MaternalMusing

A Personal Adventure Into Parenthood

Occupational Therapy: Tool Kit – Grotto Grip July 21, 2015

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This is our second purchase from fdmt.ca. As I mentioned previous, most of V’s materials can come from discount or dollar stores but the Grotto Grip was another exception. Our OT recommended it because it attaches to his pencil, marker, crayon, etc to help him maintain a proper grip. There were a few grips she considered for him but did eventually decide that the three-point grip would be the most beneficial. She let us know that a few stores in our area did carry a version of this particular grip, but she’d found they didn’t work quite as well for children with fine motor issues and since we’d be ordering the scissors anyways….might as well add some more!

I was really excited to see how these worked with V because, as a general rule, he HATES to colour or draw. He would scribble as fast as he could, and then tell you he was done. If you wanted to pull out some colouring books his attention span would last for all of about 5 minutes before he was running around again. This may have led to some speculation in the past that he had behavioural issues, however now that he’s been properly diagnosed we know that it was purely frustration and boredom. How much do you like being force to do something you’re not good at or find incredibly hard? Can’t blame a pre-schooler for letting his feelings be known! Anyway, I was excited to try them out and see what type of change it would make in both his skills and his attitude.

Here is a highlight of what our pencil grip/pre-writing program looks like.

Material:

Grotto Grip

Stabilizer (dice, large bead, etc)

Grotto Grip! V prefers the blue but we also have black, green and purple!

Grotto Grip! V prefers the blue but we also have black, green and purple!

How It Works:

It slides onto the pencil/pen/marker etc near the tip and is essentially a plastic mold that, for all intents and purposes, forces, his hand into the proper grip with his thumb and forefinger ‘pinching’ the sides of the instrument and a cradle for his middle finger just below. We keep his other two ‘stabilizing’ fingers busy by holding the same object he would for any of our ‘pencil grasp’ OT exercises.

V also gets his choice of pencils for his daily activities. Choice choice and more choice is key!

V also gets his choice of pencils for his daily activities. Choice choice and more choice is key!

Exercises:

  1. Connect the Dots

V’s OT told us that ‘Connect The Dots’ puzzles and mazes are amazing activities for children with fine motor issues. They make them practice drawing firm, straight lines as well as constantly changing angles and adjusting their grip. V loves them so we’ll pick one a day to do together. It’s also a great way to practice his numbers and counting!

You can find this stuff everywhere if you're looking. This booklet is full of 'Connect the Dots' place mats!

You can find this stuff everywhere if you’re looking. This booklet is full of ‘Connect the Dots’ place mats!

  1. Colouring

V is also practising his grip by learning to colour inside the lines and switching his grip between different coloured pencils. We usually colour our ‘Connect The Dot’ picture once we’ve completed the first part! V has about 4 different colouring books in his OT kit so he gets to choose which one he’d like to do for that day.

All those colour choices!

All those colour choices!

  1. Pre-Writing Activities

V isn’t at this point yet since we’re still trying to get him practising his grip but we will eventually move into repeating the tracing/copy activities from his OT assessment. V will practice tracing and drawing simple finite shapes like X, T, O, squares, triangles etc.

Tracing lines between matching pictures and their shadows. Who doesn't love Transformers?!?

Tracing lines between matching pictures and their shadows. Who doesn’t love Transformers?!?

  1. Writing and Letter Tracing

Also not an exercise we’re doing right now but V will also soon start tracing his letters in workbooks and trying to write his own name! We have to keep the end goal in mind here!

Notes:

  • We purchased 4 Grotto Grips from the website. 2 are for home use and 2 will be sent to school, labelled, for V to use when they are doing any drawing/writing lessons there.
  • Make sure you continue to use a stabilizer for all of the writing activities. Just because your child has the grip for the first three fingers, they also need to learn to use the other two to help stabilize their hand as they go.
The Grotto Grip in action! You can't even see the stabilizer hidden under the outer two fingers now! He's learning to close that fist.

The Grotto Grip in action! You can’t even see the stabilizer hidden under the outer two fingers now! He’s learning to close that fist.

  • Encourage your child to use their other hand to hold the paper and move it along as they draw/write. Part of the writing skill is using their hands cooperatively!
  • Choice is important! Have a variety of workbooks/activities for your child. Again, it’s all about getting that buy in to produce the sense of control and the feeling of success!
This is a sample of our writing activity choices! Kids really appreciate that small sense of control so make sure you provide options.

This is a sample of our writing activity choices! Kids really appreciate that small sense of control so make sure you provide options.

  • Invest in some magnets! V loves the ability to display his work on the fridge when he does a new, exciting activity! Pride in their work is important especially when learning new skills.
Look at what I can do! He is so proud of his accomplishments.

Look at what I can do! He is so proud of his accomplishments.

The beginnings of our Refrigerator Art Gallery from our 'Artist in Residence'. Definitely need to buy more magnets... Although the Canadian bottle opener does add a certain 'Je ne sais quoi'...

The beginnings of our Refrigerator Art Gallery from our ‘Artist in Residence’. Definitely need to buy more magnets…
Although the Canadian bottle opener does add a certain ‘Je ne sais quoi’…

Results:

I can’t say enough great things about this tool! Even after 3-4 days of use I can already see a HUGE improvement in V’s grip and his abilities. He knows how to hold the pencil with confidence and is able to exert more pressure as he makes his marks. His lines are darker, straighter and more firm. He can also colour much close to the lines, tries to colour in smaller shapes and will actually sit and colour for more than 5 minutes at a time! He is rarely drop his stabilizer now and he looks forward to our craft time each day. As least from my end the Grotto Grip is highly recommended!!

I have never, in almost 5 years, seen V draw such straight, firm lines. I almost cried and I definitely sent out a picture text to Daddy.

I have never, in almost 5 years, seen V draw such straight, firm lines. I almost cried and I definitely sent out a picture text to Daddy.

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Occupational Therapy: Step One – The Assessment July 13, 2015

After requesting an Occupational Therapy consult through our family health team in early June we finally got the call with about two weeks remaining in the school year. I was pretty pumped to get a jump on V’s needs for Senior Kindergarten and the therapist seemed very thorough and kind, even on the phone!

She started by asking me what our concerns were with V and why we’d requested the consult. She listened actively which was a relief, since I originally felt pretty brushed off by our family physician. The therapist immediately recommended that I contact the school and request that V had Physiotherapy set up for Sept, as soon as school starts.

Her reasoning was two-fold:

One – V falls a lot, and since the school is aware that this happens, it is a liability for them if he falls, injures himself and they’ve done nothing to assist him. PT will help his gross motor development and hopefully have him running, jumping and generally keeping up with his peers in the playground/gym class.

Two – The wait list for Physio is much MUCH shorter than the list for Occupational Therapy in the school system. There are fewer students with gross motor development needs and teachers are less aware that Physio is even an option in their classroom. As adults we typically only consider Physio in the context of injuries and rarely in relation to developmental issues.

V’s teacher is an amazing educator and truly cares for her students. I let her know the Occupational Therapists recommendation and the paperwork for V’s Physio in the fall had been submitted and approved by the end of the week! One thing check off our list for back to school!

The Occupational Therapist then scheduled our first visit so that she was able to evaluate V’s skills in person. She let us know that she would likely need two visits; one to evaluate and one to impart a treatment plan, and they would be about an hour apiece.

We prepped V for the appointment by letting him know we’d be going to see a fun ‘doctor’ who was going to play some games with him. 4 year olds don’t distinguish between different medical professionals and since it was at our dr’s office…they’re all doctors in there! He was excited to go visit.

At the first appointment the therapist did several exercises with V to evaluate his hand strength, coordination and writing abilities. Some of the activities were:

Cutting:

  • Cutting along a straight line (about half a page in length) with basic school scissors. She had him try to hold the paper and cut, and then she held the paper while he cut.
  • Cutting around a right-angled corner with basic school scissors. She held the paper, then had him hold it, then she used coloured markers to mark where each of his fingers should be when holding the paper while he cut.
Scissors worksheet example. Before the exercise.

Scissors worksheet example. Before the exercise.

Trying to coordinate the scissors and his holding hand to cut a straight line.

Trying to coordinate the scissors and his holding hand to cut a straight line. Also note that although he is left handed, he manipulates the scissors with his right hand.

End result of the scissors exercise. You can see that he can't cut a smooth or straight line right now.

End result of the scissors exercise. You can see that he can’t cut a smooth or straight line right now.

Writing:0

  • Tracing between two lines in different shapes using a pencil. He had to trace between two straight lines, two lines with sharp V-like corners, and two wavy lines.
  • Tracing on top of lines using a pencil. Again she had him trace straight, sharp curves and wavy lines.
  • Pre-writing exercise by copying basic shapes: cross, x, square, circle, triangle.
  • Copying the writing of his own name. She had him trace over-top of her writing and then try to copy it by himself.
Line tracing exercise. The large gap between the lines is because we want him to experience success. The width will decrease over time.

Line tracing exercise. The large gap between the lines is because we want him to experience success. The width will decrease over time.

Note the bizarre, fist-type grip he uses because his fingers aren't strong or coordinated enough yet.

Note the bizarre, fist-type grip he uses because his fingers aren’t strong or coordinated enough yet.

End result of the lines exercise. Notice there isn't a lot of movement if he can help it.

End result of the lines exercise. Notice there isn’t a lot of movement if he can help it.

At the end of the exercises she gave us a quick evaluation of what she’d seen. In V’s case she let us know that he has minimal fine motor skills and we’ll need to start right at square one to help him build up to where he needs to be by the time he enters Grade 1.

Pre-writing exercise. V needs to copy the shapes as close as he can in the boxes to the right.

Pre-writing exercise. V needs to copy the shapes as close as he can in the boxes to the right.

Examining his work. This one frustrates him the most.

Examining his work. This one frustrates him the most.

Pre-writing results. Notice that his shapes lack definition and tend to be pretty similar. They will improve as he learns to stabilize and control his pencil.

Pre-writing results. Notice that his shapes lack definition and tend to be pretty similar. They will improve as he learns to stabilize and control his pencil.

V has little to no co-ordination in his hands. He struggles to even open and close the scissors in a cutting motion, let alone have the ability to cut along a line or co-ordinate both hands to hold and cut. V is also left-handed but cuts with his right. The OT told us this is very common in school aged kids because there are rarely, if ever, left-handed scissors consistently available in the classroom. We aren’t going to try to modify this…he’ll be a left-handed writer, and right-handed scissor wielder!

Writing exercise. He needs to trace his name and then try to copy it independently.

Writing exercise. He needs to trace his name and then try to copy it independently.

Funny grip again! He really enjoys trying to write his name though. He's almost got the V down.

Funny grip again! He really enjoys trying to write his name though. He’s almost got the V down.

Writing results. We definitely have a few steps to go before he's able to write legibly.

Writing results. We definitely have a few steps to go before he’s able to write legibly.

As for writing he has no consistent pencil grip. He alternates from a fist, to a modified three-point grasp, to a bizarre grasp stabilized by his middle finger along the length of the pencil. This stems from the fact that he can’t coordinate his fingers so that the far fingers are stabilizing his hand and the inner fingers and thumb manipulate the pencil. His whole hand works as one whole grasp. We’ll need to help him learn to co-ordinate his fingers and find a proper grasp before we can even move into tracing and pre-writing. The goal is to have him writing his name at the end of the year. There is no rushing this type of thing. We want him to learn consistency and co-ordination, not shortcuts to create the appearance of him learning.