Very very long sorry.....
DS (aged 5.8) was referred to the CDC by school due to concerns with fine motor skills, poor balance and inability to sit on the carpet. we have had all sorts of issues as I have listed below against the Dyspraxia Foundation website - also provided to them during the assessment.
The report that I have received today doesn't really help as there is no diagnosis, no linking of behaviour and physical issues and they said that they will give him one OT session at school and then be discharged and leave the school and home to deal with his issues.
Where do I go next? I am already going to ask GP for referral to Behavioural Optometrist following recomendations on here. Should I also ask for a Paed referral as their recommendations don't feel that they are going to help me hugely esp with things like needing to go shopping, refusal to walk, tantrums etc
The report says:
- He behaved himself during the assessment
- Posture - He sits and slumps taking up all support offered to him - work on core stability
- Visual motor integration - percentile score of 4 on Developmental Test - below average
- Movement ABC - manual dexterity 37th, aimign and catching 50th and balance 27th = overall 37th percentile so average and no movement disorder is evident.
- Sensory Processing - They have noticed that they did not observe him being very fidgety as it was 1:1 with regular change of activity
- Daily living skills - difficulty with dressing, cutlery, wetting at night
Recommendations:
- Fizzy
- Caring Cutlery
- Support feet during meal time - will buy Tripp Trapp or similar
- Long loop scissors
- Continue to use move and sit cushion that I have already bought
- School to consider his position in class
- Regular breaks at school
- Use chunky pencils
My list of issues is
By 3 years old
Symptoms are evident from an early age. Babies are usually irritable from birth and may exhibit significant feeding problems.
Jacob was born three weeks premature. He had reflux from birth although he was breast fed. He was a difficult baby who required feeding very often and had to be propped up both in his cot and on the floor. He was not able to have tummy time as he would not tolerate it.
They are slow to achieve expected developmental milestones. For example, by the age of eight months they still may not sit independently.
Jacob sat independently at 8 months. Crawled at 12 months. Started to walk at 18 months. Started to speak at 24 months.
Referred to SENCO at nursery for behaviour issues including spitting
Pre-school children - 3 to 5 year olds
Very high levels of motor activity, including feet swinging and tapping when seated, hand-clapping or twisting. Unable to stay still
J cannot sit still on the carpet at school. He lies on the floor or rolls under the table. At home he finds it difficult to sit still at the table. He spins around or moves his legs around. He will often climb around on the settee at home.
High levels of excitability, with a loud/shrill voice
J often talks very loudly especially when tired and does get over-excited which often leads to being told off due to the volume or it getting out of control.
May be easily distressed and prone to temper tantrums
J has very bad temper tantrums which he finds it very difficult to get out of.
May constantly bump into objects and fall over
He knocks things over and stands on things that are on the floor. He trips over his own feet whilst out in the street quite often. He sometimes doesn't appear to know where his body is ? ie he will dig in with his elbows or knees when trying to cuddle us.
Hands flap when running
He tends to use just the right arm to run with and his gait when running is much more uneven than his friends.
Continued messy eating. May prefer to eat with their fingers, frequently spill drinks
He cannot use a knife and fork. He often eats with his fingers or just the fork in his right hand using his left hand to help the food onto his fork or spoon. He spills drinks which means that I normally give him a half cup. He will squeeze the carton of juice too tight sometimes so it spills everywhere.
Avoidance of constructional toys, such as jigsaws or building blocks
He is very good at puzzles but can't see the difference between the edge and middle pieces. He needs to find the pieces that look the same first.
Lego is very difficult for him to use the ?grown up? version as the pieces are very small but he enjoys it. Meccano is also very difficult ? even the junior version as there are too many pieces to hold and move and he has to have a lot of help.
Poor fine motor skills. Difficulty in holding a pencil or using scissors. Drawings may appear immature
J does not use the proper grip for a pencil. He cannot cut straight along a line with scissor and his drawings are very babyish and do not depict what he wants to draw.
Limited creative play
He has lots of action figures and toys but does not play with them very much at all ? despite wanting them at the time.
Isolation within the peer group. Rejected by peers, children may prefer adult company
J does not appear to have lots of friends but has a few that he appears to be closer to. He has one close friend (who has ASD).
Limited response to verbal instruction. May be slow to respond and have problems with comprehension
Jacob has to be reminded often what he needs to do. He initially understands the instruction but then due to lack of concentration he needs constant prompting. He talks over other people all the time.
Limited concentration. Tasks are often left unfinished
As above. Often forgets to wipe when going to the toilet.
Sensitive to sensory stimulation, including high levels of noise, tactile defensiveness, wearing new clothes
Hates having his hair or nails cut. Can't stand itching of the hair and says it hurts when he has his nails cut. At nursery, I sometimes took him to nursery with no clothes on as he refused to get dressed and had screaming tantrums. He hates shrill sounds such as a drill or loud hand-dryer. He often gets into a very over-excited/meltdown state in supermarkets (not sure what the stimulus is for this).
By 7 years old
Difficulties in adapting to a structured school routine
It appears so
Difficulties in Physical Education lessons
Having observed a PE lesson in the playground, he was unable to follow the instructions of the teacher including standing on the line or throwing the beanbag as he was meant to be.
Slow at dressing. Unable to tie shoe laces
Very slow at dressing. Clothes are often put on the wrong way round.
Barely legible handwriting
Yes
Immature drawing and copying skills
Yes
Limited concentration and poor listening skills
J gets in trouble for not concentrating on his school work which leads to him missing his golden time. Apparently he is now disturbing the rest of the class as the teacher has to spend so much time with him.
Inability to remember more than two or three instructions at once
Yes. Leads to activity not being completed without prompting or lists. J often writes lists at home (on his own doing) of what we need to complete that evening/day.
Slow completion of class work
Yes
Continued high levels of motor activity
Yes
Hand flapping or clapping when excited
Tendency to become easily distressed and emotional
Problems with co-ordinating a knife and fork
Yes ? he cannot do this at all. He eats with just an implement in his right hand and uses his left fingers to assist.
Sleeping difficulties, including wakefulness at night and nightmares
Waking at night to urinate despite reducing drinks in the evening. Often wets himself. He needs to have a set routine at night otherwise he is not able to settle ? rhis makes it diffiult to take him out in the evening. Has to have a potty in his room as often wets himself on the way to the downstairs toilet. Too big for potty so then wets floor.
Walking ? J finds it difficult to walk any longer distances and often refuses to walk meaning that he has to be carried as we no longer have a pushchair. He says that walking hurts his legs and feet and also makes him very tired.
Bathroom ? J frequently makes a huge mess in the bathroom, pouring whole bottles of shampoo etc into the bath and pouring water all over the floor
Lights ? J constantly turns lights off in the house despite being told not to.
Bike ? He is terrified of the balance sensation without the stabilizers or even if the stabilizers are raised a bit
Tantrums - He often gets out of tantrums or apologises by writing me a letter.