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Post by Just Beth on May 3, 2018 0:51:35 GMT
Update 11/3/18 We saw the neurologist in July. She ordered an MRI and a CK, which were both normal. Due to the doctor being out on maternity leave then leaving the practice we were not able to get in for the recheck until this week. Wow, what a surprise was in store for us. The new neuro did a repeat exam. Apparently both docs think there is something wrong and want him to go to a university hospital for genetic testing. He is lacking in muscle bulk and seriously lacking in motor strength in addition to the fine motor issues. The doc looked at "Jason's" dad and asked him some more questions. He was noticeably weak as child and teen himself as compared to his peers. For now we are working on some more tests his local pediatrician can order then we will work on the higher level stuff when those are resulted. Jason's dad and I got married this week also, partly so the kids can be on my insurance which is much better than his.
OP:My 11.5yo stepson seems delayed in his fine motor skills.
Background: I will call him "Jason" for this post. SO and I are his primary parents and I have been in his life as a mother figure since he was 6. Bio Mom is involved but takes a small role in the kids' life. I have my own college age kids as well. Jason is the oldest grandchild/child on his dad's side and I think his mom, grandma, and dad still see him as a little child along with his little brother and younger cousins so they don't expect much from him as far as being capable to do things for himself. Thankfully, he is healthy, happy, well mannered, has friends, does not seem immature behaviorally, and gets good grades.
Tell me what you think: He can't use scissors very well. He can't cut his food up with a knife and fork unless its something like cut a plain hot dog into chunks. He likes adult style food not kid menu items which is great but for example when he holds a burger with more than just a patty and bun to eat it, it all falls apart in his hands because he can't hold it well. He holds a pencil with just fingertips, nothing close to the correct grip and shakes his hand because it aches after just a couple lines of writing. Consequently he really hates to draw a picture or write an essay by hand. His grip has gotten worse over time not better. What can your 11.5yo do?
We took him to his pediatrician for this and she seemed not to think much of it until she asked him to unbutton his pants for a quick exam and he struggled and finally his dad had to unbutton his pants for him because he couldn't do it. I am concerned because I love him and dang, I just don't want to send him to high school in two years still needing adults to cut up his food and unbutton his pants!
Pediatrician referred him to a pediatric neurologist and he has an appt in a few weeks. SO and I were surprised by this and honestly were just hoping for/expecting a referral for an eval by an OT or PT.
Am I wrong that he seems delayed in these skills? What kind of fine motor skills should he be capable of at this point? I have Googled this to death and all I can find are baby and toddler milestones.
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Post by revirdsuba99 on May 3, 2018 1:00:45 GMT
Go with the referral you have, they are the experts. Have you spoken to his teachers and/or the school? If he needs testing and help/services they should provide them when they know about them! As an example: I just got off the phone with a friend. Her DS's school had to go on 1/2 days for mold and asbestos issue and he lost his extra reading help for weeks.. 23 hours... Back into their regular school they wanted to take his recess for the reading. No way! He gets a tutor at home a hour twice a week.
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Post by Darcy Collins on May 3, 2018 1:07:46 GMT
Does he go to a traditional school? I'm surprised the school wouldn't have picked up on the scissors and pencil group a long time ago.
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Post by Just Beth on May 3, 2018 1:08:19 GMT
Go with the referral you have, they are the experts. Have you spoken to his teachers and/or the school? If he needs testing and help/services they should provide them when they know about them! As an example: I just got off the phone with a friend. Her DS's school had to go on 1/2 for mold and asbestos issue and he lost his extra reading help for weeks.. 23 hours... Back into their regular school they wanted to take his recess for the reading. No way! He gets a tutor at home a hour twice a week. No, we have not spoken to his school. SO has been very reluctant to acknowledge there is a concern at all. And wow, good for your friend! I can't imagine taking away her son's recess! SaveSave |
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Post by Just Beth on May 3, 2018 1:16:03 GMT
Does he go to a traditional school? I'm surprised the school wouldn't have picked up on the scissors and pencil group a long time ago. Yes he goes to a traditional school. It is K-8. I think he probably was less behind compared to his peers when they were all learning these skills originally and the gap has just widened over the years. They don't do a lot of projects that require that skills in older grades it seems. He tends to avoid activities that use fine motor skills and choose other things like reading or math when he has spare time in the classroom. His school also issues each child a tablet so they do a lot of work on there. Typing he does OK with and video games also. He gets nearly straight As so I don't blame the teacher or school for not picking up on it. He's very bright and school comes easily to him. There are so many students with more obvious needs that he could be missed. And I second guess myself like maybe I am overly concerned but my older kids were able to do things much more easily and earlier. Jason's 8yo brother exceeds him in fine motor tasks like opening packages. SaveSave |
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Post by revirdsuba99 on May 3, 2018 1:16:07 GMT
And wow, good for your friend! I can't imagine taking away her son's recess! They know she knows the rules!! They should respond accordingly. |
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Post by Eddie-n-Harley on May 3, 2018 1:26:13 GMT
I think an OT/PT referral is part of a treatment protocol; they first have to figure out what's responsible for the delay, hence the referral to neurology.
Has he ever had any strep infections, or any infections that maybe could have been strep that went untreated? Was he on track and some point and regressed?
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Post by peasapie on May 3, 2018 1:27:08 GMT
I do think his motor skills are not typical for his age. I think the fact that his motor skills seem to be weakening with time (based on your description) is what triggered the referral to a neurologist.
Sometimes when kids can't do something very well, they compensate by avoiding it. These days, with less handwriting being taught and tablets introduced at earlier ages, he may not be getting the practice and strengthening he needs. Assuming they rule out any neurological basis, he will benefit from OT.
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Post by birdy on May 3, 2018 1:28:58 GMT
DD (just turned 12) doesn't have any of the issues you mentioned, but she does still have trouble cutting food with a knife.
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Post by Just Beth on May 3, 2018 1:36:56 GMT
I think an OT/PT referral is part of a treatment protocol; they first have to figure out what's responsible for the delay, hence the referral to neurology. Has he ever had any strep infections, or any infections that maybe could have been strep that went untreated? Was he on track and some point and regressed? No, he's almost never sick. I think these skills were never a strong area for him and other kids gained skills over time but he did not. It doesn't seem like he has regressed in his skills. SaveSave I do think his motor skills are not typical for his age. I think the fact that his motor skills seem to be weakening with time (based on your description) is what triggered the referral to a neurologist. Sometimes when kids can't do something very well, they compensate by avoiding it. These days, with less handwriting being taught and tablets introduced at earlier ages, he may not be getting the practice and strengthening he needs. Assuming they rule out any neurological basis, he will benefit from OT. I agree about this. |
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Post by crazy4scraps on May 3, 2018 1:45:47 GMT
I agree, using a pencil and scissors correctly was something that was heavily addressed when DD was in pre-K and kindergarten. I would think by almost 12 all of those things mentioned should be second nature.
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Post by Skellinton on May 3, 2018 1:57:14 GMT
I think an OT/PT referral is part of a treatment protocol; they first have to figure out what's responsible for the delay, hence the referral to neurology. Has he ever had any strep infections, or any infections that maybe could have been strep that went untreated? Was he on track and some point and regressed? You are correct that the first step is a referral to try to figure out it causing the delay before they will refer to OT. Those skills absolutely sound delayed. The pencil grip isn’t that big of a deal, plenty of people don’t hold their pencil correctly and are fine, but the fact that he is holding it in such a way that his hand aches after a few lines is worrisome. You said his skills have not regressed, but in the op you say that his grip has worsened over time, that is probably another reason you have been referred to a neurologist, although in all likelihood that probably would have happened anyway. An 11 year old should absolutely be able to cut food, write and unbutton his own clothing. How does he do with zippers? Who has been dressing him and how has he been bathrooming all these years? Can he fasten his seatbelt? You say he can’t cut well, can he cut on a line, does he get tired quickly when cutting? I agree I would get some thera putty in the meantime and check pinterest for activities he might like that would work on fine motor skills. I understand how worrisome this must be, hopefully neurology will have good news and this is just from lack of practice. |
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Post by Eddie-n-Harley on May 3, 2018 2:05:51 GMT
I think an OT/PT referral is part of a treatment protocol; they first have to figure out what's responsible for the delay, hence the referral to neurology. Has he ever had any strep infections, or any infections that maybe could have been strep that went untreated? Was he on track and some point and regressed? No, he's almost never sick. I think these skills were never a strong area for him and other kids gained skills over time but he did not. It doesn't seem like he has regressed in his skills. I asked because there can be a complication from strep infections called PANDAS; I know someone whose fine motor skills were (and still are) impacted because of it, and it isn't always an easy diagnosis to get. Anyhow, sounds like that is not likely to be in play here, and I hope the neuro report will otherwise be clean! Hopefully it is just as "simple" as just needing to work on developing those skills with the OT/PT folks. |
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Gennifer
Drama Llama
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Post by Gennifer on May 3, 2018 2:07:19 GMT
My son turned 11 in January, so almost 11.5. We don't need to do anything for him. I'm glad you've gotten a referral for further evaluation. Good luck!
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gsquaredmom
Pearl Clutcher
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Jun 26, 2014 17:43:22 GMT
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Post by gsquaredmom on May 3, 2018 2:12:01 GMT
I think it’s good he has a neuro referral to rule out some things.
I read an education article a couple months ago about there being lots of kids who enter kindergarten with hands too weak to hold a pencil correctly, cut, etc. because they played too much on devices and not with crayons, scissors, blocks, etc before entering school. Wish I could remember where I read.
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Post by Just Beth on May 3, 2018 2:20:54 GMT
I think an OT/PT referral is part of a treatment protocol; they first have to figure out what's responsible for the delay, hence the referral to neurology. Has he ever had any strep infections, or any infections that maybe could have been strep that went untreated? Was he on track and some point and regressed? You are correct that the first step is a referral to try to figure out it causing the delay before they will refer to OT. Those skills absolutely sound delayed. The pencil grip isn’t that big of a deal, plenty of people don’t hold their pencil correctly and are fine, but the fact that he is holding it in such a way that his hand aches after a few lines is worrisome. You said his skills have not regressed, but in the op you say that his grip has worsened over time, that is probably another reason you have been referred to a neurologist, although in all likelihood that probably would have happened anyway. An 11 year old should absolutely be able to cut food, write and unbutton his own clothing. How does he do with zippers? Who has been dressing him and how has he been bathrooming all these years? Can he fasten his seatbelt? You say he can’t cut well, can he cut on a line, does he get tired quickly when cutting? I agree I would get some thera putty in the meantime and check pinterest for activities he might like that would work on fine motor skills. I understand how worrisome this must be, hopefully neurology will have good news and this is just from lack of practice. The pencil grip is the only thing that has gotten worse over time. I am not sure why and we have tried a couple different grip aids on his pencil but it just made him frustrated. He can cut soft food but takes short cuts such as to lift a huge piece of food and bite off of it whenever we are not looking or eating with his fingers. We correct this because obviously this is not good table manners but it hasn't helped his skills. He can cut on a line but gets tired easily and the scissors sort of flop in his hands. He can't hold tension on the scissor blades well so the paper sometimes just bends instead of being cut. He almost looks like someone who has never held a pair of scissors before every time he uses them. And he only uses them when he needs to or is told to. He can fasten his seatbelt. He does ok with zippers but he is very, very thin so all his clothing hangs loose and easy is to zip. He just slips them on and off and avoids tying them. When he was in 3rd grade we made a rule not to buy him any more velcro shoes so he would be forced to practice tying. This did help the tying eventually. It wasn't until 5th grade that he could tie his shoes so they stay tied. He is so thin he just pulls his pants down for bathroom visits. He doesn't act babyish or ask for help. He just quietly avoids things. His dad signed him up for a class to learn soldering and they are doing it together. It only meets once every couple months though. We bought him a kit for home but his dad ended up doing a lot of the soldering because it was too hard for him. I have tried to get him interested in cutting and making Shrinky Dinks, learning to braid, learning to sew fabric, play with clay. He loses interest after a few minutes. I can't see him willingly playing with any sort of therapy putty unless he sees a doc or OT and gets "assigned" specific things to do. Bio mom and grandma are not likely to follow through when they have him either unless it is "doctors orders." SaveSave |
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Post by houston249 on May 3, 2018 2:23:19 GMT
My first thought was dyspraxia. Here is an article by dyspraxian (not sure if that is a true word, if it is not, I just invented it) Daniel Radcliffe. He is 19 years old in the article but is very open about his condition. He has had this condition his whole life. If this is what your son is dealing with, it is proof that dyspraxia will not prevent him from being a successful adult. abcnews.go.com/Health/story?id=5605093&page=1 |
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scrapngranny
Pearl Clutcher
Only slightly senile
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Post by scrapngranny on May 3, 2018 2:23:45 GMT
My DD #2 had some fine motor skill issues, but nothing like that. Scissors and pencils were an issue. At the time they attributed it to the fact that she walked without ever crawling. She was in a body cast from 4 months until 13 months. Supposedly, not crawling messes with the how brain pathways are formed. I’m not sure I buy that. She is now a functioning adult, who still is not very handy with scissors.
Occupational therapy might be a benefit to your stepson.
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Post by Just Beth on May 3, 2018 2:29:13 GMT
I think it’s good he has a neuro referral to rule out some things. I read an education article a couple months ago about there being lots of kids who enter kindergarten with hands too weak to hold a pencil correctly, cut, etc. because they played too much on devices and not with crayons, scissors, blocks, etc before entering school. Wish I could remember where I read. My gut feeling is that this is the case here. I certainly hope it is not a neurological problem. It is hard being a stepmom because you love them but you don't have all the authority you would with bio children. His dad is loving and very much involved but probably in denial here that he needs some assistance. SaveSave |
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Post by Skellinton on May 3, 2018 2:45:14 GMT
I think it’s good he has a neuro referral to rule out some things. I read an education article a couple months ago about there being lots of kids who enter kindergarten with hands too weak to hold a pencil correctly, cut, etc. because they played too much on devices and not with crayons, scissors, blocks, etc before entering school. Wish I could remember where I read. My gut feeling is that this is the case here. I certainly hope it is not a neurological problem. It is hard being a stepmom because you love them but you don't have all the authority you would with bio children. His dad is loving and very much involved but probably in denial here that he needs some assistance. SaveSaveI am glad your husband is at least willing to meet a neurologist and hopefully will follow through with ot. Does he like legos? Would he be willing to those to work on his fine motor skills? How about wood working, like building things, hammering, nailing, stuff like that? Origami is huge for kids around here,would he be interested in that? He is lucky to have you |
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Deleted
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May 22, 2024 3:03:02 GMT
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Post by Deleted on May 3, 2018 3:11:15 GMT
I think it’s good he has a neuro referral to rule out some things. I read an education article a couple months ago about there being lots of kids who enter kindergarten with hands too weak to hold a pencil correctly, cut, etc. because they played too much on devices and not with crayons, scissors, blocks, etc before entering school. Wish I could remember where I read. Thank you for saying this. I have a 3.5 yo DGS & a 1.5 yo DGS that I provide daycare for. I don’t let them do games on devices. We do play with blocks, play doh, & paint. We don’t do much with crayons or pencils so I need to get on that. |
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craftymom101
Pearl Clutcher
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Post by craftymom101 on May 3, 2018 3:28:48 GMT
How are his gross motor skills? Was he delayed walking? Do his feet pronate? My youngest son has very similar issues, along with gross motor delays, and he was diagnosed with Charcot-Marie-Tooth Type 1A at 3 years old (but it is usually diagnosed in adolescents or early adulthood). CMT is a neurological disorder that affects the nerves and how information is transmitted from the brain. Delayed motor skills is what made me push to see a neurologist when my son was just 13 months old. It took us almost 2 years to get a diagnosis. Keep the appointment with the neurologist. S/he may be able to determine if this is a simple issue or requires blood tests for a much larger problem. Due to my son's diagnosis he receives both OT and PT at his school. I didn't share this to scare you! But I agree with your doctor giving you a Neuro referral.  I hope your family gets some answers soon. |
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LeaP
Pearl Clutcher
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Location: Los Angeles, CA where 405 meets 101
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Post by LeaP on May 3, 2018 4:50:12 GMT
As others have said, go with the referral. The problems unbuttoning his trousers is a problem
Insofar as the handwriting, Handwriting Without Tears is what a friend who is a pediatric OT uses. My friend's son went to her clinic and used it with great success.
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Post by Linda on May 3, 2018 11:10:30 GMT
My DD #2 had some fine motor skill issues, but nothing like that. Scissors and pencils were an issue. At the time they attributed it to the fact that she walked without ever crawling. She was in a body cast from 4 months until 13 months. Supposedly, not crawling messes with the how brain pathways are formed. I’m not sure I buy that. She is now a functioning adult, who still is not very handy with scissors. Occupational therapy might be a benefit to your stepson. I was told the same thing about crawling building pathways when I was a teen - I had difficulty alternating sides (like swinging arms opposite the foot that's going forward) and have always been awkward. I had some PT but it's still something I struggle with, esp. when I'm tired or in pain - it's just not automatic like it is for most. Just Beth - my youngest is 11.5 - she struggles a bit with knife skills still - she does okay cutting vegetables for dinner prep (holding with her hand and using a knife) but not so well when she's holding the food with a fork and cutting with a knife at dinner. We don't cut her food for her, we remind her to hold the fork still and use the knife to cut, and continue to re-direct. My oldest had some delays - and he was in OT for handwriting skills (among other things) at 11 - they had him use a mechanical pencil because the lead breaks so easily it gave good feedback on how hard he was holding it. Usually a PCP won't refer directly to PT/OT unless there is already a diagnosis in place and they usually aren't qualified to make a diagnosis. The neurologist referral makes sense to me. Prayers |
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Post by Really Red on May 3, 2018 11:18:25 GMT
I love that you are concerned and worried for him. My son had some pencil grip problems, but he has dysgraphia (in a nutshell, he can't physically write). The pants buttoning is worrisome and I'm glad your pediatrician took it seriously. It sounds like Jason doesn't play sports, so you wouldn't notice his gross motor skills as much.
I have no thoughts except there is NOTHING as important as having a disability and having someone have your back. It sounds like you are going to be that person. I hope you get your husband on board.
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Post by Rainy_Day_Woman on May 3, 2018 11:33:20 GMT
The other day my daughter was struggling with her button on a new pair of jeans. It made me do a double take actually as well, as she is 11 also. She has good coordination and hand strength- she plays an adult sized guitar and sculpts and uses knives and scissors. She never does up jean buttons though- all of her jeans have stretch to them and slide on. These were the first pair of pants she had to unbutton. I must have missed teaching her and it apparently takes some practice I hope the referral goes well and you get a plan set up. |
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Post by Sorrel on May 3, 2018 11:52:05 GMT
As someone already said, this sounds like dyspraxia to me. My older daughter is 15, bright, and has this. We identified this when she was very little, and she received OT when she was 3-5. If a child doesn’t have other learning problems they will typically not get picked up for OT at school. My daughter is an excellent student but learning any kind of new physical task is very difficult for her. She still has a hard time tying her shoes or putting her hair in a ponytail. What we do is identify any task that is essential and we break them down step by step and practice them over and over until she improves. Some things she struggles with we find alternate solutions. She doesn’t wear tie shoes often, or we put those elastic ties in them instead. Her hands are weak, and for awhile we did some strengthening, but it didn’t make a lot of difference.
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Post by mikklynn on May 3, 2018 12:23:33 GMT
Good for you, advocating for him. I agree, the neuro evaluation is a good idea.
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Post by myboysnme on May 3, 2018 12:28:12 GMT
My son was diagnosed with fine motor deficit at age 12. He went to OT several times a week for a few years and he learned alternate ways to do things.
However that was 10 years ago and it sounds like they've identified other specialists that can be helpful with fine motor deficit.
Just for general info - fine motor deficit is not a delay. It is a deficit in the brain getting messages to the fingers and does not go away but there are other ways to master fine motor tasks. Many times people with fine motor deficit are highly skilled in gross motor skills. My son could not tie his cleats but he could throw a ball over the plate with great accuracy.
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Post by peano on May 3, 2018 14:11:47 GMT
My DD #2 had some fine motor skill issues, but nothing like that. Scissors and pencils were an issue. At the time they attributed it to the fact that she walked without ever crawling. She was in a body cast from 4 months until 13 months. Supposedly, not crawling messes with the how brain pathways are formed. I’m not sure I buy that. She is now a functioning adult, who still is not very handy with scissors. Occupational therapy might be a benefit to your stepson. It's interesting you say this because DS had fine motor delays, especially with writing, to the degree that we had him repeat K. He also walked without crawling--went straight from sitting to cruising to walking. |
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I hope your family gets some answers soon. 
