Appointment with new occupational therapist

I brought my son to see a new occupational therapist on Tuesday 20 Oct 09.

As part of the assessment, I had to fill in a form on his background (pregnancy, birth, milestones, medical history etc) and she had him perform various tasks. We then had a long discussion.

She was very patient and understanding with my son, which is great. She also listened well to what my concerns were, of what he can/can't do etc, without being condescending. She was genuinely helpful - gave a lot of ideas and guidance.

In summary, these are the broad areas that I should work on with my son:
- hand/finger strengthening
- hand/finger manipulation
- gross motor

These were the observations she noted:

- his pencil grip ok
- he has the attention span
- he does not have behavioural problems
- he will have a developmental gap when compared to his peers. But we're not looking to perfectly close gap. The aim is to minimise the gap.
- he knows the alphabets

I said that I feel really stupid about it but I had to ask her to show me the following:
- the way he should learn to put on his T-shirt (lay out in front of him, with the back of the shirt facing him, then both hands hold & pull over his head, etc). It's supposed to be easier to put on the T-shirt than to take off.
- how to take off his T-shirt (use right hand to tug the left sleeve down to create a wider opening so that with the left elbow bent, the left arm can disappear back into the sleeve. Then use right hand to lift up T-shirt from the bottom of the shirt, up over his head towards the right side. Then left hand just tugs it off the right arm.
- it's important to set him up for success, so use loose shirts initially and give plenty of practice
These tasks were part of the assessment:
1. Lacing beads
He needed help for the 1st bead then gave up on the 2nd bead. It's been quite sometime since he did lacing beads at home & even then, it's not often.

2. Lacing card
He's never done this, so he needed help from the begining. He didn't finish the 2nd hole. I'll make my own, by punching some holes in one or 2 of his large picture of cars.

3. Draw line
We used the whiteboard as he didnt want draw a line to join the 2 dots on the paper. He could draw uneven lines with the whiteboard marker: a horizontal upward sloping line, a vertical line, an uneven oval that was supposed to be a circle, a cross which she gave step by step instruction, drew within 2 parallel horizontal lines.

4. Wooden stacking toy
He could eventually place the wooden cross shaped pieces into a shaped tower, but pieces didnt stack flat as he didn't really adjust the shape of the piece to the shaped opening of the tower. Later she said that he's also meant to feel (sense of touch) for the shape, not just look (sense of sight) at the opening.

5. Clothes pegs
He needed help positioning it between pincer fingers and help to pinch it open. With the smaller pegs, he could pinch it open.

6. Catch ball, kick ball
He of course couldn't catch. And instead of throwing, he dropped/placed it in the therapist's hands. He kicked well though.

7. Alphabet flash card
He correctly mentioned the names of the alphabets shown, except that his pronounciation of the letter 'e' was unlcear.

8. Wooden manipulative toy with 9 pegs, requiring clever placing of 3 different shaped pieces to form a square on each level.
He's never seen that toy before. Surprisingly he correctly placed the first level which had a 3 hole rectangle, a 2 hole rectangle and a 4 hole square. I wondered if it was a fluke cos he's not good with manipulative objects. He struggled with the second level which was a 4 hole L shape, and a 3 hole L shape and a 2 hole rectangle.

I'll write a separate posting on the activities suggested for hand/finger strengthening and manipulation.