? for Jambuttie

[hels9]

Hi, Jambuttie,

You said on another thread that your son is hypotonic and extremely hyperflexible in his hands and wrists, and that he is going to be getting bike riding lessons from his OT...

My son is also hypotonic and hypermobile (in every joint), and is getting a bike for his 4th birthday. I was wondering whether your OT had indicated how much she thinks your son's problems are caused by his hypotonia and hypermobility and how much by co-ordination difficulties? Could it be solely a muscle tone/strength issue? It's just that I find my son's difficulties a bit of an enigma, as in many ways he seems to be rather well co-ordinated, and he can pedal a tricycle indoors and has no trouble steering at the same time, but take him outside on it, onto rougher ground, and he can't get it to go anywhere. I'm sure part of this is caused by his hypotonia and hypermobility, but I also think his pedal action is not the most efficient, as he does back pedal quite a bit, especially if pushing forwards on the pedals seems to be too much like hard work. And I really don't think his strength is such an issue that pedalling should be impossible on a rough surface.

As yet, we have no proper diagnosis for my son (waiting to see geneticist and neurologist to rule out connective tissue disorder or myopathy), hence seeking any feedback from anyone who might have an inkling of how to separate issues with co-ordination from those relating to muscle strength and tone. Our son certainly picks up how to do things quickly if he's physically shown how to do them, step by step, but he does tend to need to be shown, first, and seems to learn cognitively, rather than instinctively. Apart from this mild motor planning issue, he doesn't have any other signs of dyspraxia (in fact his memory, concentration, organisation and visual skills are exceptionally good, which is probably why he responds so well to being taught motor skills), although he has a somewhat unusual personality/social skill set, which may or may not be mildly AS (or gifted, I've recently discovered!!!).

Has your OT given any advice to you on how to help your son with riding a bike?

Hi hels

Sorry just seen this thread.

OT hasn't really said much about it tbh just that he feels DS1 would benefit highly from the bike group.

DS1 seems to have no power/strength in his legs to pedal- he struggles to run with other and walking becomes most uncomfortable for him- he then believes every1 runs away from him as he is much slower in actual fact they dont bless him.

OT has said the extreme hypermobility in his hands/wrists contributes highly to his difficulty in writing etc as he put excessive pressure on his pencil- mostly because his fingers are all over the place.

I will have a look for a leaflet we were sent on teaching him bike riding see if I can lay my hands on it for you.

hope that helps , if you need to ask more fire away!!!!

FOUnd it!!!!!

If I knew how to work my scanner i wouldd have sent it to u lol

If you want I will happily post it too you though

Thanks for that, Jambuttie. The OT, PT and paediatrician are coming to observe my son at pre-school in the next few weeks, to assess what we need to say to the teachers at his primary school in September, so I might ask the OT, then, if she has one of the leaflets on bike riding - he hasn't had any OT treatment, yet, but she's always helpful with advice on how we can help him at home.

My son is also a very slow runner, his ankles pronate and he has very flat feet, but apart from being slow, his technique is fine. He still walks slowly, too, but he can walk quite a long way at a slow speed before he wants to give up and doesn't seem unduly tired by the end of the day... I hope it doesn't upset him too much when his little brother starts running past him!

On the matter of writing... Both my and my husband's families are hypermobile, which hasn't caused any of us any problems in life, but I have noticed that my husband's family all have a rather unusual pencil grip - with forefinger and middle finger on top of the pen. They all have lovely handwriting, but it's made me wonder whether this is a way of increasing the stability of the grip to overcome the hypermobility, as my son is also happier if he can grip his pen that way. If he uses a conventional grip, he can only make a sufficient mark on the page with a felt tip pen - he just can't seem to apply enough pressure with anything else until he's adopted a slightly more unusual grip (either two fingers on top or, preferably, with the pen sloping forwards in his hand instead of back into the web between thumb and forefinger). Has your OT indicated whether other grips might be acceptable for a child with unstable joints, or is your son persevering with learning to write with a traditional grip?

Hels9 - there is an alternative pencil grip which you might like to try. Basically, the pencil sits between the index and middle finger. The fingers are slightly curved andand grip the pencil at the top and bottom of both fingers.

The thumb supports the pencil underneath (ish). It's still a tripod grip, but I've taught children who struggled with the conventional grip yet found this more comfortable and efficient.

No idea if this is any good for your ds, but it might be worth a try.

Thanks, Littlefish. Does the pencil still have to rest back in the web of the hand, between index finger and thumb, or can it be held a bit more upright and away from the web? It's just that, trying it myself, I can see that my grip is tighter if I don't let the pen rest back, so I can see why my son wants to do it.

Have you thought about a sloping writing table too? These help children with their handwriting too..............

The pictures I've seen show the pencil resting back in the web of the fingers (between the index finger and middle finger. I think it makes it more stable than just gripping it between the fingers. The thumb is just used to support underneath. It's quite different to the normal tripod grip, but even just trying it out now, it feels comfortable.

Perhaps you could mention this possible grip to the OT and see what he/she says.

Wow! That is very different. I'll definitely ask the OT about it.

Are you a primary school teacher, as a matter of interest - you say you've taught children this alternative method?

Many thanks for the suggestion.

Hi hels, your son sounds similar to mine. my ds1 has HMS, and dyspraxia. He holds a pencil with the normal grip, but has two foam rubber grippers on the pencil to make it really fat. He also has a softer grade pencil as he struggles with making enough pressure on the table. He has good muscle tone, but is so hypermobile that his joints jsut bend the wrong way. It helps too, if he has a 'warm up' by exercising the arm first. He has things like sticks with ribbons on to do little exercises with.

He also has to make sure that he is in the correct position, he needs the paper square on, and his feet flat on the floor to write. By having it square on, his elbow is tucked in to his chest so he doesn't have that going all over the place and can concentrate on his wrist and fingers. A tilting table was discussed, but they thought it would be more hassle than help, so they've left that for now. Eventually they are talking about finding a laptop, I personally don't want him to waste too many hours learning to write and falling behind with the things that he IS good at.

ds1 can't ride a bike at all, and gets tired very easily. He cries if I try to make him walk the mile to school. He can't run very fast and walks like a penguin! I was actually considering getting him a skidder for his birthday, one of those sit down bike things. I think he might find that easier, since he doesn't have to balance perched on a seat at the same time as trying to pedal.

Thanks, lottiejenkins and chopster. It's interesting hearing from other people with similar, but slightly older, children, as it does give good ideas on how to help and what problems to look out for.

I have thought about a writing slope, if he does continue to have problems, and have bought the "Write from the Start" books that were recommended elsewhere, as I thought they might help.

My ds really doesn't like the foam rubber grippers on his pens, unfortunately - he'll just refuse to draw or write with them at all. He might get used to them and accept them more when he's really expected to start learning to write, though.

I'll let you know whether I have any success with my son's new bicycle!!! At least he's got a little brother who can enjoy it after him... At the moment, the biggest dilemma is how to encourage him to try it without taking on that look of "this will make your legs stronger and is good for you, so I REALLY want you to enjoy it" which is enough to put anyone off, really.

Hi Hels9, yes, I was a primary teacher (now a nursery teacher). I was shown the grip by an OT when I was working with a child who suffered with muscle fatigue if she wrote for too long. I subseqently saw pictures of it in a book. I've been searching around to see if I could find a picture of it to show you, but I can't find one anywhere. I'll keep looking though!

Would your ds enjoy a scooter more? Would pushing with one leg, and then swapping to the other side build up his muscles enough?

good luck with the cycle.

I think the scooter is a good idea. Ds1 has one of the toddler scooters with the three bigger wheels and loves it. I've found trampolining has helped him too. He started out on jsut a little one, and we now have a big one and he is always on there in the summer.

Yes, trampolines are great - my son also loves trampolining and it's the one thing that has made the most noticeable improvement to his leg strength. He has also recently started swimming lessons and loves those, too, because they make him feel very grown up, which is great, as I was told it's the best way to strengthen up all the muscles around the joints without doing any damage. He's not really interested in scooters at the moment, so I might save that until my other son's birthday in October, get one for him and see what ds1 thinks of it, then.