Putting together the pieces, am I missing something?

[Deleted]

Quick history:  DS- high risk pregnancy, IUGR,  born at 37 weeks, just under 5 pounds.  Heart surgery at 4 would have been released then from cardiology but is missing part of a valve, so monitoring for rest of his life, possible valve replacement maybe around 60 or 70 years old.  History of fluid in ears, ear infections, and hearing loss.  Now has hearing aids- mild moderate hearing loss lower ranges.  Eyes seem to be OK. Severe sleep apnea solved last year by taking out tonsils and adenoids which were swollen and very large.

IEP- for speech and hearing.

History of clumsiness, but doesn't affect him school wise, so no OT or PT.  Improved motor skills but still clumsy, for example chipped his tooth once then a year later fell running up the stairs in his socks and knocked out both front teeth.  The concern would be knocking them out when they are permanent teeth as I can see them coming in.  Writing is messy, can't color in the lines.  I was reading coloring in the lines is a milestone for 4.5 and he is 6.  Was behind in balance, but caught up with gymnastics.

I don't see the district going for PT still.  Should I ask about OT?  Is he getting clumsy again since he is out of gymnastics since mid Dec?

[greysonsmom]

I think I would try and push for PT or OT

[Deleted]

greysonsmom , thanks for the opinion. He is in half day K, I can check with his teacher now on the OT. I am wondering for both OT and PT (which I think they would just label him as clumsy and not clinical) if that would be too much pull out in half day K. Does it make sense to push now or wait until full day 1st grade when the school district would have more time with him? I am going to e-mail his teacher now though.  He is below normal on the cusp of normal which makes it hard because its not that bad, but its not good either.

[mamaturtle]

Have you gotten a private OT and private PT evals?

Have you already done a full evaluation with the school district?

I had some trouble getting DS OT and PT when he was three at the district preschool and I requested DS be evaluated for everything. I remember the OT that conducted the eval, run into me and told me "I see what you mean in why you think DS needs OT." This was after I had DS got to private OT for a year or two.

[Deleted]

No previous evaluations. School evaluated for speech and hearing loss and nothing else. His handwriting may have been on par with students entering K especially if some have never written before, but may not continue to be on par?

For physical therapy the pedi said I can do the therapy or do other activities. I told her he was improving and she thought well that's good no need for therapy then. But then he has these moments of clumsiness where I wonder if I am going to get him to be an adult intact (I know probably more common with boys). Especially with hitting his front teeth twice- I don't want him to knock out his permanent ones just because he is clumsy.

I e-mailed his teacher, and she said she noticed it too. She is going to reach out to OT for me. She says it doesn't affect him too much because he is so ahead academically, but obviously if it is writing then it affects him a little.

Honestly, we are still paying medical bills from 11 months ago. The insurance claimed there was other insurance (there wasn't) and hospital billing sucks, so between the 2 there are still bills trickling in. Plus he had hearing aids and chronic ear infections leading to about 9 appointments in the fall, and I work full time. So I pretty much need this to be done at school or it won't be done at all. I just can't afford more doctor bills.

Now if it is essential, I will make sure he gets PT and OT privately but we may have to wait until summer when we have a chance to build up our savings again.

[mrsbuttinski]

Adaptive skills in school count- can he safely move about the classroom and hallways? can he safely access playground equipment and participate in recess games and PE? These could be seen as part of his educational day and are as critical as academics at this age.

I'd also want him evaluated for APE.

Does any of this sound familiar-

canchild.ca/en/diagnoses/developmental-coordination-disorder

[Deleted]

Feb 2, 2017 17:50:02 GMT -5 mrsbuttinski said:

Adaptive skills in school count- can he safely move about the classroom and hallways? can he safely access playground equipment and participate in recess games and PE? These could be seen as part of his educational day and are as critical as academics at this age.

I'd also want him evaluated for APE.

Does any of this sound familiar-

canchild.ca/en/diagnoses/developmental-coordination-disorder

Sounds familiar. If he has it it's a mild case because it doesn't interfere with life and he can do all of the things mentioned. So it's just borderline which is good but makes it more confusing. Sometimes I think all is well, and sometimes I think are we going to make it to adulthood intact? which could just be my anxiety. I will say as a baby he had almost a permanent bump on his head constantly falling on his head. Whereas DD would fall in her hands or butt. She shows me the difference between the 2, although I know there is definitely a difference between the sexes with development.

[brachysira]

DD is like this--she's only 4 but at nature class today she was the only one who didn't color in the lines and just scribbled. But once I asked her to color in the lines and she did it, so I guess she can. She got OT because she was so clumsy and they said she had terrible visual attention but I didn't think OT really helped her. Gymnastics very much seems to help her tho...I'd go back if you can. I think she builds more muscle there in addition to practicing the coordination and balance so it works together more than just carrying puzzles pieces up the stairs 100x in a row like at OT.

[luvboston]

I think you make enough of a case for him to get it. DS has certain things that are similar in that if they are not taken care of now he will end up bumping his head and being severely debilitated forever.

[greysonsmom]

I'm glad his teacher is supportive and is going to help you push for OT.

[Deleted]

brachysira, was OT through school district? My guess is they will concentrate more on writing. He is 6 and not coloring in lines.

[brachysira]

@clarypax, no, it was private. It was the kind of place that would tell you that you needed OT even if you didn't, I'd say. Coloring in the lines just makes no sense to me...I still probably can't and I'm pretty sure my kid just doesn't know why anyone would. But yay for some good OT that might deal with writing and coordination.

[akafred]

Meh, Charlotte is 7.5 and only just now coloring in the lines...sometimes. Part of it is weak fine motor skills (and she has been in private OT since age 4), but largely she just didn't care and was in a "hurry". She has ADHD and just didn't care to spend a lot of time on the details. I don't think an OT eval is a bad idea at all (especially since he may have some gross motor problems too), but if his handwriting and cutting and other fine motor skills are ok, I probably wouldn't worry too much about the coloring. With C, a lot of times one small part of the picture would have good or decent coloring in the lines and then it degenerates. So maybe Santa's hat looks great but his suit is just a mess. Just for reference.

Do you think the clumsiness could be because of fluid or damage from the fluid in his ears? Or do you think it is a muscle coordination thing?

[mrsbuttinski]

@clarypax, I would be careful around the old wives tales that ascribe very different developmental patterns to one sex over the other. The differences are very subtle and exist on a continuum. A lot of parents miss a dx and services because they believe things like "boys are more physical" or "boys talk later than girls". The difference could be personality. A couple of the kids I know who are like your son are girls- 2 of them have ADHD and a connective tissue disease (EDS) which impacts them physically although both are very active in sports- tennis, swimming, sailing, gymnastics, cheer. They get hurt a lot.

Coloring in the lines is a "thing" in some schools- a precursor to handwriting skills. If a teacher notes it, it is an educational need. It can also reflect a child's personality. DS never really got the point of coloring- he could do it and would from time to time. But it wasn't his thing which made a multisensory reading program "unfun" at times. I recall a conference with his 1st grade teacher where she's all whining about how he "can't color in the lines"- she showed me evidence- a paper in which DS scribbled on the stuff he was supposed to color with a painstakingly precise drawing of a train using 3 point perspective (which is a middle school milestone)

[Deleted]

As far as writing I don't know if it's his fine motor or he doesn't care and is in a hurry. Handwriting is messy. Scissor use is messy, but I don't know what's normal for his age.

For gross motor I don't know if it is muscles or ears. However I did ask the ENT maybe a year ago and even if it is ears the treatment would be the same- physical therapy. I think it could be both ears and muscles. 

@msbuttinski- yeah this is why I posted here because I don't want to say oh he's clumsy because he is a boy. If he needs help I want to give it to him.

It's just in some things DD is far more ahead while being 2 years younger. She tends to be my comparison even if that's not the greatest thing- it does point out that he may need even more help. This is made a little more difficult because she is ahead for her age in almost every way.

[mrsbuttinski]

This is a list that describes "normal" scissor skills progression.

www.schoolhealth.com/blog/scissoring-skills-pt-2-the-4-stages-of-scissoring-skills-development/

I know my DS was just about 4 when he could use scissors fairly well. He managed to lock himself in my bedroom and shear my old himalayan with my best dressmaker shears. They're really well balanced and easy to use, but he finished the cat's head off with some pinking shears which aren't. Poor cat ended up with a kinda mowhawk and no fur on his starboard side. DS managed to avoid nicking his skin.

If he's having issues with scissors at 6; that could be used to advocate for OT.

[Deleted]

Based on that chart mrsbuttinski, he is missing stage 3 and 4 and perhaps part of stage 2.