Our journey through autism

Posts tagged ‘fine motor’

Vision Therapy

It appears that all of Bilal’s fine motor muscles skills are affected by his autism or by his under-development in the womb. At age 3 we learned that he had fine motor issues in his hands and was unable to do anything precise or even hold a crayon or children’s scissors correctly. Alhamdullah that has been remedied by two years of occupational therapy. At age 4 we realized that one of the reasons his speech was affected and also his eating habits was due to weak tongue and mouth muscles, he’s been doing myofunctional therapy for a little over a year now and has somewhat improved. This year at age 5 we’ve come to notice that he’s having trouble seeing properly, we go through a couple evaluations and his eye muscles are weak which means he needs vision therapy to strengthen them. He has 20/20 vision but his eyes arent working together, they tire and lose focus quickly and tend to wander outwards. We always noticed that his right eye may wander sometimes especially when he was tired, but the eye doctor we were seeing said that as long as it didnt get worse we’ll just monitor it. Lately though his OT and PT therapists noticed he was having trouble staying on task and that he was tilting his head to the side to perform certain tasks which they suspected was due to a convergence/divergence issue. Also his dad noticed that he was afraid of heights or didn’t enjoy the rock climbing classes because he had trouble seeing what was expected of him. We first visit Dr. Free at the eye center at our local Costco. She performed all the typical eye exam tests but the bit extra was having him do some eye tracking computer game. She concluded that he does in fact require therapy and she suggested a Dr. Cook in the Marietta area or Dr. Iyer in Roswell. So I forwarded the report to Dr. Iyer and set up an appointment. We went in this week and she performed similar tests and some things that were new to us. She got his left eye to wander, the first time I’ve seen it and when it does wander he sees double. She said this was actually better than just one eye cause if it was just one that one would be very weak and require a lot of therapy but when he switches them maybe for distance or closeness that means they are both equally weak and wont require as much therapy. He also has binocular issues which mean his eyes don’t team together, they work separately so that would affect his reading and copying something off a board, also may impact sports. So right now she’s recommended 36 weeks of once a week therapy with an at home program to further practice the skills learnt at the office.

The medical terms for Bilal’s condition are as follows:

  • Oculomotor Dysfunction in Pursuits and Saccades (affects the ability to see where a word is on a page, and go from one word to the next)
  • Accommodative Infacility (This will cause blurred vision when reading, his eyes to fatigue when reading, headaches while reading, and make it difficult to change focus when looking in the distance (i.e., the board at school) after reading (or doing desk-work).)
  • Alternating Exotropia (wandering outward eyes)
  • Binocular Dysfunction (Bilal’s eyes have difficulty working as a team. Either eye has a tendency to drift out when looking at something in the distance. This will cause double vision, especially when looking at smaller objects. These conditions will also make it more difficult when Bilal is learning to read, since the words may look double to him.
  • Convergence Insufficiency

I always feel like we should have done this sooner always being told early intervention is key to improvement of symptoms, getting therapy at 3 is better than at 4 and 4 better than at 5 etc… That constant feeling of mommy guilt. But alhamdullah getting treatment now at this age is just perfect, right before the start of Kindergarten and right before he actually starts learning to read and real academic learning or serious sport playing.

When school starts I need to make sure this is included in his IEP. It’s stated that his right eye wanders when tired but that was it, just a small note. These were some of the doctor’s classroom suggestions for Bilal’s vision issues.

Recommendation for classroom:

  1. Reduce conflicting peripheral stimuli. Removing materials unrelated to the task will increase attention.
  2. Encourage your student to use his finger to follow the line of print when reading, if necessary. (A marker assists, but directs tactile finger contact with movement will offer greater support.)
  3. Printed material should be copied to larger size to reduce visual stress and fatigue
  4. Reduce the number of items on a page to reduce visual overload.
  5. Short visual work periods will tend to reduce visual stress and fatigue and the resultant difficulty with attention.
  6. Promote a reading and writing distance equal to the length of your student’s arm from elbow to middle knuckle (Harmon distance).
  7. This child has extreme difficulty with visual-motor tasks, such as handwriting. Please keep this in mind for all activities that involve eye-hand coordination

These recommendations may no longer be necessary once the program of optometric vision therapy is complete.

And finally here is some suggested reading or websites that the doctor recommended so we could better understand his diagnosis.

Suggested Reading:

  1.  Fixing My Gaze by Susan R. Barry.  2009
  2. Moro Reflex: A teachers window into a child’s mind. By Sally Goddard
  3.  College of Optometrists in Vision Development www.covd.org
  4. Optometric Extension Program Foundation www.oepf.org
  5. Vision Care and Therapy Center www.learningisvisual.com
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First Drawing

Bilal as Cowboy

 

Yesterday was Bilal’s annual re-evaluation for private OT, his therapist said he did so well and so much better than from the initial evaluation, while she was telling me about how well he did she started explaining this drawing, I interrupted her and asked “He drew this?” “By himself” she said yes and went on to explain that he didn’t attach his arms or feet to the drawing which indicates that he is unaware of his body in relation to space and blah blah blah OT technical talk that I don’t really understand but pretend I do lol. I was more proud of the fact that he can actually draw something that really resembles a boy, face, eyes, ears, mouth, body its prefect, I don’t really believe all that space continuum talk, he’s not even 5 and this is the first drawing I’ve seen him do, of course he doesn’t know how to attach his arms to the body. Bilal says its him as a cowboy, and he’s winking 😉 I have it pinned up on the fridge and his dad and I are really proud and impressed. I wanted to know more about the drawing than his evaluation, like did he totally draw this on his own, or did she draw one and told him to draw his own, or did she keep prompting him, now draw a head, with eyes, and a mouth or did she just say draw yourself and he took it from there. I’ll make sure to ask her next week, didn’t seem right to interrupt all her technical and important diagnosis to ask about a child’s scribble. lol

 

What do you think?

Equine Therapy

Also known as hippo-therapy which basically is horseback riding therapy, it is a well known and accepted therapy for those on the autism spectrum. Horseback riding in itself teaches discipline, strength and posture while the movement of the horse teaches the child balance. Dealing with the horse teaches the child compassion towards animals and how to treat them nicely. Used as therapy they also include brushing the horse before and after riding as a sensory stimulation, the child helps with the saddle for fine motor skills, on the horse they have the child use his words to command the horse to “go” and “stop”, they have the child hold on with 1 hand or no hands (for balance and vestibular training), they had little games of stopping the horse leaning down and picking up a toy and dropping it off at another area, the therapists would describe the toy or animal for speech therapy, they also had him throw bean bags into a bucket from atop the horse and pick rings and slide them on horizontal poles. They also let the child ride backwards for awhile also for balance and vestibular training.

Bilal has been in speech and OT for 4 months now and making a lot of progress alhamdullah mashaAllah so we decided we could move onto something else, something beneficial but also fun, so we looked into horseback riding. Last month we had gone to a county fair and they had pony rides and Bilal loved it, he sat tall and held the saddle on his own and had a lot of fun so therapy would be great. When we got to the farm and he could see all the horses in the distance he got really excited and rushed into it, no apprehension towards the new therapists and he followed all directions really well. So we’ve decided to continue with it, an hour a week every weekend weather permitting inshaAllah it will be of benefit to him.

I found the therapy location through the Autism Speaks resource guide website. It’s called Brecht Stables and Dustin’s Place, it was founded by a mother of a child (Dustin) with Down’s Syndrome to teach children with disabilities. It is in Cumming, GA. She has a website, Facebook page (lots of pictures of the farm, horses and her family), and Twitter account.

In Islam there is a Hadith (a saying for the Prophet Mohammed peace be upon him) in which he said “Teach your children swimming, archery and horse riding”  it means that children should grow up fit and knowledgeable of such recreational activities, which at the time were essential to survival, now it could be adapted to mean swimming and car driving but horseback riding is still important as the benefits are so many for children with disabilities and for those typically developing.

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