. We have tried different styles of grips, as has his teacher, so he was showing the OT which ones he had used in her huge array of different styles. She had him choose his favourite and set him about writing his name a few times. As usual he was gripping his pencil so hard his fingers were turning white, and his pressure was causing the paper to go through. Seeing him do this, it is amazing the things you just accept and not realise they are a little out of the ordinary! She then gave him a sloping board to use, it meant that not just the angle of his hand changed, but that of his whole body as he had to improve his posture to use it! Straight away, the writing he did was much less pushed through the paper. They decided he should be given a board to take to school to use.

He then had to demonstrate his use of scissors, which is something he usually looks so dangerous doing as he fumbles with, but instead today, he was cutting very patiently, and looked as if he had no problem there.    He so wants to please people that he made sure he did what he was asked to do, even though it was at half the speed and potentially painful.

Using cutlery has always been an issue for him, and he much prefers to use his hands.  We have not been sure if this is because of his fingers, or a sensory thing to do with his aspergers. They tried him with various styles of cutlery, having him cut up play-doh sausages, and he said it was easier with proper ones. I do think it was more a case of the chunky handles looked like ones he had when he was just starting to learn to use them so he didn’t want “baby things”. He was told to remember to make sure his hands were in the correct position – which he was shown, and then cutting would be much easier for him.

He then was shown an easier way to tie his shoe laces.   When we have tried  before,  he has ended up saying his hands are sore from trying – never convinced if its a reason or an excuse.    This way was much easier, and we will definitely be practicing with this – if he can master laces it will be so much easier to get shoes that will fit his ridiculously wide feet.

Then came buttons.     Large ones he was fine with on a garment on the table in front of him, but as soon as it got to smaller ones he was fumbling.     It was suggested a way to make it easier was to replace the tread with elastic so the button moves more to get it through the hole, so I might have to get Old person on a sewing task!    Another idea was that he always did his buttons in front of a mirror so he could actually see what he was doing – painfully simple but something we had not thought to try!

He was then taken to the matted area to test his core strength, because of his clumsiness.    His balance was dire – which I knew it would be.    I did have to remind her it was just 8 weeks since his knee op as he looked in pain as he was asked to go onto all fours!        It was suggested that he had additional sessions which are about core strengthening.     I think it will be really good for him, so readily agreed to that.     She had him trying to walk along a line on the floor, going toe to heel.   It was one of the funniest things I’ve seen in a long time as his feet were nowhere near the line however hard he tried!

They had seen enough, and decided to summarize what had been seen.

They said he needs to slow down when doing tasks – I didn’t laugh out loud at this but D doesn’t do slow, once his brain gets going, his body just has to keep up or we go into meltdown.     Their reasoning is that if he thinks more about doing things correctly it will help his body know what it should be doing.   Great theory which we will try to implement.

Then came the bomb shell.    They think its important he learns to type as the more writing he does at school the more pain he will be in!      I asked about exercises that might help strengthening his hands, and basically they said that just keep using them!     We were given a pile of handouts about tasks and games that were good for honing fine motor skills, we will defiantly be having a go at some of them.

So how do I feel now.     As usual, you come out of these thing feeling as if you are a failure as a parent.    It is nobodies fault, just the nature of sessions where strangers are telling you what you should be doing with your child, or what you have been doing wrong!      I do think its a positive getting the board to help with his writing – I did have a chuckle when thinking when I was at school, all desks were angled anyway!     I am upset that they feel becoming keyboard confident is a priority because they feel he wont improve his hand strength.      I think it is something we continue to work on in the home, and I will just keep making the play-doh for him to spend hours squeezing to try to strengthen those muscles.    The core building sessions sound as if they will be good for him, and if he can strengthen his core it has to be good for his legs.

For now though, it’s another box ticked and we move on.


Preparing for the OT.


D has been waiting for an appointment with the occupational therapy department at the hospital since last June.     At the end of year review at school, his dexterity problems were raised and it was advised we visited our GP to ask for a referral to OT.     The GP thought he would be better seen by the school doctor service, and that came around in September of last year – https://jas2jar.wordpress.com/2013/10/01/d-and-the-doc/.       The appoint was what ultimately led to his recent operation on his knees.

D was in the system to see OT, but we were told he could wait up to 18 months for an appointment as the service was spread very thinly.      We received a letter saying we could go on the short notice list if we wanted, we opted for this.   It means if for some reason there is a cancellation, then the appointment can be offered to someone else.

Anyway last week I got a phone call offering me two possible dates for an appointment, one was when we are away at Easter, so he is going to have to miss another half day from school to go to this appointment – it is only a matter of time before I get a letter about his poor attendance this term, but if he is ill or in hospital, there isn’t much to be done about it.

Yesterday I then received a pack to be completed as it is his first appointment with them.     The kit consists of two checklists to be filled in, one by us, and one by the school.   It will give them a better idea, of where they are starting at with his needs.

Last night Hubby and I sat down to fill in the form.    I was instantly heart-broken.    I really hate these things.     I have always had the attitude of putting a positive spin on as much as possible for the kids.    I think it is so important to boost a childs self-esteem, but not to a level that they think they are invincible!        To focus on what your child can’t do is just an unpleasant task.      For us, the boys are just the boys, and we do for them what they need to have done.    Isnt that just part of being a parent?      When though you have to tear apart every activity they do and look at it in such a way that compares them with their peers to see if they are attaining the same level of competence it is difficult – after all, should we really be comparing kids achievements?         If it was about mental ability, D would be all happy thoughts as he is ridiculously intelligent – a post for another day I feel, about how upset I get that he would rather hide in the crowd than show his true potential but luckily his present teacher has engaged him to pull him out of himself a bit.        However, it is his physical problems that we are talking about here, and after all, that is why we wanted to see OT in the first place.

In my head, my kids can do whatever they put their mind to – all be it with guts and determination a lot of the time.      I think maybe one reason I don’t look at D’s problems so much is I was always the plodder.    I got there in the end as long as I went at my speed and did it my way!     He is a lot like me in this respect.   He is not the fastest, but didn’t the tortoise teacher us an important life lesson?

So the forms looked at everything from dressing – the fact we don’t buy him things with buttons on because his finger have problems is just normal for him, but isn’t normal for your average 6 yo, to feeding himself – he often asks for help with cutting or resorts to picking food up because he doesn’t have the strength in his hands to cut his food for a full meal.      Even the things like his clumsiness have been detailed – apparently walking into stationary items is not what “normal” kids do, and yet D runs into a tree in the school playground at least once a week, and falls over our coffee table every day!

It was a heart breaking hour filling this in.    Then it asked what do you want your child to be able to do?      There is only oner truthful answer to that for me, and that is whatever he wants to do!   That however isn’t really a sensible answer to write down so we went for improve his writing as it is holding back everything else at school, but if holding a pencil hurts then its going to be hard for him.    We actually purchased some wide bore pencils and pencil grips for him to try to help him.       We asked D what he wants to achieve and he said he wanted to be just like the other boys in his class.      Well, that’s never going to happen, for in my mind he is in a class of his own, but I know what he meant.   He wants to be able to do things they do without feeling pain or discomfort.

I am preparing myself for another lecture about his weight.   I know it’s a factor, but it’s not the only thing.    The physio he worked with recently commented on more than one occasion about his flexibility being on the high-end of the scale, and you only have to feel his fingers to think you are holding hands with an elderly person riddle with arthritis, they are so nobly.

I will put the form in to his teacher, but I imagine their findings will show something different to ours.   Not that there will be unfair judgement, but because D works so hard to be invisible in school.    He doesn’t want to be thought of as different even though the truth is far from that.     I can understand he doesn’t want to make a fuss but if he spoke out more when he was in pain or having physical hardship then he would get help more often.        I know though his teacher will be as honest as possible in the way she fills it in, as in the long run, anything that helps D will make her life a little easier.

It’s now a case of returning to focus on the positive until the actual appointment, as the negative thinking last night turned me into a nightmare of a person.     I need to think happy thoughts and while my kids row constantly and behave like total ratbags the majority of the time, I love them to bits and want above all else them to be happy and have happy memories of their childhood.

D and the Doc.


Yesterday was the long-awaited appointment with the school doctors service for D.           My GP had referred me to them after us asking for a referral to occupational therapy on the recommendation of the school.

D was a mixture of excited and nervous about the appointment.     He asked what it was about and I explained that it was trying to get him some help because of his funny hands.      His fingers have hyper mobility, which basically means they bend in ways they shouldn’t!   His knuckles look like those of an old person riddle with arthritis.     He is not in any pain with them, but he has problems with his fine motor skills, which is why at his end of year meeting last term, they had suggested the referral.

I wasn’t looking forward to it, as I thought it was a box ticking exercise to see if he actually needed to see OT.      Their waiting list is at them moment about 6 months, so I imagine they are doing everything they can to only make sure those that really need to see them get put on the waiting list, which I suppose is understandable.

The appointment was at 10:30am, so it wasn’t worth putting D into school in the morning, just to pull him out again less than an hour later.      He therefore made the most of winding M up as he headed out to school!

I managed to time it right getting there so he didn’t have too long to wait before the doctor came and got us.

The first ten minutes were spent talking about family medical history, and my pregnancy with D.   I was getting a little annoyed by this, as D was getting agitated by the time she seemed to notice him.    When she said his notes were missing and she only knew about his diagnosis, and his referral, I was flabbergasted!     No wonder she needed all the background information.

She then had D doing some block building and peg placing to see how his hands were coping.    She agreed he was having some difficulty.

Then the nasty part started as she had him up on the bed and manipulated his hips, knees, and ankles, until he was almost in tears.       She then repeated the process with his arms.     The poor wee man was holding it totally together, but I could see the discomfort he was in.     This went on for a good 20 minutes.

She then had him running up and down the corridor.       Then walking foot in front of each other as if on a tightrope.     It is only when you are observing things like this, and someone asks if things are always that way, that you see things that you don’t notice everyday!     D couldn’t put his feet toe to heel, as his feet splay to a ridiculous degree, it is what my Dad would have called ten to two feet – as in if he was stood on a clock face that’s the time he would be pointing to!        Also his bandy knees were pointed out.    I know when I try to cut his toenails, he can’t straighten his leg at a forward facing angle, but just took it as he was being awkward!       I don’t think he will every stop a pig in a passage anyway!

She then did his height and weight.    I stopped her before she started on this, and said I wasn’t prepared to discuss it in front of D as he was already becoming paranoid about his weight because of bullying and comments at school.       To my surprise, she was quite understanding!     I said if she needed to talk about it, I would do so over the phone or at an appointment when he wasn’t in the room.     She said as long as we were monitoring things then she was happy with that – I did however hear the “for now” that wasn’t actually spoken!

After all this D sat down, and half lay onto my lap, he wasn’t happy, but was keeping quiet.

She then said that there was quite a plan of action she wanted to discuss with her team as to moving D forward.    Firstly she said she would refer him for physio which would help him to be moving his problematic joints correctly.      She will also refer him to OT as there are definitely things they can do for him to make his life easier.     Lastly though is the slightly more worrying thing, and that is she wants him to been seen by orthopedics to have his joints properly assessed.     She believes he has hyper-mobility definitely in his knees, and probably in his hips and ankles, and his arms need to be checked as this is probably be why he refuses to lift his shoulders.

It was a whoosh of information!

She will see him in 6 months to see how he is getting on.

As we came out, he just let rip about the things she had done to him, and how he didn’t like it.       I’m sure he will remember this when we do go back!      We didn’t head back to school, instead, I let him run his anger off in the park.   He would have achieved nothing had he attended for the afternoon.

I put my hands up and say I was wrong to have been annoyed at the GP not giving me the referral I had asked for.    If we had of just gone to OT, then the rest of his problems would not be in the system.

I feel so sorry for the wee man, as he copes with things with little or no complaint, and yet you see that he struggles.        I of course feel guilty for the times I shout at him for dawdling, as I now believe there is a reason for it other than laziness!

It is moving forward, and as always, doing things to help him cope better it always the priority.