A “Real Birthday Party” was in order for Raymond this Year!
A “Real Birthday Party” was in order for Raymond this Year!
Several years ago, I met a 9-year-old boy named “Raymond”, who had recently been diagnosed with Aspergers Syndrome. He was very bright and got A’s in classes like math and history. Raymond knew a lot about video games and video game systems, and was willing to tell you every detail about them. He also confided in me that he had no friends and that kids laughed at him and turned the other way when he came over to them. The reason that he came to me was that his handwriting was illegible and very slow. And during his OT evaluation, I discovered that his coordination was well below age level (much more like a 4 year old) and that he had weakness throughout his body. I also noticed that his focus and concentration was very poor for non-preferred topics.
Children who have a Traumatic Brain Injury typically go through a course of rehabilitation. It seems that although there are clusters of similarities in these patients, there are rarely ever 2 that exhibit the exact same difficulties after their injury. I met a 7 year old who had fallen off of a truck, and had suffered a TBI. He required surgery to repair a hole in his skull from the fall. This little guy received OT, PT and speech for a year in an intensive program and did very well. One year post his accident, he was demonstrating great recovery in every area – walking with no support or braces, cognitively intact and able to complete 1st grade work without assistance, speaking clearly and without difficulty. His last resulting effect was a left hemiplegia. His left arm dangled from his side and was non functional. This was very frustrating to him and to his family.
Some children with cerebral palsy have great difficulty with coordination and timing. They may have difficulty with their fine motor skills, catching a ball or walking smoothly. In watching these wonderful kids over the years, I have noticed 2 things, (1) that their timing can be off when they try to perform coordinated tasks. For example when they work on their ball skills they close their hands too early or too late to catch/bounce the ball and (2) that they sometimes lack self confidence in their physical skills making them less likely to practice them. Many of these kids have been in therapy for their entire life, and then when they reach 10, 11, 12 years old they grow tired and weary of the typical weekly sessions of practicing the skills themselves. While practice of skills is definitely necessary, I think we are learning to go a step further to address the underlying issues of timing and coordination with the Interactive Metronome program. 
Mom came to me one afternoon, and in telling her story her eye’s teared up. She had phoned home from work one afternoon, and her daughter answered the phone! This was the first time that this had EVER happened! Mom was thrilled as she was able to ask her daughter questions and have them answered. She also noticed that her daughter was much more interested in going to school and church functions. She actually asked to invite a classmate over for a play date. Read the full story
Erin had a diagnosis of PDD/Autism. She was verbal, but unable to have a purposeful conversation. Her voice was very high pitched, and other children turned away from her when she would go up to them and start reciting lines from various Disney movies or Barney episodes on TV. She had been attending traditional OT/PT and Speech therapy visits for 7 out of her 8 years of life and the family was reaching burn out status, as her progress seemed to be very slow.
Ricky is a 10-year-old boy with a diagnosis of ADHD, aspergers syndrome, anxiety and fine motor delay. Ricky attends public school and is in the 4th grade where he had been struggling with paying attention in class, completing assignments, and focusing on tasks. Ricky’s mother was very fearful that in 4th grade he would get lost in the shuffle and fall behind in his schoolwork. Ricky would never choose to sit and read a book. Getting homework done took hours each night and included a fight from Ricky.
There are so many children diagnosed with ADD and ADHD these days. Some kids are struggling to pay attention in class or are labeled as the class clowns or troublemakers at school or other organized events. Whether it be a hyperactivity or an inattention to task, could there be a common thread that was missing when we evaluated these children? We utilized standardized tools such as the Bruininks, VMI ,WOLD and Jebsen. They all tended to score below their same aged peers on these tests, handwriting was poor and sometimes it just didn’t seem like they heard what you were telling them.
