Finally got to see the OT today - hypermobility and poor body awareness...

[AngryFeet]

DS (5) was referred by school as they noticed his fine motor skills were poor and that he couldn't sit on the carpet (can't do cross legged and wriggles all the time so they had him on a chair). He also has bad spatial awareness. He struggled socially in reception and was teased a lot by the other boys. Luckily with lots of help from the school he made a friend in the summer term and started to grow in confidence. His speech is delayed but we have been working with the SALT and it is improving.

We saw the OT today after an 8 month wait. She did lots of tests and when she examined his hands she saw that his joints bent back very far (I had never even noticed this!). She said he is hypermobile. She said that it is hard for him to write due to the hypermobility as his fingers keep going back as he pushes against the pencil. She also said he has poor proprioception. Things I have noticed about him such as barging into people instead of going around them, struggling with sports (swimming he watches his feet all the time and his legs fail around), pain in his feet and legs many nights etc make more sense now. She said they will work with the school and we have to go back in a month for further assessment and to get more feedback.

What does this mean for him?

DS2 has this and struggles with handwriting. He doesn't have a lot of strength in his hands, so when he carries things it is generally in his arms, not by his hands. And he struggles with cutlery, handwriting, colouring, buttoning, zips, brushing his hair or teeth. Basically anything using fine motor control.

There are things you can do to help, such as pencil grips, caring cutlery, pull straps on zips (on jackets). They should be giving you exercises or things to encourage to help build up some strength in his hands, arms, and through the shoulders as well.

Angry, Is the OT going to treat him or give you a programme to work on?
At least school were on the ball to refer him instead of labelling him fidgety.

We can find it hard to sit still if one has poor proprioception, we need the movement to 'tell' our brain where our body is.
Treatment activities are usually 'heavy work' first....lots of carrying heavy loads, groceries, bag of books for teacher, watering can. Large movements over the head e.g cleaning windows, washing the car, writing on an easel at eye level or higher. Swimming can be hard to learn but invaluable as the water gives extra information about where our body is.
Get him pushing the supermarket trolley for you, Vacuuming, small sweeping brush.
Wheelbarrow walking, commando crawling through obstacle courses, climbing under, over and through things.
Does he like play dough...get him rolling it, pinching it, cutting it with a scissors.
Does that give you some ideas?

One of my dc has this. Your OT will tailor activities to your child's specific needs.
My child got terrible leg pains and had bad proprioception. The thing that helped my child in particular was a referral to the R.D.A. as riding is very good for core stability. In particular was a block of vaulting also through RDA. My child could not ride a bike, but staying on a horse did wonders for self esteem!
At school my child had a writing slope, and pencils with raised spots on to give extra feedback from the fingers because they always pressed too hard.
Your son is young enough to benefit from some specific work to help him; once they reach 9 or 10 the window of opportunity is passed, so I am told.
Hope this helps. Good luck at your next appointment!

Thank you very much for those ideas :) Yes they will be giving us some sort of programme I think. She did say everything would be passed to the school so we wouldn't see the OT long term. Is that normal? Luckily the school my kids go to is very good with SEN/SN so I know he will be looked after there which is a weight off :)

I will make sure I take him swimming once a week outside of his normal swimming lessons as then he has a bit more freedom in the water. He did gymnastics for a bit last year but it was very frustrating for him so I have cancelled those for now.

We do have a stables right behind our house so I might go and talk to the lady there. They have a small pony for beginners and she is happy to do lessons from 5. Think DS might get bored just sitting on a horse for 30 mins though.

I feel awful that we are always telling him off for not being able to keep still now :(

Swinging - on a swing, hammock, ropes, zip line etc - balancing, rolling can help with body awareness and gross motor skills. Playing with sand, water (making marks with fingers in wet sand), playdough, threading beads, Lego and model making. Kneeling up at a low table while occupied with such tasks can help core stability. Also ask if he could use a Move n Sit cushion or wedge at school and check he can sit with back supported and feet flat on floor for stability while writing.

As to what it means long term these are potentially traits of dyspraxia. It may mean he finds sport especially team sports hard (judging speed , distance, physical contact, throwing and catching particularly while moving), handwriting may continue to be an issue in which case at some point he could learn to touch type and use a laptop in exams as he could tire more quickly with the effort of gripping a pencil and he may press too hard to compensate for the lack of feeling through lax joints (leaning paper on a soft inclined surface may help), coordinating movements to do tasks such as playing an instrument or driving may take longer to master and need practice. By identifying this so young he has the best opportunity to find alternative ways of remembering and doing things which will help longer term too.

I agree with horse riding for core strength...that's most likely an issue for him too as the proprioceptors at the lower spine are involved in posture.
I don't know about the OT handing off to school to do all the work; I would probably be asking for an annual review at least.

Did the OT do a sensory processing questionnaire...probably not necessary but would be best practice.

Don't worry about not 'seeing' it....BUT if you do need him to sit still (church, family meal, whatever) make sure he gets lots of the large movements beforehand. And learn how quickly the effect wears off for him.

Not sure porridgelover - what does the questionnaire involve? I don't think she did. She got him to copy some shapes and lines, did a visual perception test which he passed with flying colours then did lots of physical stuff like walking along a line on tip toes, throwing and catching a bean bag etc etc.

Just to clarify, the work the RDA do with the children is amazing. There is no way that it is just a question of being led around in circle for the session (as I too thought!) They are taught to ride properly, do different exercises and play games on horseback. No 2 sessions are the same. It really helps balance and concentration.
The other thing at first dx was sitting on a T stool. Great for balancing.
Your OT will tell you the best sorts of things to help your ds.

Angry this is an example of a sensory processing checklist.
If its ringing any bells, it might be worth printing and forwarding to the OT to discuss at your next appt.

An exercise ball is a good investment for sitting on to improve core strength, sensory input to help with fidgetting, lying and balancing across while "walking" forwards and backwards with hands and to play with outside. Also a rocker/balance board.

Angry - is the ot referring you to a paed for a dx as to what is causing the hypermobility and poor proprioception?

Hi sorry to hijack but where can I find a rocker or balance board please?Do they have to be from specialist suppliers like sensory direct? And did someone say there is special cutlery?

OP my DD has the same issues and I have told her off so many times for swinging her legs, delibertely barging into me etc. I was sceptical about how the exerccises the OT gave us would help to begin with but they have helped with her behaviour, and calm her down.

usedtobe, the cutlery is called Caring cutlery, if you google you should find some.

Dd3 refused to use it so I bought a set of cutlery with chunky handles which have helped. We have a wobble cushion rather than a wobble board and you can get them from TKmaxx sometimes.

AngryMy Dd3 has hypermobility and poor core strength and that thing I cant spell when you dont know where your body is. I would recommend that you get a referral to a podiatrist and get his gait checked incase he needs orthotics.

Dd3 had some physio and does excersises everyday[well most days], she uses a stabilo pen and pencil at school to help with her writing.

She has recently started going kayaking and I think this is really helping her core strength as she has to sit up straight or she capsizes and the coaches nag her for being floppy.

Thanks going to google and buy now-DD1 will only use a spoon/her hands! Always happy for an excuse to go to TKMAXX too!

Just spent a happy hour on completely care and ordered the cutlery set, some gel resistance training squeezy balls and some things to put on pencils to make it easier for DD to grip.

She didnt mention it sparkling. What sort of thing can cause those two problems?

Ehlers Danlos Syndrome (EDS hypermobile type) and benign joint hypermobility syndrome (BJHS) which are probably them same thing at different extremes, can be a cause of hypermobility and poor spatial awareness and gross motor skills. My ds has eds and has very poor proprioception.

A rheumatologist can make a dx and then help you get support with physio, OT support if necessary and manage any pain. I would go to your gp and ask for a referral to a rheumatologist.

usedtobe - put wobble cushion into amazon and you get a whole selection of reasonably priced balance cushions, my ds uses them for sitting on and standing on for physio.