After our initial visit with all the cutting and drawing we made a follow up appointment with the therapist for the following week so that she’d be able to lay out our treatment plan for V. We wanted to make the most of our summer holidays, while I was still on mat leave, to make up any ground we could before he headed back to the classroom in Sept and I headed back to work!
V absolutely loved this visit…it was all about ‘games’! The therapist explained that all of his exercises needed to be fun, motivational, and most importantly he needed to have a buy in and experience success. Nothing will have a 4 year old checking out faster than if they think it’s boring and they can’t do it.
I won’t get into all the details on the different exercises that we practised during this appointment because I’ll be adding each individual one as it’s own separate blog post; including pictures and a materials list. Keep in mind I am not the Occupational Therapist, I’m only sharing what we’re doing for V on the recommendation of his OT, teachers and doctors.
What we did leave this appointment with was some labels for what the OT thought might be the underlying causes of V’s fine and gross motor delays. I’ll highlight the two big ones here.
Poor Motor Planning:
What this means is that V can watch a teacher, therapist, or peer perform a new, unfamiliar task but he has trouble breaking it down into steps and repeating them himself. He can’t quite translate all that sensory information into a plan on how to get things done. He will often drop things, stumble, trip etc when he’s trying things for the first few times. To help him overcome this we need to take extra time to teach him and repeat more often. For example, when he participates in a song or dance performance at school we should obtain the music and actions from the teacher before hand and help him practice at home.
Luckily this skill can be taught over time and it will be generalized to different scenarios he’ll come across in school, home, and life!
Low Muscle Tone:
V is a tiny kid. Seriously. He’s almost 5 years old and his favourite pair of swim shorts is a pair of size 18 month trunks. And they fit. Well! He is all skinny arms and long legs at a whopping 29 lbs and 39 inches tall. Not a lot of meat on those bones!
This should have been a good indicator that V hasn’t exactly packed on the muscles and the OT indicated that he does show signs of poor muscle tone. If you watch him do pretty much anything you can see that his joints flex to the point of ‘double-joint’edness and he doesn’t exhibit a lot of stability or stamina. A lot of the exercises that we’ll be doing both for OT and Physio will focus on building muscle tone and control.
As a fun FYI this is not the first time we’ve been told that V might have issues with muscle tone. I remember the NICU physiotherapist having some concerns when he was still in the Level 3 NICU. He was a pretty floppy baby but I assumed that issue was behind us when he started to sit, crawl and walk. Guess I shouldn’t have been so hasty on that one!
We left the appointment with several sheets of exercises plus a shopping list for the website of an excellent Canadian sensory tools company (FDMT: Educational Materials and Sensory Tools – FDMT.ca) and the Dollar Store. We are spending at least 15 minutes a day with V on fine motor activities 5-7 days a week. Our goal is for him to be able to control scissors, have a consistent pencil grip and rudimentary pre-writing skills by the start of the school year. I’ll be highlighting our home Occupational Therapy box with it’s individual ‘games’ for V in the next few posts. Feel free to ask any questions you’d like and I’ll try my best to answer them, at least from our experiences and perspective. Wish us luck!