Perspectives on sensory, texture, and environmental control factors: tips for picky eaters, feeding problems, and expanding your child’s diet.
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Children with autism almost always have medical conditions that cause or make the symptoms of autism worse. Treating those conditions makes the child healthier and when they are in less pain, they learn better, have less aggression, communicate, and learn coping skills among many other improvements. Some children even recover from autism through the use of biomedical treatments used alongside traditional therapies.
The primary cause of fine motor control problems is a lack or over abundance in muscle mass. A child having high muscle tone may make mistakes based on the over activation of muscles, resulting in activities being sloppy or even clumsy in nature. A child having low muscle tone is quite common; a child with low muscle tone may struggle to maintain even the smallest control of a pencil or even scissors. Small feats like finger movement may prove to be an extreme effort for a child with low muscle tone.
It can be said that genetic and environmental factors can lead to fine motor skill problems. While pregnant, a mother exposed to alcohol and drugs can be a big factor in the development of a baby. Alcohol can directly affect the neurons in the brain. If a baby is born premature the connection of the neurons in the brain may be disturbed. The more premature a baby is the risk for this problem rises. Disturbing the connection of neurons can lead to difficulties with attention span and/or self control in fine motor skill development. Even smoking has been known to have negative effects on motor skills.
Treatment with pediatric occupational therapist can greatly improve a child’s fine motor skills with the right therapy geared to successful treatment of fine motor problems. The pediatric occupational therapist may try two approaches in the treatment of your child. The first is a relatively general approach dealing with the assessment of their sensory development. How a child moves and reacts to stimuli. Finding that underlying factor helps them form a second approach designed specifically for fine tuning the way they perform more complex tasks using fine motor skills. Teaching them how to accomplish and fine tune their skills can greatly improve motor function.
Being that no one method is successful for all patients a Pediatric Occupational Therapist may also treat a child in these areas:
– Their finger strength, hand strength, hand position and stability
– Overall pencil grip and control
– Control of the wrist and forearm
– Finger movement
– The spatial organization of space and letter formation
– Speed and dexterity
– The isolated movement required for tweezers and scissors
It is necessary for parents to take an active role in their child’s treatment for the continuation of improvement outside of the pediatric occupational therapists office. For at home improvement of fine motor skills the occupational therapist may suggest activities like drawing (sample activity), coloring and paper cutting art involving cutting out paper chains and making paper snowflakes. Drawing can improve how neatly the child can draw lines and shapes, improving the overall appearance of letters and shapes all together; paired with coloring this helps the eyes determine where to stop by staying within the lines in shapes and forms. Tracking movement is one of the key factors in fine motor skills. There are also toys and games available that are geared for the improvement of fine motor skills.
Developing and improving fine motor skills can take a lot of time but with the proper guidance from a pediatric occupational therapist you can make all the difference in the way your child learns and perceives life in general. Children with fine motor skill problems can suffer greatly in school and even social situations. Therefore it is important to identify any fine motor control issues and begin an occupation therapy program to help them develop these skills as quickly as possible.
Fine motor skills are important to a child’s development. Not having these skills can interfere with school and home activities. It is important to understand the difference between fine motor skills and gross motor skills. Fine motor skills are those skills that require smaller, more delicate movement; usually using the smaller motion with an emphasis on the coordination of those movements. Gross motor skills are those skills using the larger muscles in the body, those to run, jump and move about.
Concerns with a child’s fine motor skills can be treated by a therapist with a strong focus in the area of pediatric occupational therapy. A child with fine motor problems may become easily frustrated in school when having to copy things from the blackboard or in art class because he or she may have problems either writing neatly, staying within the lines when coloring or cutting out shapes.
A child’s motor planning and speed of movement can be greatly affected in cases of fine motor control development. Motor planning involves the visual detection of motion and errors in movements. For a child’s movement to be effective things must be timed adequately and fine motor skills require a certain amount of attention and concentration as well. What is more important is the order in which certain movement is made to accomplish a task. Managing complex activity using the smaller muscle groups may be compromised when dealing with fine motor skill problems. School age children face more fine motor skill problems than most other age groups, making pediatric occupational therapy a very important step in the treatment of this problem.
Children with fine motor skill problems may present other behaviors as well. At times a child may have underlying issues that could be associated with fine motor skill problems. They may actually present problems with articulation of words and sounds due to the fact that fine motor control has to do with tongue movement as well; being the tongue is a smaller muscle. Fine motor control struggles can be due to sensory problems in the brain; the child may have an aversion to being touched and being introduced to new things. In these cases the child’s ability to behave and control their fine motor skills may be hampered by the over stimulation of the senses, causing frustration and clumsiness.
Children experiencing fine motor skill problems may present the following issues:
– Clumsy pencil grasp (pincer grasp activities)
– Poor scissor skills
– Not able to grasp and release things in a controlled manner
– Cannot hold small objects or use tools such as pencils and scissors
– Dislikes completing mazes and dot to dots due to being easily frustrated with them
– Has problems copying from the blackboard in class
As a toddler, Ian Barrier got expelled from day care.
“They just said that he was all over the place, he couldn’t handle the structure, they didn’t have the staff or the skills to deal with it,” said his mother, Amy Barr. “They said, ‘We think he has ADD or ADHD’ and I’m like, ‘What is that?”
Ian, now 11, and his 9-year-old brother Aidan are just two examples of some 5 million children in the United States who have received the diagnosis of attention deficit hyperactivity disorder (ADHD), a condition marked by impulsive behavior and a lack of focus.
But although this is a medical condition with medical treatments available, often doctors aren’t the ones suggesting a diagnosis.
Many parents begin their struggles with treating their children’s ADHD the way that Barr did: with a suggested diagnosis from a school or day care setting. That’s a problem, doctors say, when there could be many other factors contributing to a child’s behavior.
For a teacher to suggest that a child has ADHD is “inappropriate and dangerous,” says Dr. Elizabeth Roberts, child psychiatrist in Murrieta, California. Depression, anxiety and abuse are all possibilities in a child’s life that could lead to attention problems, Roberts said. That means that many children are receiving medication for the wrong problem.
Roberts wants to say to all educators: “There are many, many diagnoses that cause these problems, including abuse and depression and anxiety. So please, withhold your judgment.”
But Barr is happy that her son’s day care center mentioned the condition to her. It explained Ian’s behaviors that she had been excusing with the adage “boys will be boys.” The center also directed her to a facility where he could get tested.
“I’m just glad that they brought it up, because I was living in it and didn’t know any better,” she said.
In Barr’s case, having gotten her kids tested for ADHD even before school, the educational system has been supportive. But the question of medication has plagued her, with years of trying different combinations of drugs — sometimes four or five at a time.
Despite medication, Ian pulled the fire alarm at his fourth day care center, dispatching the same fire department that would get him out of a tree at age 9, Barr said. And both brothers have spent time in a psychiatric ward at a children’s hospital; for the younger one, it may have been because of overmedication, Barr said.
“You go through all of that, and it’s just various different medications, and then you start to feel guilty: I’m drugging my kid,” said Barr, of Fleming Island, Florida. Her boys are now both on just one medication — Vyvanse (lisdexamfetamine) — for focusing in school.
All too often, parents come to pediatrician Dr. Claudia Gold’s office asking for a prescription for ADHD, based on a recommendation from school. When she consults with parents alone, however, she’s likely to hear stories of trauma: a death in the family, an abusive relationship, and other life experiences that the teacher knew nothing about.
“I think that sometimes folks want an immediate answer and they want to help a child as quickly as possible,” said Cheryl Rode, Director of Clinical Operations at the San Diego Center for Children in California. “Medication is quick and easy but it’s not the answer alone for working with kids who have ADHD.”
Experts agree that ADHD does exist as a real disorder, and that some children really do benefit from medication. Studies have shown a biological basis to the disorder and a genetic component, suggesting it can be passed down in families.
But it’s not the teacher’s place to make diagnoses, or to recommend medication, Gold said.
Teachers and related school personnel have an important role in identifying learning and social challenges faced by students, including those with ADHD, says Clarke Ross, CEO of CHADD (Children and Adults with Attention Deficit / Hyperactivity Disorder). But teachers should never give a diagnosis for the purpose of medication use, or advise the use of medications, he said.
Alana Morales, of Thornton, Colorado, is one of those teachers who has brought up the subject of ADHD testing with many parents. She doesn’t tell parents to medicate their kids, but brings up the subject of getting children tested because she thinks it’s important for parents to know.
“You have to be so careful because, again, we are not doctors,” she said. “But does that mean we don’t recognize it? No.”
Not every child with ADHD needs medication, doctors say, and Morales said some students benefit more from counseling, special adjustments in school, a tutor, or a different environment for doing homework. It’s helpful for parents to get informed about the condition and become advocates for their children — but some may make the situation worse by having a closed mind to interventions and denying that there’s anything wrong, she said.
“You’re really setting them up for failure, because it’s not a crime, it doesn’t mean you’re less of a parent if your child learns differently,” she said.
Rode agrees with Roberts that teachers should not recommend medication, but thinks that teachers have an excellent frame of reference for what is typical or normal development.
Also the parent of two children with ADHD, Morales has specific strategies she uses when there are kids with ADHD in her class: don’t seat them together, put them on the edges of the classroom so she can see them better, and sometimes modify assignments.
Providing an environment conducive to helping kids with conditions such as this is getting harder as budget-tightening schools cut back on teachers, Morales said.
Last year, teaching at a public school in Arizona, Morales had one classroom with 37 students, which included at least four kids with ADHD and one with Asperger’s syndrome. And teachers whose job it is to provide extra help to those kids get responsibility for more students, leaving them with less time for each one.
Roberts estimates that only about 10 to 20 percent of children who receive the diagnosis of ADHD actually need medication.
While parents like Barr have tried to inform themselves as much as possible about ADHD and treatment options, some doctors say the condition gets misapplied because it is a quick and easy catch-all diagnosis for a variety of behavior problems, with drugs available to treat it.
Parents are also culprits, and bear some responsibility for their children’s behavior, Roberts said. She thinks a lot of kids just need better structure and discipline in the home.
“Parents want to leap-frog over the parenting job and get right to the grandparenting,” she said. “Everyone wants to have fun with their kids and everyone wants to be popular with their kids like Grandma is. But the reality is: Someone has to be the bad guy or the kid never learns.”
Morales recommends that parents stay involved in their child’s school lives by helping them with homework, assisting with organizing their papers, and writing notes to teachers so that everyone is on the same page.
On behalf of her own two children with ADHD, Morales is writing letters now to their teachers explaining how her kids learn differently and what accommodations have been made in the past (they are both on medication). She is also asking the teachers to let her know about any problems this school year.
Looking back, Barr wishes that when her children first got the ADHD diagnosis and then started school, she could have had a teleconference with the school and the psychiatrist at the same time. Instead, she had to relay what the teachers said about her children’s behavior to the psychiatrist, and then the psychiatrist’s treatment decisions back to the school.